The Lamp December 2020

WAGES

REGIONAL NURSING

AGED CARE

REGULARS

Picking the pockets of nurses and midwives

Regional nurses have their say

Time to reward aged care workers

page 18

page 24

page 28

Your rights and entitlements at work p.35 Nursing research online p.43 Crossword p.45 Reviews p.47

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 77 NO. 6 DECEMBER 2020 / JANUARY 2021

COVID-19

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CONTENTS Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including The Lamp subscriptions and change of address, contact our Sydney office.

Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au Hunter Office 8–14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962 For all editorial enquiries, letters and diary dates T 8595 1234 E lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148

VOLUME 77 NO. 6 DECEMBER 2020 / JANUARY 2021

8

COVER STORY

NSWNMA recognised for going “above and beyond” in workplace safety

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 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.

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10

COVER STORY

REGULARS

COVID in the air that we breathe COVID-19’s airborne transmission poses a challenge to hospital infection control, says an Australian biosecurity expert.

12

5 6 26 35 36 38 43

COVER STORY

Life-saving PPE is non-negotiable Protection from airborne infectious disease requires respirators and effective, professional fit testing.

18

PHS PAY CAMPAIGN

Picking the pockets of nurses and midwives NSW Treasurer, Dominic Perrotet, thinks a miserly 0.3 per cent pay increase for the next 12 months followed by a pay cap of 1.5 per cent in following years is “completely fair and very generous”. Nurses and midwives think otherwise.

22

SOUTHERN NSW LHD RESTRUCTURE

Senior positions saved in restructure Members got organised to influence a restructuring plan for the Southern NSW Local Health District.

24

Editorial Your letters Competition Ask Judith What’s on News in brief Nursing Research Online and Professional Issues 45 Crossword 47 Book Club 49 At the Movies

WAGES

REGIONAL NURSING

AGED CARE

REGULARS

Picking the pockets of nurses and midwives

Regional nurses have their say

Time to reward aged care workers

page 18

page 24

page 28

Your rights and entitlements at work p.35 Nursing research online p.43 Crossword p.45 Reviews p.47

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 77 NO. 6 DECEMBER 2020 / JANUARY 2021

REGIONAL NURSING

28

Regional nurses have their say Nurses in country NSW will tell city-based decision makers how their local health services can be improved.

AGED CARE ROYAL COMMISSION

COVID-19

Time to reward aged care workers Royal commission lawyers call for mandatory staffing ratios, significant wage increases and a greater role for registered nurses in aged care.

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OUR COVER: Souraya Farah IMAGE: SHARON HICKEY

THE LAMP DECEMBER 2020 / JANUARY 2021 | 3

Mary Seacole

(23 NOVEMBER 1805 – 14 MAY 1881)

“….and the grateful words and smile which rewarded me for binding up a wound or giving a cooling drink was a pleasure worth risking life for at any time.”

Mary Jane Seacole (née Grant) was a pioneering nurse and heroine of the Crimean War. As a woman of mixed race, she overcame a double prejudice.

Born in Jamaica from a Scottish father and a Jamaican mother, Mary learned her nursing skills from her mother, who kept a boarding house for invalid soldiers.

Although technically 'free', being of mixed race, Mary and her family had few civil rights – they could not vote, hold public office or enter the professions.

In 1854, Mary travelled to England, and approached the War Office, asking to be sent as an army nurse to the Crimea where there was known to be poor medical facilities for wounded soldiers. She was refused. Undaunted Seacole funded her own trip to the Crimea where she established the British Hotel near Balaclava to provide ‘a mess-table and comfortable quarters for sick and convalescent officers’. She also visited the battlefield, sometimes under fire, to nurse the wounded, and became known as ‘Mother Seacole’. Her reputation rivalled that of Florence Nightingale.

Photo courtesy of Mary Seacole Trust. Authorised by B.Holmes. General Secretary, NSWNMA

4 | THE LAMP DECEMBER 2020 / JANUARY 2021

torical nurses g hidiswives n i t b r a nd m Cele a

EDITORIAL

BRETT

Holmes GENERAL SECRETARY

Safety is the number one priority In a difficult and dangerous year, the safety of nurses, midwives and patients has been our overriding concern.

At the end of this strange year, full of uncertainty, light is appearing at the end of the tunnel.

Evidence that several vaccines are showing signs of strong effectiveness against COVID gives us reason for hope that the threat of coronavirus will be reducing in 2021. The massive task of immunizing the world lies ahead but at least the prospect of having vaccines to do it with is uplifting.

While it seems like it has been a very long year, truth be told, the vaccines have been developed in a breathtakingly short time.

