The Lamp December 2019 by NSW Nurses and Midwives' Association

WORKPLACE VIOLENCE

Armband protest widens page 12

AGED CARE

‘Shocking tales of neglect’ page 18

MENTAL HEALTH SCHOLARSHIPS

Bob’s legacy: support for junior mental health nurses page 22

REGULARS Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 76 NO. 11 DECEMBER 2019 / JANUARY 2020

TENTERFIELD FIGHTS TO KEEP NURSES Print Post Approved: PP100007890

p.35 p.36 p.37 p.39

Join the health fund that’s all about you. Nurses & Midwives Health is dedicated to caring for the carers. And as a member of NSWNMA, you’re eligible to join! When you’re a member, you’re part of our family. So that’s why your family members are also welcome to join us.

For your free, side-by-side comparison, and our latest offers, visit nmhealth.com.au or call 1300 344 000 Eligibility criteria and conditions apply. Nurses & Midwives Health Pty Ltd ABN 70 611 479 237. A Registered Private Health Insurer. NMH-NSWNMA-11/19

DIABETES UPDATE EVENING for nurses

Your NDSS agent in NSW & ACT is

Learn while you earn CPD points Wednesday 12 February 2020 Coffs Harbour Wednesday 11 March 2020 Albury Thursday 19 March 2020 Miranda

Ticke ts $20

More dates and locations available on our website. Diabetes NSW & ACT is offering a diabetes evening workshop (including a light dinner) for nurses working within a hospital, medical practice, community health or aged care setting. The training will provide participants with an increased understanding of diabetes and the services available to their patients. This session is suitable for Enrolled Nurses and Registered Nurses. CPD points for this seminar will be available with the Australian College of Nursing (ACN) and Australian Primary Health Care Nurses Association (APNA).

For more information or to register visit diabetesnsw.com.au/events or call 1300 136 588. The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. The NDSS agent in New South Wales and the ACT is Diabetes NSW & ACT.

CONTENTS Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including The Lamp subscriptions and change of address, contact our Sydney office. Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au

VOLUME 76 NO. 11 DECEMBER 2019/JANUARY 2020

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

Printed by Ovato Print Pty Ltd 37-49 Browns Road, Clayton VIC 3168

A man’s death throws the spotlight on a rural hospital starved of resources.

Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Adrian Hayward, Coordinator. T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General Disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Statement The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information, please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained, you can contact the Privacy Commission. Subscriptions for 2019 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $84, Institutions $140, Overseas $150.

COVER STORY Town fights to keep nurses, doctors

WORKPLACE VIOLENCE

REGULARS

Armband protest widens Nurses don grey armbands and badges to highlight workplace violence as survey reveals the problem is commonplace but under-reported.

WORKPLACE VIOLENCE

Violence widespread but under-reported More than a quarter of NSWNMA members were physically assaulted in a six-month period.

AGED CARE

‘Shocking tale of neglect’ The Aged Care Royal Commission has delivered a scathing indictment of Australia’s aged care system.

MENTAL HEALTH SCHOLARSHIPS

41 43 45 46

Bob’s legacy: support for junior mental health nurses Up to 20 mental health nurses will have the opportunity to take part in a mentoring program in 2020, named in honour of Bob Fenwick, a mental health nurse who tragically died in a workplace incident in 2011.

5 6 26 28 32 35 36 37 39

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

WORKPLACE VIOLENCE

Armband protest widens page 12

AGED CARE

‘Shocking tales of neglect’ page 18

MENTAL HEALTH SCHOLARSHIPS

Bob’s legacy: support for junior mental health nurses page 22

REGULARS Your rights and entitlements at work Nurse Uncut – your stories What nurses and midwives said Nursing research online

p.35 p.36 p.37 p.39

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 76 NO. 11 DECEMBER 2019 / JANUARY 2020

NEW GRADUATE PROGRAM

The virtuous circle The Lamp spoke to Catherine about how the new graduate program works, and how it helped her build her nursing career.

TENTERFIELD FIGHTS TO KEEP NURSES Print Post Approved: PP100007890

69,008

Avg Net Distribution per Issue

The Lamp is independently audited under the AMAA's CAB Total Distribution Audit. Audit Period: 01/04/2018 - 31/03/2019

On the cover Stacey Butler and Kimberley Druitt Image by Sharon Hickey THE LAMP DECEMBER 2019/JANUARY 2020 | 3

Registered Nurses working in NSW Public Mental Health Services

BOB FENWICK MENTORING GRANTS PROGRAM Can help towards your CPD hours

OPPORTUNITY FOR CAREER DEVELOPMENT What is it?

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

Who can apply?

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

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

Seeking mentors for the Program

APPLICATIONS OPEN 1 FEBRUARY 2020 CLOSE 15 MARCH 2020

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

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

How do I apply?

More detailed information about the Program (including a video interview of past participants) can be found on the NSW Nurses and Midwives’ Association website www.nswnma.asn.au 2020 EXPRESSION OF INTEREST FORMS WILL BE AVAILABLE FROM 1 FEBRUARY 2020. If you require more information contact the Program Manager by email: mhmgrant@nswnma.asn.au or contact Matt West on 1300 367 962.

Reproductive and sexual health for everyone, everywhere. Family Planning NSW delivers reproductive and sexual health education for nurses and midwives. Our highly popular education program will enable you to step up to the next stage of your career or to advance your skills.

2020 Education Program Contraceptive Implant (Implanon NXT) Insertion and Removal Training for Nurses and Midwives ASHFIELD: 30 Jan, 20 Feb, 23 Apr, 18 June, 16 July, 20 Aug, 29 Oct, 3 Dec DUBBO: 7 March Reproductive and Sexual Health Clinical Accreditation Program ASHFIELD: 10-11 Feb NEWCASTLE: 21-22 July Reproductive and Sexual Health Clinical Forum for Health Care Professionals DUBBO: 7 March Reproductive and Sexual Health Professional Development Day for Nurses and Midwives 4 | THE LAMP 2019 /JANUARY 2020 ASHFIELD: 22DECEMBER May NEWCASTLE: 4 Sept

“The structure of the learning was comprehensive and done really well in an easy to follow format. The course resources provided have supported me in my own clinical environment. So lucky to have experienced your knowledge.” –Participant, Contraceptive Implant (Implanon NXT) Insertion and Removal Training

Visit www.fpnsw.org.au for dates, course information and to register your place in our courses.

EDITORIAL

Brett

Holmes GENERAL SECRETARY

Defending our right to speak and be heard NSW nurses and midwives are respected and trusted by the community and should not be silenced for standing up for patients and our precious health system. Our democratic right to campaign on behalf of our patients is under threat. On two occasions over the last two years the Berejiklian government has attempted to muzzle our voice through legislation or regulation. The first time it was stymied by a High Court decision that deemed its law restricting our right to campaign as unconstitutional. A Joint Standing Committee of the NSW parliament is now conducting an inquiry into the 2019 NSW state election. While such an inquiry is routine following an election, we feel compelled to challenge important restrictions on campaigning by third parties that the NSW government introduced by regulation prior to the election. In May 2018 the state government brought in an electoral law that severely limited our capacity to campaign by: • Reducing the expenditure cap to $500,000 for third party campaigners (read unions) • broadening the definition of electoral expenditure so it even captured our everyday staff and travel costs as part of the cap and • making it unlawful to act in concert to campaign on member issues with other unions and or civil society organisations to exceed the cap. The NSWNMA with other unions challenged the constitutional validity of this legislation in the High Court. In an important decision, the High Court agreed with us that the law was invalid because it burdened “the implied freedom of communication on governmental and political matters, contrary to the Commonwealth Constitution”. The High Court also agreed with us

‘ All we seek is a fair and democratic electoral system where our voices will be heard on the issues affecting healthcare in NSW.’ that “it was clear what this law is doing but one does not know why it is doing that other than to shut down … protected speech”. Its decision confirmed our right to keep the people of NSW informed about issues around patient safety in our public health system. The NSW government subsequently circumvented this ruling by introducing a regulation just prior to the March state election that introduced an electoral funding cap of $1,288,500 and a stringent definition of election expenditure. The regulation remains valid until 31 December this year.

A DANGEROUS EROSION OF OUR DEMOCRATIC RIGHTS These draconian measures are damaging for our democracy. In a submission to the parliamentary inquiry we have argued that “as part of our democracy it is essential that in the lead up to elections our voices and those of other campaigners be heard in amongst those of political parties and powerful media organisations. The expenditure cap must be fair to enable us this opportunity to be heard and to participate in the public debate”. This is all the more so because the state government has previously rolled back our industrial right of access to the NSW Industrial Relations Commission and restricted our bargaining rights

through its wages policy. The right to a voice in the public domain on issues that impact on our members and the community is now of critical importance. The NSWNMA has been left with no option but to campaign on issues like ratios and patient safety during elections when political parties are more likely to listen to the voices of their constituents.

OUR REASONABLE RECOMMENDATIONS In our submission to the parliamentary inquiry we have recommended an electoral expenditure cap of $2 million with annual indexation for third party campaigners. This would allow us to adequately campaign on our issues using television advertising. We have opposed the restrictions that make it unlawful for us to campaign with other unions or civil society organisations and we have argued that electoral expenditure should not include expenses that are part of the day to day running of the union. All we seek is a fair and democratic electoral system where our voices will be heard on the issues affecting healthcare in NSW. If we are unable to have our voices heard then we may have no choice but to form a political party ourselves – a motion that was democratically endorsed by the 2019 Annual Conference. n THE LAMP DECEMBER 2019/JANUARY 2020 | 5

YOUR LETTERS

Have your

Say

LETTER OF THE MONTH Making outlaws of those who care

THIS CHRISTMAS GIVE THE GIFT OF LIFE ●

Support Breast Cancer Trials Research Stay Organised Keep Healthy ●

●

THE PERFECT CHRISTMAS GIFT, STOCKING FILLER OR SECRET SANTA

18.95

from Newsagents, Woolworths & womenshealthdiary.com.au

breastcancertrials.org.au

MEMBERSHIP FEES 2020 NSW Nurses & Midwives’ Association – in association with the Australian Nursing & Midwifery Federation Year

Quarter

Month

Fortnight

$195.75

$65.25

$30.10

$166.25

$55.42

$25.58

Registered Nurse & Midwife $783.00 Enrolled Nurse $665.00

Gladys Berejiklian and her cronies are trying to shut us down! The NSW Government has introduced a bill to the NSW Parliament that significantly infringes on everyone’s right to peacefully protest! Called the “Right to Farm” Bill, the legislation will unjustly punish citizens for “unlawfully entering and disrupting on inclosed lands”. Inclosed lands is defined so broadly it will outlaw peaceful protests in any enclosed area, including schools, offices, ports, banks and even public land. The bill also introduces a new offence that would make it an offence to organise a peaceful protest. The bill has nothing to do with farming. If this bill passes it would prevent peaceful actions by students, unions, refugee supporters, knitting nanas, farmers, and other environmentalists, who are standing up and fighting for climate action. Skye Romer EDITOR’S NOTE The Right to Farm Bill has passed parliament and received assent. It was subject to amendment to narrow its scope to farming land/industry and preserve union rights.

Assistant in Nursing+ & Assistant in Midwifery $548.00

$137.00

$45.66

Letter of the month

$21.06

Undergraduate Bachelor of Nursing /Midwifery or Diploma of Nursing^ $274.00

$68.50

$22.83

$10.52

Membership fees are tax deductible Trainee AIN’s have fees waived for the duration of their traineeship Students working in a nursing role undertaking fulltime studies in an undergraduate Bachelor of Nursing/Midwifery or Diploma of Nursing for the duration of the bachelor/diploma *All membership fees include GST ABN 63 398 164 405

The letter judged the best each month will win a $50 Coles Group & Myer gift card! Union Shopper offers members BIG savings on a wide range of products!

+ ^

6 | THE LAMP DECEMBER 2019 /JANUARY 2020

unionshopper.com.au 1300 368 117

Union Shopper Letter of the Month.indd 1

23/02/15 11:53 AM

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.

WANT TO GET MORE INVOLVED? Join NSWNMA Activist Facebook page: https://www. facebook.com/groups/nswnmaActivists/

“Devastating” cuts to violence prevention training

Cardiovascular nursing is a joy

Pill testing is harm minimisation

I am a CNS currently working in an Emergency Department in a Regional LHD in a lower socioeconomic area. Because we have high incidence of violence and aggression from our patients, our LHD decided they would train our staff in PMVA (Prevention Management of Violence & Aggression) also known as VPM (Violence Prevention Management) in some other LHDs.

I have worked as a cardiovascular RN ever since I started my nursing career. It has always been so challenging and rewarding. Preparing my patients as they go for their heart surgeries, and encountering them again as they come back to the cardiac ward from ICU a couple of days before they are discharged is always rewarding. It gives me a sense of pride being part of the health care team involved in a patient’s road to recovery.

As a public health academic of over 25 years, specialising in health promotion as well as alcohol and other drugs (AOD), I am a passionate advocate of harm minimisation. A brief reminder – harm minimisation has been a key policy of the Australian state and federal governments since 1985 and aims to reduce the harm caused by AOD by considering the health, social and economic consequences of AOD on individuals and the wider community. It is strongly supported by scientific evidence. Pill testing fits all these criteria. Pill testing allows people to be aware of the content of illegal drugs, allowing them to make informed choices.

The idea behind this course is to attempt to recognise and de-escalate a situation before it gets out of hand. A well-controlled and de-escalated situation has better outcomes for all involved, including the patient, nurses, surrounding patients and relatives. PMVA training is invaluable to our staff who have any contact with patients and at times are in the firing line and end up in aggressive or violent situations. Budget cuts made effective in early October 2019 (without warning) meant that the PMVA trainers now no longer have funding to train staff. From October through to December 2019, 40 per cent of courses have been cancelled and there has been a significant reduction of up to 60 per cent of courses booked in for next year due to the availability of nurses being released and paid to train these courses. Only 25 per cent of current trainers have been approved to continue training next year and most of those at reduced frequency. This will have a devastating effect on training our staff how to de-escalate and keep safe in volatile situations. To think this happened during Safe Work Month for nurses – feeling deflated and very unsafe at the moment.