It is a powerful reminder, thrilling really, of the potential of science and medicine to solve enormous problems confronting humanity when they are backed by political will and appropriate resources.

COVID has also laid bare the effectiveness of global health systems in a crisis – for better and for worse.

In the United States we have seen the worst. In the richest country on the planet more than a quarter of a million people have died from the coronavirus with more than 12 million infected.

For the US health system, and the nurses working within it, COVID is an unmitigated disaster.

A fragmented and unevenly resourced system combined with political ineptitude has put patients and health staff at a risk that is unconscionable.

A recent survey by National Nurses United, revealed more than 70 per cent of US hospital nurses said they were afraid of contracting Covid-19 and 80 per cent feared they might infect a family member.

More than half said they struggled to sleep and 62 per cent reported

‘Underinvestment in health and the health workforce poses mortal threats to the community and to the economy.’

feeling stressed and anxious. Nearly 80 per cent said they were forced to re-use single-use, PPE, like N95 respirators. Nearly 1400 US health staff have died from the virus.

that COVID has brutally exposed globally: that underinvestment in health and the health workforce poses mortal threats to the community and to the economy.

Australia is up there among the countries who have dealt best with the pandemic thanks to a world class health system, a skilled and dedicated health workforce and an effective, evidence-based strategy.

Yet, unfortunately, there are signs that some politicians have not learnt these lessons.

Even Victoria, the state hit hardest, is one of the few places in the world to have overcome a substantive second wave.

In NSW, nurses and midwives should be proud of their achievements during this testing year. You have been “the safe pair of hands” throughout.

NSWNMA members have not only contributed to the safe environment for patients and the community through their daily work but also through effective campaigning they have brought about enduring safety improvements to the health system with better PPE and the use of fittesting as a norm.

It was pleasing to see these achievements recognised in the SafeWork awards (see pp 6-7).

Despite Australia’s success in dealing with COVID, there is no room for complacency and lessons still need to be learnt.

The insulting pay cap imposed by the NSW government on nurses and midwives as a “reward” for their valiant efforts at the frontline of COVID is one such sign.

The policy paralysis in aged care and failure to invest in improved nursing care in that troubled sector is another.

It was instructive to see that the counsel assisting the Royal Commission into Age Care point out in their final report how nursing unions have been sidelined by the federal government, even though they have been advocating for the obvious improvements to care needed to provide a safer environment for elderly Australians, and have been doing so for a long time (see pp 22-23).

It is high time politicians listened to what nurses and midwives, and their representatives, have to say about safety in our health and aged care sectors. They are at the frontline and know what they are talking about. n

Governments need to realise this success did not come through luck.

They need to fully grasp the reality THE LAMP DECEMBER 2020 / JANUARY 2021 | 5

YOUR LETTERS

Have your

Say

LETTER OF THE MONTH

The government doesn’t appreciate our sacrifices As a nurse, you just cannot walk out at finishing time like you can in a lot of other professions.

You need compassion to be a nurse. A premier, apparently, does not Shame on you, Premier!

During this pandemic, nurses and other frontline workers have put their physical, mental and financial wellbeing on the line.

You pay lip service to us and thank us for our contribution, then reward us by cutting our promised wage rise, and freezing future wage rises.

You represent everything that is wrong with this country!

It is the same old story: the rich get richer and the poor get poorer.

Why don’t you and your fellow politicians take a pay cut and save the country some money?

You should climb down from your ivory tower and walk a mile in our shoes.

You wouldn’t last one day as a nurse. You don’t have the compassion and dedication that is needed.

You will never get my vote!

Robyn Mason, EN

What happens when there are no staff to hand over to?

Who will care for your loved one who may be coming into hospital distressed or suicidal?

Yes, we do mandatory overtime. This becomes a requirement, rather than an option, as you cannot leave a distressed or suicidal person.

We can’t ask them to come back tomorrow as they may not be alive, so we stay to make sure they are safe.

We are very short of qualified mental health nurses, so it is up to the team to fill the extra shifts. And yet, I cannot believe that we have been offered just 0.3 per cent this year.

This makes me feel like we are not appreciated by the government for all we do for our communities.

So, I ask our premier: if it was your loved one who was suicidal, wouldn’t you want a qualified clinician assessing them? Because I hope you appreciate what we do to make sure your loved one is safe.

Raelene Costello, CNC

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

Call the NSWNMA on 1300 367 962

and find out how you can access this great service 6 | THE LAMP DECEMBER 2020 / JANUARY 2021

Offices in Sydney and Newcastle with visiting offices in regional areas (by appointment)

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.