Kelly Falconer

At the same time being a patient’s advocate is not only rendering nursing care but emotional care as well, as some patients struggle to recover as expected and need supplementary support as they strive to come back to their daily routine of life. It makes me appreciate my role being a nurse and as that person in whom patients trust and confide as they convey their thoughts and apprehensions. It can be challenging at times when you feel and see the patients’ and their families’ frustrations. I admire their family and friends for their love, support and care when at times days are rough for their patients. It is always with a sense of fulfilment and the passion of being a nurse that makes my heart beat faster and makes me smile every time I see a patient being discharged with their family and happily excited going home. At the end of the day, I go home to my family grateful that I am lucky to be in a profession that I love and enjoy, and to be in a specialty area that is my pride and joy.

Jocelyn Lee

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.

According to the position statement of the Drug and Alcohol Nurses’ Association of Australasia (2019): ill testing has been shown to change P the black market. Products identified as particularly dangerous that subsequently became the subject of warning campaigns were found to leave the market. (abridged)

Margie Harris

UPDATED NSWNMA PRIVACY POLICY The NSW Nurses and Midwives’ Association takes seriously its obligations to adhere to the Privacy Act 1988 (Commonwealth) and the Australian Privacy Principles. We update our Privacy Policy from time to time to ensure transparency around how our activities and privacy governance reflect these regulations. The Privacy Policy on our website was last updated in October 2019. We also update our Social Media Terms of use from time to time. Please check our website to see the latest: www.nswnma.asn.au

THE LAMP DECEMBER 2019/JANUARY 2020 | 7

COVER STORY

Town fights to keep nurses, doctors A man’s death throws the spotlight on a rural hospital starved of resources.

‘

No doctors at Tenterfield Hospital this weekend; HNEH says it will manage situation.’ – Tenterfield Star, Friday 25 October.

‘Patient dies while no doctor present at Tenterfield hospital.’ – Tenterfield Star, Tuesday 29 October. The above headlines bracketed the death of a male patient who went into cardiac arrest at the hospital on Sunday 27 October. The hospital, in the northern New England region, had no doctor from Tuesday to Monday because the usual medical officer was on leave and HNEH could not find a locum. Only two nurses – an agency registered nurse and an enrolled nurse – were on shift when the man died. Paramedics were called in to work on him. The hospital was “unable to provide sufficient clinical resources to manage the rapidly deteriorating patient” a spokesperson for Hunter New England Health told the Star. The patient’s death followed months of community protest over HNEH’s decision to cut staffing to two nurses on day shift. The cut was imposed shortly

8 | THE LAMP DECEMBER 2019 /JANUARY 2020

‘ We have warned for years that understaffing can be fatal and we need to fight to make this hospital safe again.’ — Stacey Butler before a new emergency department opened and was done without any consultation or risk assessment for remaining staff. The NSWNMA’s Assistant General Secretary Judith Kiejda voiced her concerns after the cut. “The LHD has a duty of care to ensure the hospital is safely and appropriately staffed at all times. Unless a modest increase in nursing staff occurs quickly, nurses will be forced to work in isolation, with no capacity for relief or assistance if two nurses are required for a medical procedure,” Judith said in a media release.

TECHNOLOGY IS NOT AN ADEQUATE SUBSTITUTE NSWNMA General Secretary Brett Holmes told the Star that two nurses had been on duty in an unfamiliar, new ED when the

man died. The nurses received telephone help from a Narrabri doctor and subsequent assistance from Armidale and Tamworth, but technology “can’t replace the physical presence of a medical officer or additional skilled nurses,” Brett said. “We don’t know whether it would have changed the outcome, but it would have made it a much easier situation to manage with another pair of skilled hands.” He said it had been “very tough” on staff – and was compounded by having to deal with a bus crash the next day in which almost 20 students and teachers were involved. “It is no wonder our members are on edge and the community is on edge.” He said paramedics “did a great job when they got there after being called from theirs homes” but the

COVER STORY

STACEY BUTLER AND KIMBERLEY DRUITT WERE OVERWHELMED BY THE SUPPORT FROM THE TENTERFIELD COMMUNITY

incident “demonstrated the reason you need three nurses on duty: trying to manage a critical incident with two nurses, particularly when it progresses to cardiac arrest, is extraordinarily difficult”. “Even when you might have a doctor on the phone, you need more than two pairs of hands to undertake resuscitation. “The fact that the district knew there was no doctor and did not or could not add additional nursing staff to give that extra support is very disappointing.” Since the staff cut, the NSWNMA has been campaigning for three staff on each shift – or two plus an on-call nurse as a minimum – to manage the 18-bed ward and ED. The hospital has been hit by a wave of retirements and resignations. Five registered nurses are reported to have resigned this year solely due to excessive workloads. The hospital had only three permanent RNs – including one on long-term leave – and six permanent part-time ENs when The Lamp went to press.

RESIDENTS SHOW SUPPORT FOR NURSES In August, Tenterfield residents rallied at a local park in support of nurses. The crowd heard reports of many missed meal breaks and difficulty even finding time for a toilet break, long waits in emergency while staff were busy elsewhere, nurses lifting heavy patients single-handedly, and returning home at the end of a shift exhausted and fraught. Speakers said understaffing had ‘poisoned’ the work environment to the extent that potential recruits are turned off and agency staff don’t want to return to the hospital. Following the ra lly, and intervention by the NSWNMA, management introduced a crossover shift from 11 am to 7.30 pm, to cover meal breaks. However, attempts to recruit staff to fill the crossover shift have so far been unsuccessful. RN Kimberley Druitt said with only two nurses on shift, staff were often forced to work alone or leave the ward unattended – and the new ED is even more isolated from the wards than the old one.

“Even if we get staff for the crossover shift, that won’t solve the problem; we need an on-call,” Kimberley said. In September, about 200 residents gave nurses a standing ovation at a community health forum on hospital staffing. “It made us all cry – it was a lovely gesture,” said RN Stacey Butler. She said paying an on-call allowance was an insignificant cost to support nurses with extra staffing in busy periods. “We have warned for years that understaffing has to be fixed and we need to fight to make this hospital safe again.” n

STOP PRESS Meetings have been held with the NSW Health Minister and Hunter New England LHD Chief Executive, Michael DiRienzo, with neither giving any commitments to improve staffing, despite the tragic outcomes. THE LAMP DECEMBER 2019/JANUARY 2020 | 9

COVER STORY

‘Save our hospital – and our town’ Tenterfield residents urge Berejiklian government reverse cuts to nursing hours.

esidents of the New England tow n of Tenter f ield , population 4000, have sent two delegations to Sydney to plead with the NSW Health Minister, Brad Hazzard, to intervene to save Tenterfield Hospital – and the town itself.

‘ Without doctors on site at hospitals, nurses are under too much pressure and patients are at risk.’ — Kate Washington

Health services have badly deteriorated as a result of cuts to nursing hours and difficulty in finding doctors to work at the hospital (see story page 8-9).

out of the minister's office with an agreement and time frame regarding doctors and nurses, and crossborder transfers.

Residents have demanded that staffing levels return to three nurses on each shift. The second delegation met Mr Hazzard at Parliament House in November, following a delegation to the minister in September. The second delegation comprised State Labor MP Janelle Saffin and Tenterfield deputy mayor Greg Sauer. Ms Saffin said she wanted to walk

10 | THE LAMP DECEMBER 2019 /JANUARY 2020

More than 200 Tenterfield residents attended a public meeting in November. Speakers included NSWNMA General Secretary Brett Holmes. He told the meeting that as a result of staff cuts, nurses were “going above and beyond” what they are required to do. “HNELHD have them on a ‘guilt’ roster, unwilling to leave their community and colleagues in the

lurch,” he said.

NO SHOW FROM THE LHD Senior management of Hunter New England Local Health District (HNELHD) sent a n apolog y, saying “no appropriate senior representative” was able to attend the meeting due to bushfires. “That left everyone in Tenterfield Memorial Hall on the same page, full of praise for their nurses but labelling HNELHD the worst in the state,” the Tenterfield Star reported. The Star said staffing levels are “the crux of the matter”.

COVER STORY

‘ The government gave a commitment to deliver 5000 nurses and midwives to public hospitals in NSW. Well, they can start in Tenterfield.’ — Janelle Saffin

The paper said the dire state of the local hospital threatened the town’s future. “With known incidences of people looking to relocate from the town they love to other centres purely due to the lack of medical services in Tenterfield, the growth or even maintenance of population levels could be at stake. “There's little consolation in the fact that Tenterfield is just one of a number of small towns throughout the state suffering a health service crisis. “The others are keeping a keen watch on what a consolidated action from the Tenterfield community on the hea lth department can achieve.” The paper said the meeting heard “horror stories of patients with life-threatening conditions waiting many hours” to be transported for treatment. n

‘Angry and scared’ The NSW Opposition renewed its calls for an urgent independent inquiry into rural and regional health after the Tenterfield Hospital death. Opposition rural health spokeswoman Kate Washington said people in these areas were “angry and scared” about their healthcare. “Without doctors on site at hospitals, nurses are under too much pressure and patients are at risk,” she said. Local Labor MP Janelle Saffin said she supported the NSWNMA’s call to return the Tenterfield roster to 3-3-3. “The Liberal-National Government gave a commitment to deliver 5000 nurses and midwives to public hospitals in NSW. Well, they can start in Tenterfield, with the 3-3-3,” she said.

THE LAMP DECEMBER 2019/JANUARY 2020 | 11

WORKPLACE VIOLENCE

Armband protest widens Nurses don grey armbands and badges to highlight workplace violence as survey reveals the problem is commonplace but under-reported.

ra lly of NSWNM A members at Blacktown Hospital has called for stronger measures to tackle workplace violence. The rally coincided with the release of a NSWNMA survey, which shows violence towards nurses is widespread but under-reported (see page 14). For the second year running, Blacktown nurses, doctors, allied health staff and cleaners wore grey armbands to highlight violence in the workplace. Nurses at other NSW hospitals joined the armband protest on 30 October, with many nurses also wearing “Stop Violence” badges. The NSW NM A’s Blacktown branch started the grey armband protest last year after a nurse suffered knife wounds to her wrists and arms when attacked by a patient in a medical ward tea-room. The branch successfully moved a resolution at a NSWNMA Committee of Delegates meeting calling for grey armbands be worn statewide to signify that health care staff will not tolerate workplace violence. 12 | THE LAMP DECEMBER 2019 /JANUARY 2020

‘ We are recruiting more members, we’re more active on social media and nurses contact us more readily about problems we sometimes aren’t aware of.’ — Michael Clarke Blacktown branch president Christine Boxsell said staff chose to wear grey armbands “in the hope that we never have to wear black ones. “The armbands get people talking about the issue,” she said. “The public ask what the armband is for and we tell them that violence towards health workers is an increasing problem. “With October being national Safe Work Month, it is a perfect opportunity to bring the issue to the public.”

NEW MODEL OF CARE FOR DEMENTIA NEEDED The branch has also responded to the growth of dementia-related violence by pushing for safer staffing, better training and improved security measures in 2019.

In just one three-week period there were eight assaults on staff in an eight-bed specialised aged care unit. The unit adjoins the aged care ward and is accessed with a swipe card. “On occasions we have had to put three or four violent people in the unit together and they tend to feed off one another,” Christine said. She said a NSWNMA safety inspection of the facility helped the branch to identify a need for more nurses and security staff, improved staff training and greater involvement of allied health staff. A branch meeting resolved to keep the connecting door unlocked and opened. At the request of management, negotiations immediately commenced.

WORKPLACE VIOLENCE

Negotiations resulted in rostering of extra security staff and an additional nurse on every shift, to maintain at least three nurses on duty at all times. And more staff received training in managing and de-escalating violent behaviour. “We had nurses in that unit being sexually harassed and nurses and security guards being punched in the stomach,” Christine said. “It was a terrible time, but it seems to have settled down a lot. “The response from management has been pretty good, and we continue to have regular meetings with them to try to keep on top of the issues.” The branch argues a new model of care is needed for dementia sufferers. “We need a more holistic approach to care for people with dementia rather than putting them behind locked doors,” Christine said. n

Safer Work Safer Care Resources The NSWNMA has produced a number of resources for our anti-violence campaign to ensure every nurse and midwife in the state is safe at work. You can download them at: https:// www.nswnma.asn.au/safer-work-safer-care/

Incident reporting still takes too long Blacktown Hospital nurses are exper-iencing a new incident reporting system being trialled in Western Sydney hospitals. However, the new system called IIMS Plus is just as time consuming as the old version, said Blacktown branch president Christine Boxsell. “We know hospital staff under-report issues, not just at Blacktown, and that’s something we need to change,” she said. “IIMS Plus was introduced because people were having trouble reporting incidents using the old one. “The new version does give you the option of asking for email feedback, which is an improvement. “However, it takes just as long to complete as the old one did. “We need a system that’s simple to navigate and input data. Many staff often don’t report verbal abuse because they don’t think it’s worth the time, but ongoing verbal abuse from patients or family members of patients can take a toll. “Nurses don’t often have time left at the end of the day, so they find themselves sitting in front of the computer in their own time having to log an incident. It just discourages people from reporting violence.” THE LAMP DECEMBER 2019/JANUARY 2020 | 13

WORKPLACE VIOLENCE

Violence widespread but under-reported More than a quarter of NSWNMA members were physically assaulted in a six-month period.

ore t ha n one -t hird of NSWNMA members did not report episodes of workplace violence in the six months before a union survey was taken.

More than a quarter (26.5 per cent) were victims of physical assault, 11.2 per cent had been threatened with a weapon and 2.73 per cent had been sexually assaulted.

Only 62.78 per cent of 497 members answered ‘Yes’ when asked, “Have you reported all violent incidents?”

Three-fifths of members (59.91 per cent) said unsafe staffing levels were a contributing factor in workrelated violence.