Let’s not give up I have noticed there continues to be comments from members (not many, but they’re out there) asking what “the union” is doing about various issues, particularly regarding the wage freeze at the moment. I think it’s timely to remind everyone that we are all “the union”.

Yes, we have elected leaders and a body of paid employees working for us, tirelessly, I might add. However, the fact remains that the New South Wales Nurses and Midwives’ Association is just that - all of us.

Historically, unions came about to improve the conditions of workers.

This remains the case today. It needs everyone one of us to be active, out in our workplaces and communities, raising consciousness about the

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.

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

issues important to us – for example, nurse/midwife-to-patient ratios and fair rates of pay. The definitions of a union are: • The action of joining together or the fact of being joined together, especially in a political context.

• A society or association formed by people with a common interest or purpose.

Both these definitions apply to us all. We need everyone committed and active to make sure the NSW government does not continue its current disrespectful behaviours towards our professions.

Now is not the time to give up.

To do so is to play into the NSW government’s end game – that we’ll do just that: give up. They know how valuable we are and this year, like no other, has shown them that they can’t do without us.

Elizabeth McCall, RN

Letter of the month The letter judged the best each month will win a $50 Coles Group & Myer gift card!

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Union Shopper offers members BIG savings on a wide range of products! unionshopper.com.au 1300 368 117

Saying it like it is in aged care I would like to congratulate NSWNMA General Secretary, Brett Holmes, on his article “Aged Care’s Moment of Truth”.

The crisis in aged care has been years in the making, from when untrained nurses working in dementia were not adequately skilled to deal with patients and residents.

It takes years of university study and hospital training to understand what dementia actually is.

A great article for the Year of the Nurse and Midwife. Thank you, Brett, for saying it like it is.

Jancey McLean, NSWNMA Retired Member Activist Group The Council of the NSW Nurses and Midwives’ Association has considered the unprecedented events of 2020, along with the NSW Government unsatisfactory wage increase of 0.3% awarded to nurses and midwives and have voted not to increase membership fees in 2021.

Advertise in The Lamp and reach more than 69,000 nurses and midwives.

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

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THE LAMP DECEMBER 2020 / JANUARY 2021 | 7

COVER STORY

NSWNMA recognised for going “above and beyond” in workplace safety The Association wins SafeWork award for supporting members on the COVID-19 frontline.

T

he NSWNMA has received the top union award in the 2020 SafeWork NSW Awards for “outstanding work health and safety support to members in the changed working environment due to COVID-19”.

Em ma Hoga n, Se cret a r y, Department of Customer Services, which hosted the awards, said this was an occasion to “celebrate those workplaces that have gone above and beyond in what has been one of the most challenging years”.

The coronavirus had demanded “for ward thinking and rapid innovation” of organisations when practising work health and safety, she said.

NSWNMA General Secretary, Brett Holmes, said the Association appreciated the recognition for our efforts to ensure NSWNMA members across the public, private and aged care sectors were kept up to date as the COVID-19 situation evolved rapidly.

“When the biggest global health pandemic in 100 years is hurtling towards you, you have a duty to your members to ensure they have

8 | THE LAMP DECEMBER 2020 / JANUARY 2021

‘When the biggest global health pandemic in 100 years is hurtling towards you, you have a duty to your members to ensure they have exactly what they need to be safe in the workplace, but to also maintain the safe care of their patients and residents.’

— NSWNMA General Secretary, Brett Holmes

exactly what they need to be safe in the workplace, but to also maintain the safe care of their patients and residents,” he said.

“We recognised early that access to personal protective equipment (PPE) was a big problem, not just in the public hospital system, but also in the private sector and aged care, so we were quick to open channels of communication and get issues resolved as promptly as possible.

“The issue of fit-testing P2 and

N95 masks worn by our members was another major concern and we’ve achieved improvement, with almost all Local Health Districts committing to fit-testing programs in their public hospitals. The increased fit-testing of clinical staff will go beyond COVID19, improving respiratory protection for nurses long after the virus disappears.”

Assistant General Secretary, Judith Kiejda, said the award showed the union’s commitment to support members, “so nurses and

COVER STORY

midwives can continue their selfless work”.

“Access to leave was an issue we were determined to tackle quickly. We wanted to ensure the health and wellbeing of our members was properly considered, given the unknown territory they were working in responding to COVID-19,” she said.