The survey was conducted in the lead-up to national Safe Work Month in October. NSW NM A G enera l Secret a r y Brett Holmes said members in the public health system had repeatedly told t he union t hat repor ting systems were inadequate and open to manipulation. Worse, members had complained that managers instructed them not to report issues, Brett said. “Vital changes to transparency a round repor t ing a nd suppor t from management are urgently needed,” he said. Ninety-three per cent of NSWNMA members experienced verbal aggression and threats at work in the six months prior to the survey. More than half (50.55 per cent) were on the receiving end of physical intimidation and almost 28 per cent had been spat on.

The biggest risk factors were “behavioural conditions” (64 per cent) and “providing care to people who are in distress, afraid or ill” (61 per cent). One in four nurses (24.84 per cent) said lack of training in de-escalation strategies contributed to violence at work. “From Narrandera in the state’s south to Ballina in the north and everywhere in between, nowhere is excluded from these issues,” Brett said. “Our mental health nurses at sites such as Cumberland Hospital in Sydney’s west continue to be treated like punching bags, yet issues such as working in isolation or faulty personal duress alarms still remain.

NSWNMA SURVEY ON WORKPLACE VIOLENCE

93%

of NSWNMA members experienced verbal aggression and threats at work

26%

were victims of physical assault

11%

had been threatened with a weapon

60%

said unsafe staffing levels were a contributing factor in work-related violence

“It’s become a very sad situation and one the Berejiklian government must start taking responsibility for, otherwise nurses and midwives will continue to walk away from the profession.” n

‘ Vital changes to transparency around reporting and support from management are urgently needed.’— Brett Holmes 14 | THE LAMP DECEMBER 2019 /JANUARY 2020

WORKPLACE VIOLENCE

Weakened regulator would put nurses at risk There’s a move to downgrade SafeWork NSW despite over 13,000 injuries to nurses every year.

proposed restructure of SafeWork NSW would put nurses and other workers at greater risk of serious injury and death, the NSWNMA has warned. SafeWork’s job is to regulate workplace health and safety in NSW. However, there is a move within the state government to merge its functions with other agencies. It is happening without consultation with unions, who seek to improve workplace safety and represent sick and injured workers. The NSWNMA has called on the government to maintain SafeWork NSW as a separate independent entity to ensure worker safety is not downgraded. General Secretary Brett Holmes raised the issue in a letter to the Minister for Better Regulation and Innovation, Kevin Anderson. Brett told Mr Anderson the health care sector has the highest rate of serious injuries of any industry. Nurses, personal care workers and employees in aged care and disability have the highest number of compensation claims of all occupations. “We are still seeing over 13,000 injuries every year. Alarmingly, nearly half (43 per cent) of all these

‘ The safety of NSW workers cannot be mixed up with liquor licencing or the welfare of greyhounds’ — Brett Holmes injuries are serious, resulting in five or more days off work,” Brett said. He said the union was concerned by a statement of Ms Rose Webb, Deputy Secretary, Better Regulation Division, during a parliamentary hearing about the proposed new operating model for the Better Regulation division. Ms Webb said: “I think regulatory theory suggests that you can do these things two ways. You can bundle your people together by the piece of legislation they are administering and have all the range of regulatory functions, from complaint taking and engagement right up to prosecution, all in one bundle, or you can say that there are regulatory abilities and professional skills in people doing compliance work, or audit work or inspection work or prosecution work, and you put the people that have that professional skill together. Then they apply those skills across a range of legislation. We are moving to that second model.”

The NSWNMA understands the agencies affected by this proposal include SafeWork NSW, Fair Trading NSW, Liquor and Gaming NSW, the Office of Responsible Gambling, Office of Racing, the Long Service Cor porat ion a nd Subsidence Advisory NSW. “The Association is extremely concerned that any attempt to merge these agencies will dilute specialist skills and that without a specialist work health and safety regulator, workers in NSW will be at increased risk of death and serious injury,” Brett said. Brett said the proposal fails to take into account the detailed knowledge of workplaces and industries required for SafeWork NSW to be effective. “The safety of NSW workers cannot be mixed up with liquor licencing or the welfare of greyhounds” n

THE LAMP DECEMBER 2019/JANUARY 2020 | 15

SAFE STAFFING

Grafton floats community campaign Residents of the Clarence Valley in the Northern Rivers region learn that their hospitals are dangerously understaffed – and that nurses want solutions fast.

etired nurse Stuart Garland was initially pleased when his 96-year-old mother had surgery for a fractured hip at Grafton Base Hospital in 2018. The surgery went well. But from then on, “the care went downhill”, Stuart said in a letter to Grafton’s Daily Examiner in November. “The nursing staff were doing double shifts and were almost a nurse down on every roster,” he said. “Basic general nursing care” could not be met. The stress level of the nurses was “palpable and ongoing”. Stuart said he and his brother raised concerns with senior ma nagement who assured them the nursing shortage was being addressed. “That was more than 12 months ago. It appears no progress has been made to improve nursing numbers,” Stuart said. He noted that Grafton nurses had recently launched a community campaign for safe staffing. “So, it can be easily presumed that chronic understaffing is the gold standard set by the NNSWLHD (Northern NSW Local Health District).” Dressed in their scrubs, and carrying banners and placards calling for nurse-to-patient ratios, about 30 Grafton nurses formed a ‘walking float’ in the city’s Jacaranda Festival parade in November. 16 | THE LAMP DECEMBER 2019 /JANUARY 2020

‘ We want the community to feel that if they come to our hospital they will be looked after properly.’ — Remana Harris T hey ha nde d out f lyer s advertising a community rally in support of safe staffing. “We were cheered, applauded and thanked for our work. It was lovely,” said Remana Harris, president of the NSWNMA’s Clarence Valley branch. Before launching the community campaign, 22 branch members attended a campaign training session facilitated by the NSWNMA. The branch, which covers Grafton Base Hospital and Maclean District Hospital, wants the Local Health District and the state government to urgently fund additional staffing. For Grafton hospital, the branch is calling for one extra registered nurse in the emergency department across each shift. It is also seeking an in-charge nurse who is not allocated a patient load in the general wards across each shift, and more support for nurse unit managers, particularly in the paediatric ward. For Maclean Hospital, the branch wants an additional RN in the ED at night, and for their night duty in charge nurse to be without a patient load.

The branch calculates that 39 nurses have left Grafton’s ICU in the last three years and some have not been replaced. Hospital records obtained by the NSWNMA showed that Grafton hospital’s ICU had been hit by seven resignations since March 2019. Advertising had failed to fill any of these vacancies as of mid-November. “We’re working in unsafe conditions at the moment,” Remana said. “We are worried about patient safety and we want the community to feel that if they come to our hospital they will be looked after properly. “Across the whole hospital, people who leave have not always been replaced. Many staff are disgruntled and have left to work at other hospitals in the region. “In the ED at Maclean Hospital, the night shift has just one RN and one doctor, who does the whole hospital. That often leaves one RN alone in ED. The after-hours manager also takes a patient load at night.” During the last state election campaign, the Liberal/National government promised to fund 5000 extra nurses.

SAFE STAFFING

‘ I am concerned about the numbers of nurses at the hospital and what they have to deal with on a daily basis.’ — Chris Gulaptis MP From this number, Maclean Hospital is supposed to get an extra nurse on two wards. Nothing extra is allocated for the ED. Grafton is not even mentioned in the government’s numbers. NSWNMA General Secretary, Brett Holmes, said branch members approached hospital management about their concerns several months ago, but the ongoing issues remained. He said members tried to raise concerns via the reasonable workload committee process, covering both hospitals. “However, that committee hasn’t met for months, leaving these issues to go unresolved,” Brett said in November. “We’ve had reports of excessive workloads and fatigue setting in. Many of the local nurses are forced to work with poor skill mix profiles and are also working short staffed because colleagues who take unexpected leave are not replaced. “We also know many of the nursing staff are often working through their meal breaks, due to short staffing. “They’re also being asked to work large amounts of overtime, which is unsustainable.”n

MP says ‘short-term fix’ needed The National Party member for Clarence, Chris Gulaptis, has acknowledged the need for a short-term fix for staffing shortages plaguing Grafton and Maclean Hospitals. “Obviously I am concerned about the numbers of nurses at the hospital and what they have to deal with on a daily basis … We need something in the short term,” he told the Daily Examiner. Mr Gulaptis said he would take to parliament a petition calling for urgent staffing improvements. He would also raise nurses’ concerns with the Northern NSW Local Health District. “I will certainly go back to the LHD with their concerns because I am concerned about it and I think they need to be addressed,” he said. The petition was initiated by the NSWNMA’s Clarence Valley branch and signed by over 500 residents. The petition says nurses face unsafe staffing levels on a daily basis, resulting in excessive workloads, questionable skill mix profiles and avoidable risks to patient safety. The branch is continuing its community campaign and hopes to get 10,000 signatures.

THE LAMP DECEMBER 2019/JANUARY 2020 | 17

AGED CARE

‘Shocking tale of neglect’ The Aged Care Royal Commission has delivered a scathing indictment of Australia’s aged care system.

“

Cr uel a nd ha r m f u l”; “unkind and uncaring”; “a sad and shocking system that diminishes Australia as a nation”. T h i s i s wh at roya l commissioners Richard Tracey* and Lynelle Briggs think of Australia’s aged care industry. T hei r i nter i m repor t released on 31 October describes aged care as “a shocking tale of neglect”.

“We owe it to strangers. We owe it to future g enerations. Older people deserve so much more.” Aged care is “designed around transactions, not relationships or care” and “minimises the voices of people receiving care and their loved ones” the report says. The workforce is “underpa id , u nder va lue d a nd insufficiently trained”.

It calls for a “fundamental overhaul of the design, objectives, regulation and funding of aged care”.

And the system’s regulatory model “does not provide transparency or an incentive to improve”.

It finds the aged care system “does not deliver uniformly safe and quality care, is unkind and uncaring towards older people and, in too many instances, it neglects them.”

The report calls for an immediate funding increase for h ig h-ne e d, i n-home care recipients.

It goes on: “This cruel and harmful system must be changed. We owe it to our parents, our grandparents, our partners, our friends.

It also calls for urgent action on the use of chemical restraints in residential aged care and on getting 6000 young disabled people out of nursing homes as soon as possible.

‘ This cruel and harmful system must be changed.’ — royal commissioners *Commissioner Tracey died three weeks before the interim report’s release. He has been replaced by Tony Pagone QC.

18 | THE LAMP DECEMBER 2019 /JANUARY 2020

‘Just another body to be washed, fed and mobilised’ EXTRACT FROM THE ROYAL COMMISSION INTERIM REPORT: “We have heard countless stories about how much people grieve for all they have lost when they arrive in residential care. “They become ‘just a resident’, just another body to be washed, fed and mobilised, their value defined by the amount of funding they bring with them. “They become infantilised, lose autonomy, and are prevented from making decisions or doing physical things that were routine when they lived at home, on the grounds that they ‘could hurt themselves’. “They lose their basic rights to take risks, to choose what to do in their day, to live a life as close as possible to their previous home and community. There is no joy in this.”

AGED CARE

Vindication for witnesses who exposed truth The royal commission has confirmed the evidence of NSWNMA members who spoke out about unacceptable working and living conditions in nursing homes.

n May 2019, NSWNMA member Susan Walton took the brave step of giving evidence to the Aged Care Royal Commission about her work as an assistant in nursing (AiN). She told the commissioners what it was like to work at a chronically understaffed nursing home. Each AiN/CSE (care support employee) had the impossible task of adequately caring for 40, often infirm, residents while on night shift. “You cannot continue to treat our elderly residents like this; staff and residents need more support,” she said. “One person to 40 residents, it does not work, you can’t do it; you need ratios in aged care now,” she said. Her employer is one of the largest aged care operators in NSW. She has been an AiN at the same facility for over 10 years. Soon after the hearing, The Lamp asked Susan if she feared reprisals for speaking out. “If you tell the truth about what is happening, you can’t get into trouble,” she said. On 31 O c tob er, Su s a n’s stance was vindicated when the royal commission delivered its interim report. Susan said she was grateful the commissioners had listened to

‘Surely Australians will wake up now to what is happening to their loved ones, and force the politicians and government to do something.’ — Susan Walton family members, staff members, and “everybody else who appeared at the commission, and told the truth about what is really happening in aged care today”. Federal Minister for Aged Care, Richard Colbeck, said the government was shocked by the royal commission’s findings. Susan says politicians shouldn’t be shocked. “We have had numerous reports, inquiries and complaints on the crisis in aged care over the last 10 years. “In the lead-up to the state and federal elections, the nurses’ union and their members publicly campaigned extremely hard for changes in aged care. “State and federal politicians have known exactly what has been going on, but they have all decided to put their blinkers on and ignore this.

royal commission report under the carpet, just like they have with all the other reports. “Surely Australians will wake up now to what is happening to their loved ones, and force the politicians and government to do something. “We all need to keep talking, we need to keep this going, keep the spotlight shining, keep it going in the media.” Susan said the government and providers should be held accountable for how billions of dollars of public subsidies and residents’ fees are spent. After the interim report was released, Susan said “nothing has changed” at her facility. “Staff and residents continue to suffer from a shortage of staff and not being able to help our elderly residents with all their everyday needs.” n

“Surely they can’t sweep the THE LAMP DECEMBER 2019/JANUARY 2020 | 19

AGED CARE

Act now on aged care, Morrison told Nurses, doctors call for immediate action on workforce improvements – starting with publication of staffing ratios.

ustralia’s peak nurse and doctor organisations want the federal government to immediately require nursing homes to publish their staffing ratios and show how they are spending public funds. The Australian Nursing and Midwifery Federation (ANMF) and Australian Medical Association (AMA) urged the government to start making workforce improvements before the royal commission’s final report due in late 2020. In a joint statement, the two organisations said systemic, chronic understaffing was the basis of many of the problems being exposed across the aged care sector. “ We ca n’t wa it for t he Morrison government to act on recommendations of the royal commission to stop the suffering of our elderly,” the joint statement said.

‘We simply cannot allow the government to continue to sit idly on the sidelines and watch the extent of this suffering unfold.’ — ANMF and AMA lacks key skills. It said services must have the right number of staff with the right skill mix.

Read the report

The commission sa id its f ina l repor t wou ld include recommendations on workforce issues such as attraction and retention; educat ion and training; choosing the right staff; remuneration and careers; continuity of care; and staffing levels and staff mix.

The Interim Report of the Royal Commission into Aged Care Quality and Safety can be downloaded from: https://agedcare. royalcommission. gov.au/publications/ Pages/interim-report. aspx

“We simply cannot allow the government to continue to sit idly on the sidelines and watch the extent of this suffering unfold.”

“The government can start on this immediately by requiring aged care providers to publish the staffing ratios in their facilities and to transparently report on their use of publicly funded subsidies,” the ANMF/AMA statement said.

The commission’s interim report released in October 2019 said the aged care workforce is under pressure, under-appreciated and

“The government can then deter m ine where add it iona l funding is needed and ensure that it is provided.” n

20 | THE LAMP DECEMBER 2019 /JANUARY 2020

AGED CARE

Complaints put facility back on track Developments at a Mudgee nursing home show aged care workers can get better staffing and other improvements if they are prepared to speak up.

‘The inspectors talked to staff, residents and management and found out exactly what was going on.’

n NSWNMA member who complained to the aged care regulator about an understaffed nursing home has welcomed improvements that came after the facility was sanctioned. Jane*, an assistant in nursing, wrote to the Aged Care Quality and Safety Commission early in 2019.

cuts to try to reverse its poor financial performance.

She described the impact of cost-cutting on residents and staff of Pioneer House, a not-forprofit facility at Mudgee in central western NSW.

Counsel assisting the royal commission, Peter Gray QC said there was ongoing conflict between the CEO/DON and the chair of the board.

Her letter was prompted by staff cuts that included the loss of one AiN on morning and afternoon shifts and one enrolled nurse on morning shift.

“The chair was concerned about ongoing staff issues raised with him about lack of support from management. And the DON regarded this as interference,” Mr Gray said.

She believes other staff also wrote to the quality commission. “We were chronically understaffed and had no time to look after the residents properly,” she said. “Management also cut funding to recreational officers, which meant residents were not always encouraged to leave their rooms and activities became very limited with scarce resources. “Residents were bored, depressed and cranky. “These people were in my care yet my hands were tied because there was not enough staff to do the work.” The quality commission found the facility did not meet accreditation standards and the Department of Health imposed sanctions for six months. They were lifted in August. In November 2019, the Aged Care Royal Commission heard that Pioneer House imposed staff

STAFF QUEUED TO SEE INSPECTORS The boa rd’s cha ir, A lla n Codrington, said sanctions cost the facility about $934,000 in lost revenue, because it couldn’t accept new residents, and fees to experts required for re-accreditation. Jane said that when quality commission inspectors visited the facility, “staff were queueing at the door to talk to them”. “The inspectors talked to staff, residents and management and found out exactly what was going on.” T he qu a l it y c om m i s sion recommended improvements and Pioneer House was required to appoint a nurse adviser and improve staff training. “It was great because it instigated

a lot of change,” Jane said. “Since then, Pioneer House has reversed the staff cuts and most shifts are fully staffed – though it is hard to find skilled staff in a rural area like ours. “We have a new DON, who is fantastic. “Recommendations for better recreation have been put in place, and residents are happier and more engaged. “We now have a spare minute to actually talk to the residents, and more time to do their care properly. “More needs to be done about the food but they are having residents’ meetings about it and are talking to the kitchen as well.” She sa id her ex per ience shows aged care workers can get improvements if they are prepared to speak up. “The residents mostly can’t or won’t speak up for themselves, and it’s not fair they have to put up with terrible treatment. “I think it’s part of our duty of care to make sure they are looked after properly. “If management refuses to do it, they need to be held to account.” n *Name changed on request THE LAMP DECEMBER 2019/JANUARY 2020 | 21

MENTAL HEALTH SCHOLARSHIPS

he NSW Minister for Mental Health, Bronwyn Taylor, recently paid tribute to Bob in a speech to Parliament. “Bob was posthumously awarded an Australian bravery award for saving the life of a junior nurse in the incident,” she said. The Minister said Bob was passionate about supporting other nurses, and the award, funded by the NSW government a nd administered by t he NSWNMA since 2011, is designed to help junior mental health nurses “expand their professional suppor t net work s” and “increase their knowledge, their competence and their confidence in mental health nursing”. The program pairs junior nurses with senior mental health nurses or clinicians in a setting different to their usual workplace. The scholarship pays for the mentee’s travel, meals and accommodation, and funds their workplace to cover their absence.

22 | THE LAMP DECEMBER 2019 /JANUARY 2020

A positive rural experience for a metro nurse 2019 grant recipient Aislynn Kearney, an RN at Nepean Hospital in Penrith, spent five days with Warren Isaac, a clinical nurse consultant with 38 years’ experience at the Tablelands Mental Health Service in Armidale. Aislynn: “I work in a standard mental health ward in a metro hospital, so going into a community in a rural area is very different: we’d be driving for an hour to do a home visit. “One of the things that was really beneficial for me was learning by watching Warren, just the way that he engaged with consumers: even when they weren’t interested or were hesitant to engage he would still manage to reassure them, build rapport and let them know that if they didn’t want support now, he would be there in the future. “There are lots of challenges in Armidale, but the team works really well because of those challenges. I’ve been using the experience to guide my own professional practice, and I’ve also been working with my clinical NUM to increase engagement with the multidisciplinary team, making

sure there is a nurse representative at meetings and that meetings happen, because when you work in a really busy environment meetings can get cancelled.” Warren Isaac: “Although we are on a smaller scale than Sydney, we have a huge scope of practice, everything from crisis and assessments, acute follow up and assertive outreach, and attempting to reduce the impact of mental health problems and keeping people out of hospital. “I try to introduce the mentee to a variety of clients so they can see that there are clients in rural areas just as complex as those in city areas, and that you can have a very satisfying career in these areas helping the clients. Aislynn got to see the impact of the drought because we were travelling through very dry country. It is affecting the whole community in many different ways, because we’ve got famers, businesspeople and nurses who are involved in farms … There is a real increased risk of suicide. “I make a point of passing on particular skills and knowledge. I love promoting the New England area because it has helped me to have a really satisfying career and terrific quality of life.”

MENTAL HEALTH SCHOLARSHIPS

‘ Aislynn got to see the impact of the drought. It is affecting the whole community in many different ways.’ — Warren Isaac WARREN ISAAC AND AISLYNN KEARNEY

A placement full of insight Meggy Stevens, an RN at Manning Hospital, Hunter New England LHD, was mentored by Abiegail Koroma, a nurse working in child and adolescent mental health at Liverpool Hospital. Meggy Stevens: “Compared to where I live, Liverpool is so multicultural. And you’ve got people from war-torn countries, people with a lot of traumatic backgrounds. “Most clients had a background where English was not a first language, so interpreters were used quite a bit and you really had to be on your toes, you had to closely watch the client, the interpreter and the support person because you are relying on looking at their body language and tone of voice to get the full story, because things can get lost in translation. “Abiegail had experienced a country that had been at war and had civil unrest so she was insightful around a lot of the stuff I was seeing. It is great to be able to bring this experience back into

country areas, because we know that migration is starting to flow on to country areas as well, and I know the experience has made me more rounded as a clinician.” Abiegail: “I’ve been in mental health for the last ten years, and I believe it is important to share your knowledge with junior nurses to be able to make a difference. In Western Sydney there are a lot of migrants, and there is a stigma around mental health and isolation and people find it hard to talk about mental health issues. I was able to show Meggy a transcultural mental health service providing a holistic mental health approach. Coming as a migrant from Sierra Leone in West Africa has given me a lot of insight and a better understanding to demonstrate a lot of empathy for people who don’t speak English and come from low socioeconomic backgrounds. I think it is quite important to encourage nurses and expose them to the opportunities out there. Managers also need to be aware of this program and encourage nurses at the beginning of their career to apply.”

‘ I know the experience has made me more rounded as a clinician.’ — Meggy Stevens

How to apply To be eligible, nurses must be currently working in a public mental health service in NSW and able to complete the mentorship between May and July 2020. Applications will be available on the Association website from 1 February and close in March.

www.nswnma. asn.au/education/ scholarships THE LAMP DECEMBER 2019/JANUARY 2020 | 23

NEW GRADUATE PROGRAM

The virtuous circle

After graduating in 2012 as a registered nurse from the University of Newcastle, Catherine Ivanfy spent a graduate year at the Mater Hospital Newcastle rotating through medical toxicology, oncology and postsurgical wards. Just seven years later she is mentoring graduates herself as a clinical nurse educator at Westmead Hospital. The Lamp spoke to Catherine about how the new graduate program works, and how it helped her build her nursing career.

24 | THE LAMP DECEMBER 2019 /JANUARY 2020

How would you describe the new graduate program? The thing about the new graduate program in any hospital is that you’ve got a different role to more experienced nurses: you’re not expected to be an expert nurse straight away, but you are supported to get those skills over the year. The Mater was really good and let us choose two out of three rotations. I chose to do a rotation in a medical toxicology ward, which is also combined with geriatric patients and dementia patients. I also did a rotation in the surgical ward and in oncology.

What were some of the things that made your new graduate program so successful? They say that the new graduate year is one of the hardest years in nursing because you don’t have the skills yet, so you have to start from scratch, but meeting all the experienced nurses along the way that helped me get those skills and accrue the little bits of knowledge to be the best nurse you can be, was just really good. I still keep up with the nurses who mentored me when I was starting out. There are

things they have said that stick in my mind.

How did the year help you transition into the role of a nurse? When I did my new graduate year, I knew I wanted to be an intensive care specialty nurse, but they don’t let you do that as a new grad because it is a bit too acute; you need to build fundamental skills first. The rotations I did really helped me with my goal: the toxicology ward gave me quite good grounding and skills in managing confused patients, which you do get a lot in ICU, and the surgical ward helped as well because of things you are managing post-surgery in ICU. And the Mater intensive care deals with lots of oncology patients, so that was really helpful in building my career as an intensive care nurse.

What did you do after the graduate program? In my second year after my new grad program, with the guidance of Joanne Turdue (mentor), I was able to move into intensive care. So over the last couple of years I have been specialising in that area. Just over a

NEW GRADUATE PROGRAM

CATHERINE IVANFY

year ago I transitioned to nurse education at Westmead, and having a foundation in all of the skills I developed in my graduate year helped me to do that. At Westmead they have opened up a mixed medical ward, so it does everything, but because of my background in intensive care I can manage a wide variety of patients, so I found it easy to transition.

Can you describe your work now as a clinical nurse educator? I support the new graduate nurses when they come out, so one of my priorities is making sure they have fundamental skills to be good nurses, and then move on to whatever speciality they want to. I also support other nurses on the ward to gain higher and more acute skills. Having a really good CNE makes the difference between you getting the skills and struggling to get the skills.

What are some tips or tricks you could give someone starting their new graduate program?

Keep an open mind because you will see things that will be quite confronting that you don’t expect to see. Don’t be too harsh on yourself: the new grads are the baby nurses, so you can’t expect to have the same skills as someone who has been doing nursing for eight years or 20 or 30 years. They say it takes someone three months to get used to a new workplace so that is the first quarter of your new graduate rotation. Be friends with your other new grads, be a good team member with them because they are the ones who will support you through the first year. And don’t compete with each other: everyone is going to have a different experience and everyone is going to go through different wards at a different pace. Try to soak up the education and just try to have some fun and enjoy learning. Everything you see in the workplace will teach you a lesson so just try to learn a lesson from each clinical experience you have, and from patients and other staff interactions.

Apply for a place in the new graduate program: Final year nursing students can apply for the 2021 Grad Start program through NSW Health. Visit www.health. nsw.gov.au/nursing/ employment and look out for the 2021 application when it becomes available. NSW Health says “GradStart is highly competitive and it is anticipated that more people will apply than there are positions available, so it is important to be well prepared and organised.”

www.health.nsw. gov.au/nursing/ employment

THE LAMP DECEMBER 2019/JANUARY 2020 | 25

COMPETITION COVER STORY

SHREK THE MUSICAL SHREK THE MUSICAL, based on the Oscar®- winning DreamWorks film, brings the hilarious story of everyone’s favourite ogre to life on the stage.

Merry Christmas from the NSWNMA

Wishing all our members a Merry Christmas and offering you the chance to be part of this year’s Christmas giveaway. enter o t How

The Lamp is offering members the chance to win one of two double passes to see SHREK THE MUSICAL* at Sydney Lyric Theatre.

To be in the draw to win one of these fabulous prizes, simply provide your name, membership number and the prize you would like to win (a separate email is required for each prize) and email your entry with the subject: Christmas giveaway (prize title) to lamp@nswnma.asn.au Important: Only one entry per member for each competition will be accepted. Entries must indicate which prize you would like to win in the email subject.

Join Shrek and his loyal steed Donkey as they set off on a quest to rescue the beautiful Princess Fiona from her tower, guarded by a fire breathing love-sick dragon. Add the vertically challenged Lord Farquaad, a gang of fairytale misfits, and a biscuit with attitude, and you’ve got an irresistible mix of adventure, laughter and romance, guaranteed to delight audiences of all ages.

To book go to www.ticketmaster.com.au * Conditions apply. SHREK THE MUSICAL performance dates include Wednesday 8, 15, 22, 29 January 2020 at 7.30pm OR Thursday 9, 16, 23, 30 January at 7.30pm. Subject to availability.