“Thousands of nurses and midwives were forced to respond rapidly and absorb new workplace policies at short notice. They have lived, breathed, and continue to work through the pandemic response till today.” n

Find out more Safer Work Safer Care For resources that will assist you promote and maintain a safe environment at work go to: https://www.nswnma.asn. au/safer-work-safer-care/

COVID calls for clear communication and organisational agility COVID has emphasised the need for foresight, the highest levels of protection for health staff and patients, and the importance of local capacity to produce PPE. Veronica Black, the NSWNMA’s health and safety officer, told the online audience at the SafeWork awards that education was the key to our COVID-19 efforts.

Communication had been important to meet members’ needs, she said.

Expanded online resources on the member portal and The Lamp online delivered FAQs, WHS and workforce updates. Facebook videos and live Q&As also addressed WHS issues.

Sector-specific emails and PPE webinars and educational resources were used to give COVID advice and to educate members around the correct use of protective equipment.

The COVID crisis also required a level of organisational agility and an openness to collaborate, Veronica said.

“We extended our hours of operation and set up WhatsApp groups.

“We sought advice from the highest levels – not only governments but also the Centre for Disease Control in the United States and the World Health Organization.

“We sought advice from other unions – anyone and everyone – to make sure we were as up to date on the information as we possibly could be.

“Some of the things we are proud of are that there has been an increase in PPE availability, substandard PPE has been removed from workplaces and we’re now seeing the start of fit-testing for all nurses wearing P2 or N95 masks at work,” she said.

Veronica also pointed out how COVID had highlighted the importance of local capacity to manufacture PPE. THE LAMP DECEMBER 2020 / JANUARY 2021 | 9

COVER STORY

COVID in the air that we breathe COVID-19’s airborne transmission poses a challenge to hospital infection control, says an Australian biosecurity expert.

S

tudies that show the SARSCoV-2 virus can travel as far as 4.8 metres are challenging the 1.5-metre rule for physical distancing, according to Professor Raina MacIntyre, the Head of the Kirby Institute’s biosecurity program.

Professor MacIntyre spoke to Association members at a safe work webinar last month.

She says one study showed a viable virus 16 hours after aerosolisation. Another found the virus could be detected “everywhere – on the floor, the bedrails, on locker handles, the cardiac table, electric switch, the chair, the toilet seat and flush, and the air exhaust vent” in a hospital setting.

Large droplets emitted by infected patients travel much further than conventionally thought, Professor MacIntyre said. While the WHO has defined “large droplets”, which are assumed to fall close to the patient, as anything greater than five microns, Professor MacIntyre argues that droplets up to a hundred microns can potentially be airborne.

“Droplets that are less than a hundred microns will stay in the air and can be inhaled. But there’s

10 | THE LAMP DECEMBER 2020 / JANUARY 2021

this belief in hospital infection control that only … smaller airborne particles [travel a] great distance. The notion that one or two metres is a safe distance is therefore an ‘arbitrary rule’,” she said.

contact with the infected.

The initial response to the virus from the WHO was to focus on its spread by droplets and direct contact, Professor MacIntyre said.

In an outbreak documented in China, the virus travelled well beyond the five people first infected on the 15th floor of a building.

“But the WHO response wasn’t based on any evidence; it was only based on an assumption.”

One recent study has found that some of the earliest studies that did not detect viable virus in the air were using air sampling methods that appeared to kill the virus. A more recent study “used a different kind of air sampler and found a viable virus in the air samples up to 4.6 metres in the absence of aerosol generating procedures”.

SPEAKING TRANSMITS MORE THAN COUGHING Known outbreaks of coronavirus have also clearly demonstrated airborne transmission. In one case somebody was infected after passing by the open door of a patient room multiple times. Other infections have occurred on buses and restaurants, despite people having no close

“Other outbreaks include a choir where people rehearsed indoors for two and a half hours with physical distancing and [yet] 86 per cent of them got infected.”

“There was a vacant apartment on the 16th floor and the bathroom of that apartment was covered in virus … which means it became aerosolised through the sewage pipes and then deposited. People on the 25th and 27th floors also got infected,” Professor MacIntyre said.

“The transmission of SARS-CoV-2 really is about the air we breathe,” Professor MacIntyre said.

While we may think of coughing and sneezing as two key sources of virus transmission, in absolute terms far greater amounts of virus are emitted when people are speaking, singing or shouting, she says.

“The total amount of aerosol that’s generated is probably far greater from speaking and breathing because those things happen constantly. Whereas sneezing and coughing happen very occasionally.”

COVER STORY

AEROSOLS ACCUMULATE IN CLOSED SETTINGS The virus can build up in the air of an infected patient’s room.