SPLASH INTO SUMMER AT RAGING WATERS SYDNEY Raging Waters Sydney is the place to make your summer memories. Sydney’s biggest waterpark has something for everyone, offering over 30 rides, slides and attractions. Challenge your family and friends on the H2Go Racers, experience the thrills on the 360 Rush, chill out by the beach or slide the brand new Whirlwind. Raging Waters Sydney is the best place to spend time with your friends and family this summer. Win one of 4 x double passes to Raging Waters Sydney*. To book your tickets go to www. ragingwaterssydney.com.au/plan-a-visit/tickets

Competition entries from NSWNMA members only and limited to one entry per member per prize. All entries must be in by Monday, 16 December 2019. The prizes will be drawn on Tuesday, 17 December 2019. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/19/04224.

26 | THE LAMP DECEMBER 2019 /JANUARY 2020

*Conditions apply. Offer only valid for the current season which commences 28 September 2019 until 29 March 2020. Tickets are valid for one single day use per ticket only. Unless otherwise stated, fees for food, merchandise, locker rentals, pay-per-ride attractions (Sydney SkyCoaster), special concerts or events are not included in the admission prices. Prices and product offerings are subject to change without notice. Children 3 years and under free.

COVER STORY

UNWIND AT THE LUXURIOUS HYATT REGENCY SYDNEY Located adjacent to Darling Harbour in the heart of Sydney’s CBD, Hyatt Regency Sydney is Australia’s largest upscale hotel perfectly suited to those seeking a weekend away. Within walking distance to theatres, museums, galleries and luxury shopping precincts guests can experience some of the city’s best attractions within minutes. Hyatt Regency Sydney is the perfect place to work, rest and play. To book visit www.hyatt.com/Regency/Sydney The Lamp is offering members the chance to win two nights’ accommodation in a Harbour View Room with breakfast daily* *Conditions apply. Rooms subject to availability. Prize must be redeemed by 30 June 2020 (not valid during long weekends, public holidays or major event periods). Voucher is non-transferable, not redeemable for cash and must be presented on arrival.

HOLIDAY READING

Kick back and relax with a four-book gift pack from Penguin Random House. We have three packs (of four books each) to give away with titles including: About a Girl by Rebekah Robertson Rebekah Robertson’s extraordinary personal story of raising her transgender child, Georgie Stone, who has become a voice not just for other transgender kids – but for an emerging generation. The Diamond Hunter by Fiona McIntosh Fiona McIntosh’s breathtaking adventure story takes her readers on a journey from the harsh desert of Africa’s Kimberley diamond mine, to the misty, green plains of northern England. Island on the Edge of the World by Deborah Rodriguez A captivating story set in the colourful but chaotic land of Haiti, as four very different women work together to find a lost child. Miracle Mutts by Laura Greaves Heartwarming stories of dogs that survived – and thrived – against the odds. Whether sick or injured, lost or abandoned, recovering from cruelty or neglect, it’s the underdogs of the world who have the most to teach us.

DREAMWORKS ANIMATION: THE EXHIBITION + FORREST HOTEL & APARTMENTS STAY PACKAGE Located in a quiet street in Canberra’s garden district, Forrest Hotel and Apartments is situated just a stone’s throw away from major tourist attractions. Family owned and operated, Forrest Hotel & Apartments are renowned for their hospitality and you will enjoy all the comforts of home complimented with outstanding service and facilities. Go to www.forresthotel.com for accommodation details and bookings. Win a two-night stay in a one bedroom apartment with breakfast at the Forrest Hotel & Apartments and entry for two to DreamWorks Animation: The Exhibition — Journey from Sketch to Screen at the National Museum of Australia. Go behind the scenes of DreamWorks Animation’s most popular films. Join your favourite characters — Shrek, Toothless and Po — in a rare glimpse into the studio’s collaborative, artistic and visionary approach to animation. Exhibition on show at the National Museum of Australia, Canberra until 2 February 2020. To book visit www.nma.gov.au/ exhibitions/dreamworks-animation

ENURSE – AUSTRALIA’S LEADING ONLINE NURSE SHOP We have partnered with eNurse and are offering you the chance to win a $250 voucher – imagine yourself in new scrubs, new shoes and accessories! SPECIAL OFFER! Enjoy 10% off* all your online purchases exclusive to NSWNMA members. Simply use promo code NSWNMA10OFF at www.enurse.com.au *Conditions apply. Excludes books, Littmann Stethoscopes, Fashion Biz and specials. Not valid in conjunction with any other offers or promotions. Offer valid until 31 March 2020 for NSWNMA members. THE LAMP DECEMBER 2019/JANUARY 2020 | 27

NEWS IN BRIEF

AUSTRALIA

Significant drop in asthma deaths New data from the Australian Bureau of Statistics (ABS) reveals a significant decrease in asthma-related deaths, particularly in Australian women. Figures show there were 389 asthma-related deaths recorded in Australia in 2018, comprising 250 females and 139 males, which signifies a decrease from 441 in 2017, and 457 in 2016. Those aged 75 and over continue to account for nearly two-thirds of deaths (241 of 389), while deaths in children remain uncommon but can still occur – seven children lost their lives to asthma in 2018. National Asthma Council Australia (NAC) Chief Executive, Siobhan Brophy, says the significant drop could be attributed to several mitigating factors. “We believe that increased patient awareness following the epidemic thunderstorm asthma event in Melbourne in 2016 has played a large role in this reduction,” she said. “The development of new ways to manage severe asthma is also having an impact.” The NAC has developed a Severe Asthma Checklist for both acute and primary care nurses. ‘The checklist can help nurses in all practice settings better understand the referral pathways available to patients,” said the NAC’s educator Marg Gordon. ‘Nurses in acute settings are crucial to ensuring patients get the care they need for their asthma after they leave hospital, while those working in primary care are ideally placed to provide support and education to all asthma patients,’ she says. For more information on severe asthma diagnosis and management, visit www.asthmahandbook.org.au.

‘ Nurses are ideally placed to provide support and education to all asthma patients.’

AUSTRALIA

‘Macho’ construction culture is killing tradies Construction workers are overrepresented in suicide rates in Australia. Workers in construction are at a higher risk of experiencing mental health problems than workers in other professions, according to researchers from Charles Sturt University. In 2012 in Australia, a total of 169 men working in the construction industry committed suicide. A 2017 report indicated the suicide rate is 24.2 per 100,000 male construction workers compared to 13.9 per 100,000 males in all other occupations – almost double. The researchers said there were several factors that contributed to this problem. “Workers can be on site for up to double their contracted work time. So long hours, resulting in fatigue and poor work–life balance, are likely affecting tradies’ mental wellbeing,” they wrote in the online magazine The Conversation. They also say there are strong links between a “macho” work culture and the likelihood of mental health issues. “A ‘macho’ work culture emphasises self-reliance; there’s an expectation tradespeople can withstand insecure and transient work arrangements,” they said. “There’s also stigma associated with men talking to others about psychological distress. For this reason, many ignore stress-related mental health problems like panic attacks, anxiety, insomnia and depression. Competition at work may also lead to a breakdown of trust, a lack of collegiality, and conflict. “Macho workplaces decrease the likelihood men will look after themselves by consulting healthcare professionals, talking to a supervisor about reducing hours or asking for time off.”

‘Macho workplaces decrease the likelihood men will look after themselves by consulting health-care professionals.’ 28 | THE LAMP DECEMBER 2019 /JANUARY 2020

NEWS IN BRIEF

AUSTRALIA

Taking the bargaining out of collective bargaining “An aggressive and wide-ranging agenda for changing Australia's labour laws” has been quickly assembled by the Morrison government and its business supporters, says the Centre For Future Work. In a new report, the think tank’s senior economist Alison Pennington has compiled the various proposals advanced by employers, and shows that together they would constitute a thorough reorientation of Australia's collective bargaining system. “The end result would be a situation – very similar to the Work Choices regime of the late 2000s – whereby employers have unilateral power to determine terms and conditions, wages can be locked in for very long periods of time and the scope for true workplace negotiations is compressed,” the report says. The main findings of the report include: • The share of private sector workers covered by enterprise agreements (EAs) has now been halved since 2013, to only 11 per cent. • This decline reflects three simultaneous negative trends: declining agreement renewals, almost no new agreements being negotiated, and high rates of agreement termination. • Employers are aiming for a collective “bargaining” system that has little room for actual bargaining – it would instead be characterised by employers with increasing power to unilaterally set the terms and conditions of work. • The loss of wages resulting from that slowdown in (already weak) wage growth could cost an average private sector EA-covered worker over $2000 in lost income over just the first three years.

‘ The end result would be a situation whereby employers have unilateral power to determine terms and conditions, and wages can be locked in for very long periods of time.’

UNITED STATES

Nurse ‘worry’ spot on predicting patient status Research confirms that nurses’ intuition is an accurate predictor of a patient’s declining condition. Using a five-point rating system, 150 nursing professionals at the Mayo Clinic in Minnesota were asked to predict each of their patient’s potential for decline within the next 24 hours. A total of 31,159 patient shifts, and 3185 unique patients, were involved in the study. Three separate groups then reviewed each report: a physician in the same specialty, an experienced nurse and either a physician, nurse or nurse practitioner. Of the 492 cases in which the nurses rated a high level of worry – enough to call for medical attention – 77 per cent were backed up by the reviewers. Nurses with more than one year of experience were significantly more accurate — 79 per cent, as opposed to 68 per cent for those with less than one year on the job. The study was published in the Journal of the American Medical Informatics Association (JAMIA). Applying a nurse’s trained eye to identify deteriorating patients can sometimes raise red flags even before objective markers can, the researchers said. “Our study demonstrates that the ‘worry factor’ in its current form is accurate in detecting patient deterioration. “Nurses generally have more constant and prolonged contact with patients during their hospitalisation as compared to physicians, putting them in a particularly advantaged position to recognise patterns that can be a telltale sign of impending physiological deterioration.”

‘Applying a nurse’s trained eye to identify deteriorating patients can sometimes raise red flags even before objective markers can.’ THE LAMP DECEMBER 2019/JANUARY 2020 | 29

NEWS IN BRIEF

UNITED KINGDOM

Healthy diet, healthy planet Healthier food choices almost always benefit the environment, according to a sophisticated new study. The research was published in the journal Proceedings of the National Academy of Sciences. The analysis assessed the health and environmental impacts of 15 foods common in Western diets and found fruit, vegetables, beans and wholegrains were best for both avoiding disease and protecting the climate and water resources. The study found that eating more red and processed meat causes the most ill health and pollution. Using data from other studies on the diets and health outcomes of tens of millions of people they calculated the health impact of eating one extra portion of each food on heart disease, stroke, type 2 diabetes and colorectal cancer. The environmental harm for each food, from greenhouse gases to water use to pollution was also calculated. The study found that producing unprocessed red meat had the highest impact for all environmental indicators and was many times worse than pulses. The researchers said foods with medium environmental impacts or not significantly associated with ill health, such as refined grain cereals, dairy, eggs and chicken, could help improve health and reduce environmental harm if they replaced foods such as red meat. Michael Clark at the University of Oxford, who led the research, told The Guardian: “Continuing to eat the way we do threatens societies, through chronic ill health and degradation of earth’s climate, ecosystems and water resources. “Choosing better, more sustainable diets is one of the main ways people can improve their health and help protect the environment.”

‘Choosing better, more sustainable diets is one of the main ways people can improve their health and help protect the environment.’

AUSTRALIA

Rheumatic heart disease doubles in four years Half of the cases diagnosed were in the Northern Territory. The number and rate of diagnoses of acute rheumatic heart fever doubled in the four years to 2017, according to a study released by the Australian Institute of Health and Welfare. Rheumatic heart disease is a permanent form of heart damage, caused by exposure to strep A infection and usually begins with a sore throat or skin infection. If not treated with antibiotics, some young people will go on to develop acute rheumatic fever and then rheumatic heart disease. Those most at risk of developing the disease are young Indigenous Australians aged five to 15. The average life expectancy of an Indigenous person diagnosed with it is 40. In the four years to 2017 there were more than 1800 diagnoses of acute rheumatic fever recorded, and just over 1700 of those were Aboriginal people. Nine in 10 of those were children – predominantly girls – aged between and five and 14, the study found. More than half of all cases were in the Northern Territory. Experts say the figures do not necessarily reflect an increase in the incidence of the disease but could reflect better detection. “But these numbers show us we have got a lot of work to do in primary health care delivery as well as treatment,” said Katharine Noonan from END RHD – the peak organisation representing researchers and medical organisations working in the field.

‘Nine in 10 were children aged between five and 14.’ 30 | THE LAMP DECEMBER 2019 /JANUARY 2020

NEWS IN BRIEF

AUSTRALIA

Private system delivers poor value on maternity Mothers relying on private health cover pay much more than those who use a public hospital, according to new research. The study separated women into those who gave birth in the public or private system, and women were matched for similar birth circumstances, such as having a caesarean or giving birth vaginally. “Fees were consistently higher in all time periods for private births compared with public births: 500 per cent higher in pregnancy, 1200 per cent higher at the time of birth, and 180 per cent higher in the first year postpartum,” the study, published in the journal Birth Issues in Perinatal Care, found. “Obstetric services were the largest source of fees paid by mothers who gave birth in private hospitals ($1296), followed by diagnostic imaging ($262) and specialists ($221). For each type of service, the fees for mothers who gave birth in private hospitals were higher than for similar mothers who gave birth in public hospitals.” The study found women who gave birth in public hospitals saw general practitioners more often, while both groups of women used similar numbers of diagnostic imaging services. “The standout finding is just how much more mums do pay if they do choose to give birth in a private hospital, and how long the out-of-pocket costs are incurred for,” said Griffith University associate professor Emily Callander, who led the study. “It’s not just at the time of birth but those costs continue during the child’s first year of life. I found it surprising how many thousands of dollars mums who choose to give birth in private hospitals do pay. Private health insurance does not protect you from high out-ofpocket costs.”

‘ The standout finding is just how much more mums do pay if they do choose to give birth in a private hospital, and how long the out-of-pocket costs are incurred for.’

EMPLOYMENT OPPORTUNITY Looking for a challenge or career change? TAFE NSW is seeking suitable candidates for the following positions: Education Support Officer – Aged Care Locations: Shellharbour and Wagga Wagga Job ref no: 00007FR8 (Shellharbour) 00007FRF (Wagga Wagga) Salary: $72,774 p.a. Status: Temporary Full Time Enquiries: Kellie Harmer on 0408 230 899 Closing date: 10 January 2020

Teacher Nursing Locations: Cootamundra, Albury and Wagga Wagga Job ref no: 00007FTH Salary: $84,664 - $100,407 p.a. Status: Temporary Full Time Enquiries: Cheryl Bradshaw on 0428 220 569 Closing date: 31 January 2020

Part Time Casual Teachers Nursing Locations: Illawarra and Riverina Job ref no: 00007ER1 (Illawarra) 00007EXP (Riverina) Salary: $65.33 - $82.75 per hour Status: Casual Part Time Enquiries: Andrea Purnell on 02 4229 0186 Closing date: 6 April 2020

Part Time Permanent Teacher (2 x positions) Location: Griffith Job ref no: 00007ADC Salary: $65.33 - $82.75 per hour Status: Part Time Permanent Enquiries: Andrea Purnell on 02 4229 0186 Closing date: 31 January 2020

Part Time Casual Teachers Aged Care Location: Illawarra and Riverina Job ref no: 00007AQG (Illawarra) 00007EC5 (Riverina) Salary: $65.33 - $82.75 per hour Status: Casual Part Time Enquiries: Kellie Harmer on 0408 230 899 Closing date: 6 April 2020

Candidates will need to go to iworkfor.nsw.gov.au and search for the job reference number or job title for detailed information to apply online.

READY TO BE AMBITIOUS? Take the next step and apply today.

THE LAMP DECEMBER 2019/JANUARY 2020 | 31

PROFESSIONAL EDUCATION

SYDNEY METRO

December 2019 to March 2020 Education Waterloo

Student to New Graduate: What You Need to Know, Thursday 12 December, $30 / $60, 6 CPD Hours, New Grad / Final Year Nursing and Midwifery Students Student to New Graduate: What You Need to Know, Thursday 23 January, $30 / $60, 6 CPD Hours, New Grad / Final Year Nursing and Midwifery Students Dementia Management Training, Thursday 30 January, $95 / $190, 7 CPD Hours

Your Annual CPD Obligations, Thursday 20 February, $50 / $100, 4 CPD Hours, RN, MW, EN Alcohol and Other Drugs, The Current Situation: An update for all nurses and midwives, Wednesday 11 March, $95 / $190, 6 CPD Hours Introduction to Suicide Assessment and Management for nurses and midwives – NEW, Thursday 12 March, $50 / $100, 3 CPD Hours Know where you stand with Law, Ethics and Professional Standards in nursing and midwifery, Thursday 19 March, $95 / $190, 6 CPD Hours

Medications: How we do it better, Wednesday 5 February, $95 / $190, 6 CPD Hours

Combatting Stress and Burnout – NEW, Friday 27 March, $95 / $190, 6 CPD Hours

CPD

Blacktown

Student to New Graduate: What You Need to Know, Thursday 6 February, $30 / $60, 6 CPD Hours, New Grad / Final Year Nursing and Midwifery Students Clinical Communication and Documentation, Tuesday 25 February, $95 / $190, 6 CPD Hours

Dee Why

Know where you stand with Law, Ethics and Professional Standards in nursing and midwifery, Wednesday 25 March, $95 / $190, 6 CPD Hours

Gymea

The Deteriorating Client, Wednesday 18 March, $95 / $190, 5 CPD Hours

Foot Care: A Nurses Role Wed 19 February 2020 NEWCASTLE

Wed 4 November 2020 TAREE

Mon 9 March 2020 ARMIDALE

9am to 4.30pm

Wed 8 July 2020 GYMEA

Wed 7 October 2020 BLACKTOWN

COURSE STRUCTURE: Topic 1 – Professional and Legal Considerations in Foot Care • Policy and procedure requirements • WHS considerations • Infection control guidelines and standards. Topic 2 – Basic Foot Anatomy and Pathophysiology • Foot structure and mechanics • Pathophysiology of the foot • Neurological and vascular pathology. Topic 3 – Basic Nail Anatomy and Pathophysiology • The normal nail • Nail pathology assessment and treatment options • When to treat and when to refer on. 32 | THE LAMP DECEMBER 2019 /JANUARY 2020

All Members $95 Non-members $190 Lunch and refreshments provided

Topic 4 – Basic Skin Anatomy and Pathophysiology • Skin structure and the ageing process • Skin pathologies • Wound care considerations. Topic 5 – Practical Session • Skin assessment, diagnosis & treatment plan • Nail assessment, diagnosis and treatment plan • Pressure off-loading devices. Topic 6 – Feet, Footwear and Falls • Footwear assessment • Falls risks • Preventative interventions

REGISTRATION

bit.ly/educationNSWNMA

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

CPD

Attendance at NSWNMA education sessions may count towards your Continuing Professional Development (CPD) hours. The number of hours noted beside each course is the maximum amount of claimable CPD hours. Unless otherwise noted, our courses are suitable for all Nurses, Midwives and Assistants in Nursing/Midwifery.

ILLAWARRA SHOALHAVEN Shoalhaven Heads

NEPEAN BLUE MOUNTAINS Springwood

11 December, $95 / $190, 6 CPD Hours

NORTHERN Byron Bay

Clinical Communication and Documentation, Friday 27 March, $95 / $190, 6 CPD Hours

Medications: How we do it better COURSE FULL, Wednesday

HUNTER NEW ENGLAND Armidale

Wound Care: Negative Pressure Wound Therapy, Tuesday 31 March, $95 / $190

Foot Care: A Nurses Role, Monday 9 March, $95 / $190, 6 CPD Hours

Muswellbrook

Medications: How we do it better, Thursday 26 March, $95 / $190, 6 CPD Hours

Newcastle

Foot Care: A Nurses Role, Friday 21 February, $95 / $190, 6 CPD Hours Know where you stand with Law, Ethics and Professional Standards in nursing and midwifery, Wednesday 4 March, $95 / $190, 6 CPD Hours Standard Mental Health First Aid, 2-Day Course, Thursday 12 and Friday 27 March, $190 / $380, 12 CPD Hours

Taree

Wollongong

Introduction to Mental Health for nurses and midwives – NEW, Thursday 5 March, $95 / $190

MID NORTH COAST Coffs Harbour

Aged Care Seminar, Thursday 27 February, $60 / $120, 6 CPD Hours

MURRUMBIDGEE Wagga Wagga

Medications: How we do it better, Tuesday 25 February, $95 / $190, 6 CPD Hours Clinical Communication and Documentation, Wednesday 26 February, $95 / $190, 6 CPD Hours

Palliative Care Workshop, Monday 23 March, $95 / $190

Leaning into Health and Harmony: Visioning and Self-Care Workshop for nurses and midwives, Wednesday 4 March, $95 / $190, 6 CPD Hours

Tweed Heads

Wound Care: Venous Insufficiency, Friday 20 March, $95 / $190, 6 CPD Hours

SOUTHERN Batemans Bay

Dementia Management Training, Wednesday 26 February, $95 / $190, 7 CPD Hours

WESTERN Bathurst

Know where you stand with Law, Ethics and Professional Standards in nursing and midwifery, Wednesday 11 March, $95 / $190, 6 CPD Hours Medications: How we do it better, Thursday 12 March, $95 / $190, 6 CPD Hours

Clinical Communication and Documentation, Wednesday 12 February, $95 / $190, 6 CPD Hours

Aged Care Seminar

CPD

NSW REGIONAL

CENTRAL COAST Gosford

Thursday 27 February 2020 C.ex Coffs, 2-6 Vernon Street, Coffs Harbour 9am to 4pm All Members $60 Non-members $120 Lunch & refreshments provided

Coffs Harbour

PROGRAM:

• Consumer Consultation, risk management and the new standards – what does it mean? • Assessment, Planning and care for residents with Sensory Loss. – new standards approach; • The New Charter of Aged Care Rights; and more ...

REGISTRATION bit.ly/educationNSWNMA THE LAMP DECEMBER 2019/JANUARY 2020 | 33

Clinical Supervision for Role Development Training

3, 4, 5 March; 23, 24, 25 June; 16 & 17 Sept 2020. 9am – 4.30pm 50 O’Dea Avenue, Waterloo All

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

Clinical Supervision is a regular, dedicated time for reflection on all aspects of professional practice. Clinical supervision aims to improve care, and support the professional development and well being of staff. This eight-day foundational training equips potential clinical supervisors with a variety of techniques and approaches to conduct quality individual and group clinical supervision. For many professions, clinical supervision is now a mandatory condition of registration and ongoing practice and forms an integral part of Continued Professional Development (CPD). COURSE CONTENT: The training provides clinical supervisors with an understanding of the Role Development Model of clinical supervision, the supervisor role and a framework for clinical supervision practice. The learning includes utilisation of role theory, role analysis, concretisation techniques, action-learning techniques and role training as clinical supervision interventions. Other innovative interventions such as ‘this year/next year’ are included.

CPD

8-DAY COURSE IN 2020

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

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

PROFESSIONAL EDUCATION

YOUR RIGHTS

Ask

Judith Breaking News WHAT A YEAR … It’s hard to believe but here we are heading towards another Christmas and the opportunity to enjoy festivities with family and friends. It seems like only yesterday that I was sharing with you my thoughts and hopes for 2019, a year that promised to be as significant and pivotal for the professions of nursing and midwifery as we have experienced in decades. It offered enormous potential to further entrench the language and practice of nurse-to-patient ratios as being the barometer of safe clinical care for patient, resident and practitioner alike. We have realised some of that potential. Members throughout this state, regardless of the industry they work in, have demonstrated throughout the year an increasing level of activity and collective engagement. In the public health space, an increasing number of community groups, academics, professional commentators and various political parties have embraced the need for enforceable nursing ratios in workplaces. The current NSW Government is rolling out (albeit slowly) an increase to the existing ratios in place at rural and regional hospitals – a clear concession that more needs to be done. Evidence before the Royal Commission into Aged Care is utterly infused with the need to increase nursing staff and have minimum staffing levels. The same can be expected with the Royal Commission now beginning into the disability sector. But in the end, the most trusted profession is the one that will yet again be inevitably forced to defend their professional obligations and rights, and the one to demand a safe workplace to provide the best possible care to patients and residents. These efforts will continue and need to escalate in 2020. I am convinced we are up to meeting the challenge. So I wish all members and their families and friends, a very merry Christmas and a happy New Year. And recharge your batteries if lucky enough to have time off, for the challenges that lay ahead.

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

Change while on maternity leave I am on maternity leave and hear that a restructure is happening in my service that operates across the Local Health District. The role I did may be affected. I’m just wondering if they are required to keep me informed. Yes, as set out in Clause 34E(i) of the Public Health System Nurses’ and Midwives’ (State) Award, the employer must make information available to you in relation to any significant change on the position you held before commencing maternity leave. An opportunity must be provided to you to discuss the effect of any change on your position’s responsibility or status. Date-limited offer at Estia I made inquiries about a job at a nursing home run by Estia. There was some mention of it being a maximum-term employee job. I didn’t ask what this meant. Clause 9.4 of the Estia Health NSW Enterprise Agreement 2016 sets out that a maximum-term employee is one who is employed for a specified period of time, season or task. There is no expectation of ongoing work after the end date/time nominated. These should only be used for genuine reasons. One example may be backfilling someone on maternity leave. Posting of rosters I work in a public hospital and our department never seems to have the roster out until it is nearly due to start. This makes planning almost impossible. Disappointingly, this issue keeps arising, and it is evident that a number of wards or services are still not complying with Clause 8(ii) of the Public Health System Nurses’ and Midwives’ (State) Award. Your roster must be

displayed in a place conveniently accessible at least four weeks prior to its commencing date. Next pay increase at the Mater I work at the Mater Hospital in North Sydney. When is the next pay rise due? Clause 14.1 of the Mater Hospital North Sydney and St Vincent’s Private Community Hospital Griffith Nurses’ and Midwives’ Enterprise Agreement 2019 sets out that the next pay increase of 2.5 per cent will occur from the first full pay period commencing on or after 1 January 2020. The actual rates of pay and allowances from that time are set out in Table 1 of Schedule 1 to the agreement. Resignation and notice I am a registered nurse working in a public hospital. I am thinking about leaving, how much notice do I have to give? Clause 45(ii) of the Public Health System Nurses’ and Midwives’ (State) Award sets out that employees (other than directors of nursing) shall be required to give 14 days’ notice of their intention to resign. This can be reduced with the consent of the employer. No time in lieu I work at St Vincent’s Private Hospital Darlinghurst. I was interested in using time in lieu of overtime but I was told I had too much annual leave. Does that make sense? Clause 29(xii)(d) of the St Vincent’s Private Hospital Nurses’ Enterprise Agreement 2019 stipulates that a full time nurse with an annual leave balance of more than 8 weeks (pro-rata for a part-timer) will be paid for any overtime worked and time in lieu will not be made available to them.

THE LAMP DECEMBER 2019/JANUARY 2020 | 35

SOCIAL MEDIA

Do you have a story to tell? An opinion to share? Nurse Uncut is a blog written by everyday nurses and midwives. We welcome your ideas at nurseuncut@nswnma.asn.au outright rejection of harm minimisation strategies. https://www.nurseuncut.com. au/gladys-berejiklian-is-clearlyputting-politics-before-lives-why-isupport-pill-testing/

New on our Support Nurses YouTube channel

BANKSTOWN RALLY FOR SAFE STAFFING Nurses and midwives at Bankstown-Lidcombe Hospital came together to fight for increased staffing in their Emergency Department. http://bit.ly/ bankstown-oct-rally

Didn’t get a new grad offer? Don’t panic – here’s what you can do! Check out Nurse Uncut’s top 7 tips for getting a nursing or midwifery job when you haven’t been offered a new grad position. https://www.nurseuncut. com.au/didnt-get-a-new-grad-offerdont-panic-heres-what-you-can-do/

The International Council of Nursing has again committed to the United Nations’ SDGs. https://www.nurseuncut.com.au/ nurses-reaffirm-commitment-tosustainable-development-goals/

OCTOBER IS SAFE WORK MONTH NSWNMA General Secretary Brett Holmes speaks about the Association’s actions for Safe Work Month, which will highlight the issues of violence in healthcare. http://bit.ly/safework-2019

Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association www.facebook.com/nswnma Ratios put patient safety first www.facebook.com/ safepatientcare Aged Care Nurses www.facebook.com/ agedcarenurses Look for your local branch on our Facebook page www.facebook.com/nswnma Follow us on Twitter @nswnma / @nurseuncut Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma! 36 | THE LAMP DECEMBER 2019 /JANUARY 2020

Nurses reaffirm commitment to Sustainable Development Goals

5 things to know if you got a new grad offer And if you did get an offer, here are the things you should know before you start. https://www.nurseuncut.com. au/5-things-to-know-if-you-got-anew-grad-offer/nurse-blakes-5-toptips-for-new-grads/

Life between the flags New Grad nurse John shares his experiences of anxiety, catching yourself, and “living between the flags” as a nurse fresh out of uni. https:// www.nurseuncut.com.au/lifebetween-the-flags-johns-new-gradexperience/

Why I support pill testing Nursing academic and public health advocate Margie Harris tells Nurse Uncut why she’s disappointed with the Berejiklian Government’s

Listen to our podcast Infant Mental Health – Fran Chavasse http://bit.ly/ infant-mh-1

SOCIAL MEDIA

your

Say

Dealing with inappropriate behaviour Nurses Kate and Grace shared their stories with us on being sexually harassed at work. You were very supportive with their calls for safer working environments. Wow, I was so disgusted to hear what management said to her about making a complaint! I hope she went to the union! I would have resigned on the spot and told them to shove their job! I work in aged care. We always have two staff with inappropriate residents. I would have refused to go into his room alone as it is unsafe! As a care worker, I was assaulted twice (not hurt, but inappropriately touched) by clients. They honestly thought it was their right. Both times I stepped back and raised my voice sharply and told them no. I reported to my manager immediately and refused to go back. I was lucky enough to have a really good one who supported me and only sent male care workers in after this. It is sad that we have to even consider taking

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

any action against those who are otherwise considered fragile and are themselves at risk. But we do. The system is so broken and it’s letting down every single person down horribly! I’m still a student nurse. On my first placement in a stroke ward, I was helping an old man pull his pants up after going to the toilet as he was paralysed on one side. While I was kneeling down to get his pants to pull up, he used his good hand to rub my shoulder and tell me how long it’s been since he has had a pretty girl near him like that. I told an RN and he told me to take it as a compliment. I was asked by a 50-yearold to dry his feet. Back then we wore caps. He started flopping his genitals up and down on my head the moment I bent to dry his feet. Now that I’ve moved to aged care it is even worse. It’s absolutely not okay to assault anyone, especially those who are literally trying to save lives! It’s not okay to work anywhere where you feel unsafe! No one had the right to mistreat you or put hands on you! NO ONE!

Incredulity over health cuts Plans to cut $250 million from our health system – including $150 million directly from our LHDs – were leaked to the media. You were appalled by this decision from the government.

the gallery

I work in this industry and honestly, we can’t work safely with any more cuts. This is people’s lives we are talking about! Are you kidding me? The system is already struggling with staffing at the moment. The government should be ashamed of themselves. They have to do something about putting people lives as a top priority. No more mucking around – it’s time for action. What is going on? If this is true, I hope I don’t have to go to hospital any time soon. Health is the last place we should be seeing cuts. Gladys Berejiklian is at it again! She said she wasn’t going to touch health – now she’s after more cuts! It won’t bother Berejiklian because even if she had to use the public system she would get the red carpet rolled out. As a nurse who works in the public system I can say that budget cuts will definitely risk and ultimately probably cost lives. The system is already at breaking point!

/5 1/ Nurses and midwives from the Murrumbidgee LHD rally for safer staffing in their local area 2/ Hannah presents local MP Phil Donato with over 2000 signatures in support of health services at Parkes and Forbes 3/ Nurses and midwives at Griffith Base Hospital say it’s time to Stop the Violence 4/ Wyong ED nurses commemorate the end of Safe Work Month 5/ Mudgee Hospital nurses celebrate Perioperative Nurses Week with a bit of cake

THE LAMP DECEMBER 2019/JANUARY 2020 | 37

THE NEXT EVOLUTION OF the lamp IS COMING… From 2020, we’ll be launching Lamp Online, covering all the issues that are important to you. But don’t worry, you’ll still get your print copy 6 times a year.

CHECK OUT

www.thelamp.com.au

REGIONAL HOSPITALS

Rural towns fight to save services page 10

PRIVATE HOSPITALS

WORKPLACE VIOLENCE

Leave rights protected at St Vincent’s Health

Time for action on violence

page 14

page 16

NSW NURSES THE MAGAZINE OF THE ION AND MIDWIVES’ ASSOCIAT 2019 VOLUME 76 NO. 6 JULY

38 | THE LAMP DECEMBER 2019 /JANUARY 2020

NURSES

REGULARS at work Your rights and entitlements Nurse Uncut – your stories said What nurses and midwives Nursing research online

NURSING RESEARCH AND PROFESSIONAL ISSUES Australian Journal of Primary Health integrates the theory and practice of community health services and primary health care. The journal publishes high-quality, peer-reviewed research, reviews, policy reports and analyses from around the world. Articles cover a range of issues influencing community health services and primary health care, particularly comprehensive primary health care research, evidence-based practice (excluding discipline-specific clinical interventions) and primary health care policy issues.

The central concept of empowerment in Indigenous health and wellbeing Samantha Bobba: Australian Journal of Primary Health 25(5) 387-388 While difficult to define and undoubtedly more difficult to ensure, empowerment is a concept that is central to closing the gap in Indigenous health and wellbeing. The unresolved anger and loss associated with the targeted discrimination, dispossession of land, forcible separation of families and systematic disempowerment of Indigenous people in Australia’s colonial history has had unequivocal effects on the health and wellbeing of Aboriginal and Torres Strait Islander people and continues to have intergenerational effects (Brock 1993; Australian Institute of Health and Welfare 2015). Aboriginal and Torres Strait Islander people have a strong sense of spirituality, cultural tradition and kinship, community values, connection to and understanding of the natural environment, and an extraordinary political strength, all of which are a testament to their resilience as a community in spite of the hardships they have endured. Moving forward from Australia’s colonial past requires more than just economic resources and affirmative action policies, rather, it requires a dedication to empowering Aboriginal and Torres Strait Islander people to enable the realisation of self-determination in relation to health and wellbeing. http://www.publish.csiro.au/py/ Fulltext/PY18097 p.33 p.37 p.37 p.39

Management or missed opportunity? Mental health care planning in Australian general practice Michelle Banfield, Louise M. Farrer and Christopher Harrison: Australian Journal of Primary Health 25(4) 332-338

According to the National Health Survey, type II diabetes affected 4.1 per cent of Australians and 20 per cent experienced a mental health issue in 2017–18 (Australian Bureau of Statistics 2018). However, despite the prevalence of mental disorders, effective access and care management remain a major concern. General practice care plans were introduced into the Australian healthcare system to serve two purposes: (1) to facilitate access to multidisciplinary health care for people with chronic health conditions; and (2) to assist GPs to manage the ongoing care of people with these conditions (Department of Health 2014). Under this model, GPs are eligible to receive Medicare Benefits Schedule (MBS) payments to prepare and review plans, which involves working collaboratively with consumers to determine their healthcare needs. Chronic disease management (CDM) plans replaced Enhanced Primary Care (EPC) plans in 2005, and were introduced to enable GPs to plan and coordinate the health care of people with chronic medical conditions, such as type II diabetes (Department of Health 2014). Under the Better Access to Psychiatrists, Psychologists and General Practitioners (Better Access) initiative (introduced in November 2006) (Littlefield and Giese 2008), GPs can claim for the creation and review of a mental health care plan, which is designed to encourage collaborative care between GPs, consumers and other service providers, and to provide streamlined access to psychiatrists, psychologists and other health professionals (Department of Health 2018a). The current research aimed to examine care planning for diabetes and mental disorders from both records of GP encounters and consumer experiences. http://www.publish.csiro.au/py/ Fulltext/PY18150

Factors influencing selfmanagement in patients with type 2 diabetes in general practice: a qualitative study Julie Dao A C , Catherine Spooner A , Winston Lo B and Mark F. Harris A: Australian Journal of Primary Health 25(2) 176-184 Over the past three decades, the prevalence of diagnosed type 2 diabetes mellitus (T2DM) has tripled, with 1.26 million Australians currently living with T2DM. T2DM is a progressive chronic disease, which requires effective management to prevent complications. In Australia, general practice plays a key role in supporting self-management. Selfmanagement involves the patient working in partnership with their healthcare providers and carers so they can understand their condition and treatment options; engage in care planning and health promotion activities (e.g. diet, physical activity); and monitor and manage the signs and symptoms of T2DM. However, the 2016 Diabetes MILES-2 Survey of 1265 Australians with T2DM identified that recommended self-management behaviours were not routinely practised by all. It is well established that health behaviours are determined by a complex range of individual and environmental factors. The aim of this qualitative study was to explore the factors influencing selfmanagement of T2DM in patients attending general practices in South West Sydney (SWS) from both a patient and provider perspective. A secondary aim was to assess how consistent the findings were with the socio-ecological model. http://www.publish.csiro.au/py/ Fulltext/PY18095

THE LAMP DECEMBER 2019/JANUARY 2020 | 39

INSURANCE BENEFITS

For NSWNMA Members

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

Journey Accident Insurance provides cover for members who are injured as a result of an accident while travelling between their home and their regular place of employment. Professional Indemnity Insurance provides legal representation and protection for members when required. Make sure your membership remains financial at all times in order to access the insurance and other benefits provided by the NSWNMA.

Unsure if you are financial?

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

www.nswnma.asn.au 40 |

IMPORTANT NOTE From 1 December 2018 the insurance benefits have changed as follows: • Journey Accident Insurance: the waiting period for benefits is now 14 days • Professional Indemnity Insurance: the limit per claim is now $5 million THE LAMP DECEMBER 2019 /JANUARY 2020

CROSSWORD

test your

Knowledge 1

14 15

19 21

26 27 28

29 30

34 35

ACROSS 1. Any repeated physical or verbal conduct that causes another person distress (10) 6. To expand (6) 10. Deformity (13) 11. A solid residue of tobacco smoke (3) 12. Inflammation of a bone and its periosteum (16) 15. A condition where bits of the tissue similar to the lining of the uterus grow in other parts of the body (13) 19. Repetitive complex movements used to relieve anxiety (6)

21. Relating to personal peculiarities or mannerisms (13) 23. Needle Valve (1.1) 24. Lymph node (1.1) 25. Come together (4) 26. The lymphatic tonsils (8) 27. To move back and forth (10) 28. Gradually recede (8) 30. Agent with antimitotic activity, formerly used as a palliative treatment for leukaemia (8) 31. Leptocyte (5.4) 35. Insufficiency, deficiency (10) 36. An instrument that is used to test lung capacity (10)

DOWN 1. Inflammation of the pericardium accompanied by excessive accumulation of serous fluid (17) 2. Readjust (5) 3. Wing-shaped (7) 4. A small rodent (5) 5. The joint of the lower jaw (17) 7. Belonging to or situated within, the body or part of the body (9) 8. The bodyâ&#x20AC;&#x2122;s development of intolerance of the antigens on its own cells (10) 9. A pair of hearing organs (4) 13. Inkblot test (9.4) 14. Sick (3) 16. Occurring every day (5) 17. Earlier form of words (5) 18. The condition of gleaming with bright and changing colours (11) 20. Reluctance, unwillingness (10) 22. Continuous (7) 25. A powerful painkiller and narcotic drug (8) 29. Insulin shock therapy (1.1.1) 32. Radioactive iodine (1.1.1) 33. The conscious sense of the self (3) 34. Choriolysin L (1.1.1)

THE LAMP DECEMBER 2019/JANUARY 2020 | 41

Welcome to

Improved communication channels and engagement

MEMBER CENTRAL

Seamless access to membership details Functionality at your fingertips

THE NEW ONLINE SYSTEM FOR NSWNMA MEMBERS

Unique NSWNMA member login with email

Create your new member login account & you could win a trip to Bali! Log on to online.nswnma.asn.au and create your login to be automatically entered in the draw to win a 5 night holiday to

THE TRANS RESORT BALI, SEMINYAK

You and a friend will enjoy: • Five nights’ accommodation in a Premier Room • Return airport transfer • Breakfast daily for two • One x Friday night buffet or set dinner for two • One x Sunday Yum Cha for two • One x 30 minute massage for two • 20% off Food & Beverage.

The NSWNMA will arrange and pay for return flights for two to Denpasar, Bali.

online.nswnma.asn.au

log on and create your login from 1 Feb 2019 – 31 Jan 2020 and you will automatically be entered in the draw to win.

Prize drawn 1 Feb 2020

Full terms and conditions are available at www.nswnma.asn.au/nswnmamembers/contests-and-promotions Conditions apply. Prize must be redeemed by 31 January 2021 and is subject to room availability. Block out dates: 23 – 29 January 2020 , 21 – 31 May 2020, 1 June – 31 July 2020 and 23 December 2020 – 6 January 2021. Competition opens on 1 February 2019 and closes 31 January 2020. The prize will be drawn 42 | on THE LAMP DECEMBER 2019 /JANUARY 2020 1 February 2020. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/02955

REVIEWS

book club

All books can be ordered through the publisher or your local bookshop.

INT

SPE C

ST RE

S PE

E IALUluru Finding the Heart of the Nation – The journey of the Statement towards Voice, Treaty and Truth

Thomas Mayer Hardie Grant Publishing: booktopia.com.au RRP $29.00: ISBNC 9781741176728 I

AL Since the Uluru Statement from the Heart was formed in 2017, Thomas IN T E Mayor has travelled around the country to promote its vision of a better future for Indigenous Australians. He’s visited communities big and small, often with the Uluru Statement canvas rolled up in a tube under his arm. Through the story of his own journey and interviews with 20 key people, Thomas taps into a deep sense of our shared humanity. The voices within these chapters make clear what the Uluru Statement is and why it is so important. And Thomas hopes you will be moved to join them, along with the growing movement of Australians who want to see substantive constitutional change. Thomas believes that we will only find the heart of our nation when the First Peoples – the Aboriginal and Torres Strait Islanders – are recognised with a representative voice enshrined in the Australian Constitution.

The Mitford Scandal Jessica Fellows

Hachette Australia: amazon.com.au RRP $23.82 ISBN 9780751573930

The newly married and most beautiful of the Mitford sisters, Diana, hot-steps around Europe with her husband and fortune heir, Bryan Guinness, accompanied by maid, Louisa Cannon, as well as some of the most famous and glamorous luminaries of the era. But murder soon follows, and with it, a darkness grows in Diana's heart.

Dear Life: a doctor’s story of love and loss Rachel Clarke Hachette Australia Published date 28/01/2020: amazon.com.au RRP $32.99: ISBN 9781408712887

Rachel Clarke grew up spellbound by her father’s stories of practising medicine. Then,

as a doctor herself, one who specialised in palliative medicine, she found herself contemplating all her training had taught her in the face of her own beloved father's mortality. If there is a difference between people who know they are dying and the rest of us, it is simply this: that the terminally ill know their time is running out, while we live as though we have all the time in the world. In a hospice, therefore, there is more of what matters in life – more love, more strength, more kindness, more smiles, more dignity, more joy, more tenderness, more grace, more compassion – than you could ever imagine.

Amelia and Me. On deafness, autism and parenting by the seat of my pants Melinda Hildebrandt

Agincourt Publishing: booktopia.com.au RRP: $49.50 ISBN 9780994649126

The powerful story of a mother facing the many

ups and downs of raising her deaf and autistic daughter, Amelia. Together they approach life’s challenges with humour, hope, compassion and love. This is an intensely private story told with brutal honesty; it is also a mustread for anyone who has walked a similar road to theirs.

Working Class Man Jimmy Barnes

Harper Collins Publishers: dymocks.com.au RRP: $35.00 ISBN 9781460754207

It’s a life too big and a story too extraordinary for just one book. Jimmy Barnes has lived many lives – from Glaswegian migrant kid to iconic front man, from solo superstar to proud father of his own musical clan. In this hugely anticipated sequel to his critically acclaimed bestseller, Working Class Boy, Jimmy picks up the story of his life as he leaves Adelaide in the back of an old truck with a then unknown band called Cold Chisel. THE LAMP DECEMBER 2019/JANUARY 2020 | 43

l e g n i r Kris K e Awesom

NSWNMA Water Bottle $15

gift idea

Madrid Sunhat $25

NSWNMA Royal Blue or Red Cap $15

ORDER VIA

MEMBER CENTRAL

Spend over $6 to receiv0 e

FREE POSTAG

E $10 postage for orders $60 and under

Registered and Enrolled Nurse members of the Association are invited to apply for an OPWC Aged Care Scholarship The NSW Nurses and Midwives’ Association is pleased to announce a new round of the Old People’s Welfare Council (OPWC) Scholarships, opening for application on 13 January 2020.

The scholarship will cover the cost of a one-year subscription to the ANMF online Aged Care Training Room from 1 June 2020 to 31 May 2021, valued at $110 per scholarship.

WHO MAY APPLY 1 Registered or Enrolled Nurses;

The ANMF online Aged Care Training Room provides nurses whose area of practice is aged care in the residential or community setting with the opportunity to remotely meet their Continuing Professional Development (CPD) requirements for national registration.

2 You must be currently working in aged care;

TO APPLY

3 A financial member of the NSWNMA; 4 You must be currently registered with the Nursing and Midwifery Board of Australia; 5 The scholarship is open to Australian citizens and permanent residents.

The ANMF online Aged Care Training Room provides access to over 60 online CPD courses that you may access across a 12-month period.

1 Read the Scholarship Information and Terms at www.nswnma.asn.au/education/ scholarships 2 Complete the official OPWC Scholarship application form 3 Submit your completed application to the NSWNMA by the scholarship closing date 5pm, Tuesday 31 March. FOR ENQUIRIES, please contact the Association on 1300 367 962 or (02) 8595 1234

The Scholarship program is due to a generous grant by the Old Peoples Welfare Council Ltd to the NSW Nurses and Midwives’ Association. The Scholarships aim to enhance the care of older people by supporting the undertaking of further studies by nurses who would then apply their learning in their aged care work. 44 | THE LAMP DECEMBER 2019 /JANUARY 2020

REVIEWS

at the movies

A Beautiful Day in the Neighbourhood

Writer-director Greta Gerwig (Lady Bird) has crafted a Little Women that draws on both the classic novel and the writings of Louisa May Alcott. It unfolds as the author’s alter ego, Jo March, reflects back and forth on her fictional life. In Gerwig’s take, the beloved story of the March sisters – four young women each determined to live life on her own terms – is both timeless and timely. Portraying Jo, Meg, Amy, and Beth March, the film stars Saoirse Ronan, Emma Watson, Florence Pugh, Eliza Scanlen, with Timothee Chalamet as their neighbour Laurie, Laura Dern as Marmee, and Meryl Streep as Aunt March. In cinemas 1 January, 2020 Email The Lamp by 20 December to be in the draw to win one of 10 double passes to Little Women thanks to Sony Pictures. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

MEM AL

R BE

RUR

Email The Lamp by 20 December to be in the draw to win one of 10 double passes to A Beautiful Day in the Neighbourhood thanks to Sony Pictures. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

GIV E

Little Women

Tom Hanks portrays American children’s television icon Mister Rogers in A Beautiful Day in the Neighbourhood, a timely story of kindness triumphing over cynicism, based on the true story of a real-life friendship between Fred Rogers and journalist Tom Junod. After a jaded magazine writer (Emmy winner Matthew Rhys) is assigned a profile of Fred Rogers, he overcomes his skepticism, learning about empathy, kindness, and decency from America’s most beloved neighbour. In cinemas 23 January, 2020

Secret Bridesmaids’ Business

WIN

R BE

ME T

MEM RO

GIV E

A bride’s perfect wedding turns deadly after one of her bridesmaids unwittingly invites a malevolent stranger into their lives, triggering a life-threatening chain reaction that blows open a hidden world of intimate secrets. In this addictive, sixpart, romantic thriller, the power of female friendship could prove the difference between life and death. Email The Lamp by the end of December to be in the draw to win one a copy of Secret Bridesmaids’ Business thanks to Acorn. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win! THE LAMP DECEMBER 2019/JANUARY 2020 | 45

DIARY DATES

make a date

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

NEW SOUTH WALES

Please send event details in the format used here: event name, date and location, contact details – by the 5th of each preceding month. Send your event details to: lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space. Priority is given to non-profit professional events.

INTERNATIONAL

ACCCN NSW Critical Care Seminar

International Council of Nurses (ICN) Congress 2021

29 November 2019 Colombo House Theatres, UNSW, Randwick https://www.acccn.com.au/events/ event/nsw-critical-care-seminar-29november-2019

Abu Dhabi, UAE www.icn.ch/

The RHW Midwifery Conference: Tales of the Unexpected 28 Feb 2020 Royal Hospital for Women, Randwick www.royalwomen.org.au/rhwmidwifery EVENTS: INTERSTATE

The Alfred Pain Symposium 30 November 2019 Monash University, Melbourne, VIC https://painmedicine.org.au/

18th National Nurse Education Conference: Inspire, Motivate, Educate 28–30 October 2020 Gold Coast, Queensland https://www.ants.org.au

46 | THE LAMP DECEMBER 2019 /JANUARY 2020

EVENTS: REUNIONS

100 years of Celebration: Blue Mountains District ANZAC Memorial Hospital – Reunion of all past employees 6 pm, 15 February 2020 $65 per head – 3-course meal Carrington House, Katoomba 2780 RSVP: 10 January 2020 janejohansen@y7mail.com

Mater Misericordiae, North Sydney “Barrington’s Group” 40-Year Reunion. The Rocks Saturday 1 February 2020 Kate: 0448 494026

Advertise in The Lamp and reach more than 66,000 nurses and midwives. To advertise contact Danielle Nicholson 02 8595 2139 / 0429 269 750 dnicholson@nswnma.asn.au

CROSSWORD SOLUTION

TRAVEL

Fabulous holiday offers Can’t find what you’re looking for? Contact the Member Concierge desk to discuss the world on sale. To book email bookings@ubookdirect.com.au or call 1300 959 550. For all other packages, head to unionshopper.ubookdirect.com

Medhufishi Island Resort, Maldives

Escape Ritual Bali, Wellness Retreat Canggu

Medhufushi Island Resort, an all-inclusive 4 star resort surrounded by a spectacular lagoon in shades of turquoise and shimmering azure blue. Perfect to get away from it all and experience affordable, laid-back rustic at a Maldives resort.

Escape Ritual Bali is a luxury 5 star boutique retreat that aims to create space for those who are ready to tune out of the daily humdrum of life. Escape Ritual offers carefully curated retreats essential to maintaining harmony and balance in health and life.

Beach Villa – 5 nights $1499* (2 ADULTS)

Wellness package – 7 days / 6 nights $1899pp* (2 ADULTS)

• All-inclusive meal plan (Service charge, GST and Green tax included) • Island hopping and sunset tour for two guests • Morning fishing tour for two guests • 10% discount for spa treatments.

Discover Vanuatu Port Vila and Tanna, Vanuatu

• Choice of one of the focus packages: well-being, fitness, yoga, surf or space package • Return airport transfers • 6 nights’ accommodation in a Mediterranean luxury villa • 3 x daily healthy meals cooked by a professional in-house chef + 1 snack cooked on site (except dinners on Tues & Wed, which are nights out) • Villa facilities: 21 M infinity pool, TV/AV room, pool table • One massage per person.

Sanctuary Rarotonga On The Beach – Cook Islands

Only a few hours from Australia, Vanuatu is the perfect place to embark on your next holiday.

Best of Vanuatu – 7 nights $999*

(4 NIGHTS IN PORT VILA & 3 NIGHTS ON TANNA ISLAND FOR 2 ADULTS)

• 4 night stay at The Melanesian Hotel Port Vila (Orchid Room) • 3 night stay at The Whitegrass Ocean Resort and Spa Tanna (Ocean Double Room) • Daily tropical breakfast • Return airport transfers • Round Island Safari (full-day tour) for 2 guests • Daily guided snorkelling tour to Turtle Reef • Welcome cocktail & free Wi-Fi. * All travel deals are subject to availability. For black-out dates, high season surcharges and full T&C’s go to unionshopper.ubookdirect.com Medhufishi Island Resort: valid until 31 October 2020. Rate based on 2 adults during low season (1 May – 31 October 2020) Escape Ritual Bali: valid for travel until 15 May 2020. Rate based on 2 adults (twin share). Single supplement available Discover Vanuatu: Valid for travel until 31 March 2020. Rate based on 2 adults Sanctuary Rarotonga On The Beach: valid for travel until 31 March 2020. Rate based on 2 adults

Bout ique adult s- on ly 4.5 star beach resort. Located on the southwest coast of the island of Raratonga, offers adults-only boutique accommodation with absolute beachfront location.

Beachside Suite – 5 nights $999* (2 ADULTS)

• Daily tropical breakfast • Adults-only swimming pool + swim-up bar • BlueWater Grill, lobby bar, private candlelit dinners • Rarotonga’s best snorkelling in Aroa Lagoon Marine Reserve • Extensive complimentary activities: stand-up paddle-boarding, kayaking, snorkelling, tennis • SpaPolynesia • Adjacent to sister resort, The Rarotongan Beach Resort & Spa with direct access to all facilities and services. ADULTS ONLY

needed it. did it. loved it. Recruit a new member and go into the draw to win a 5 night Optimal Wellness Program for two at the Golden Door Wellness Retreat & Spa, Hunter Valley valued at over $6,000

THE 2019 – 2020

NSWNMA Member Recruitment scheme prize PRIZE DRAWN 30 JUNE 2020

The perfect place to reset your mind and body and gain a wealth of knowledge to create a healthier, happier and more motivated you. You and a friend will experience: • • • • • •

5 nights’ accommodation in a private villa Personal welcome consultation on arrival All nutritious meals and snacks Diverse selection of group ﬁtness activities, relaxation and mind-body classes Daily program of health education seminars and workshops Use of all the facilities including a heated indoor pool, outdoor pool, tennis courts, gymnasium, indoor activity studios and outdoor relaxation areas • Two luxurious spa treatments including one Classic Facial and one Swedish massage • One wellness consultation with your choice of: wellness coaching, meditation, yoga or standard personal training session • Access to all the spa facilities including steam room, spa bath and relaxation lounges. Guided by a team of health professionals, this program will give you a complete understanding of the art of skilful living and homegrown wellness – a results driven concept the Golden Door team is highly trained in. Optimise your goals to reach new heights in all aspects of your life.

Every member you sign up over the year gives you an entry in the draw! RECRUITERS NOTE: Join online at www.nswnma.asn.au If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form, so you will be entered in the draw.

Conditions apply. Prize must be redeemed by 30 June 2021 and is subject to room availability. Block out dates include all Australian and NZ school holidays and Christmas / New Year period. The Optimal Wellness Program commences Sunday through Friday each week. The prize will be drawn on 30 June 2020. Authorised by unclaimed B. Holmes, General Secretary, Nurses and Midwives’ 50 O’Dea Ave,date. Waterloo NSWPermit 2017 If a redraw is required for an prize it mustNew beSouth heldWales up to 3 months fromAssociation, the original draw NSW no: LTPM/19/04224.