“Essentially, one minute of loud speaking can produce thousands of droplets per second. And at least a thousand virus-containing droplet nuclei could remain airborne for more than eight minutes. Opening a window will disperse the aerosols, but unfortunately, many health facilities don’t have windows that can be opened.”

Professor MacIntyre cited one study that investigated the effect of HEPA air purifier filters in classrooms. Without air purifiers, the concentration of the airborne virus will increase in a closed room, whereas if you add an air purifier it decreases substantially.

Professor MacIntyre said: “I think we need to shift our mindset from transmission being a one hit event where somebody sneezes and this ballistic droplet comes and lands on your eye or in your nose, to [understanding] a more cumulative exposure.

“In a closed setting, where there’s no good ventilation, the aerosols are just going to keep accumulating like cigarette smoke, but you can’t see it.

The longer you’re in that closed space, the greater your risk, and that risk is there just from patient’s breathing or speaking.”

Ordinar y air c ond it ion i n g recirculates the air rather than bringing in fresh air. An effective air conditioning system in the presence of SARS-CoV-2 needs to replace and purify the air, she said.

Because the virus is shed in faeces, toilets are another huge risk.

When toilets are flushed’ you “get massive upward aerosolisation of virus particles”.

Since many hospital toilets do not have lids, there is the “potential for 40 to 60 per cent of the particles to rise above the toilet seat lid, leading to widespread contamination in bathrooms. Once aerosolised, this material can be deposited on surfaces and then re-aerosolised by human activity, like shaking out the bedsheets.”

Professor MacIntyre urged hospital staff to lobby for lids on all toilets.n

‘ We need to shift our mindset from transmission being a one-hit event where somebody sneezes and this ballistic droplet comes and lands on your eye or in your nose to understanding a more cumulative exposure.’ — Professor Raina MacIntyre

Watch the webinar https://youtu.be/oHPk6WIG7YQ THE LAMP DECEMBER 2020 / JANUARY 2021 | 11

COVER STORY

Life saving PPE is non-negotiable Protection from airborne infectious disease requires respirators and effective, professional fit testing.

A

ppropriate masks and fit testing for all workers should be mandator y in all health settings, Dr Michelle Ananda-Rajah, a Melbourne physician in general medicine and infectious disease at the Alfred Hospital in Melbourne, told Association members in a recent workplace health and safety webinar.

“Life-saving” protection for health care workers should be nonnegotiable, she said.

“The work we do is unpredictable, it’s manual, it’s heavy. You really need to be confident in your respiratory protection when you’re working with patients.”

Loose-fitting surgical masks designed to stop “splash and splatter from the surgical field coming onto the face of the surgeon, or spillage from the surgeon onto the surgical field”, do not provide the wearer with adequate protection for airborne viruses, she said.

Different masks provide different levels of filtering. While an N95 mask 12 | THE LAMP DECEMBER 2020 / JANUARY 2021

‘When the Victorian second wave kicked off in July healthcare workers in the hundreds started getting sick.’ filters at 95 per cent with an adequate tight seal, a P3 mask filters at 99.9 per cent.

P rotec t ion f rom a irbor ne i n fe c t iou s d i s e a s e re qu i re s respirators and effective, professional fit testing. Pandemic guidelines written at the start of the year by the infection control expert group avoided the problem, she said.

“They basically said that in the context of a pandemic, fit testing will be difficult due to limited supplies and a range of types and sizes. The guidelines are saying that fit testing is in the too-hard basket. We’re not going to invest in your safety.”

Early guidelines deemed that “a surgical mask was appropriate to see suspected and confirmed COVID patients”.

But when the Victorian second wave kicked off in July “healthcare workers in the hundreds started getting sick. Healthcare workers started falling like f lies [and] hundreds were furloughed”.

FIT TESTING EVALUATES DURING MOVEMENT-BASED TASKS Fit testing is formal mask evaluation that can be compared to a stress test, Dr Ananda-Rajah says.

As you talk, jog and move, the test assesses how compatible a mask is for a healthcare worker.

“If you’re a nurse, you’re washing a patient or you’re turning them over, it’s manual work, and you really need to be certain or confident that your respirator is going to stick and be stable.”

COVER STORY

Insist on getting fit tested Veronica Black, the NSWNMA work health and safety officer, says the NSWNMA campaigned strongly for fit testing for all staff who require the use of P2 or N95 masks at work.

“Fit testing is now being rolled out throughout New South Wales health facilities.

“We’re going to continue to advocate for P2 or N95 masks for all staff who are providing care to people who are suspected, or confirmed, as having COVID-19, not just for people who might be involved with aerosol-generating procedures.”

With some LHDs yet to finalise their roll out, “we need to put the pressure on”, she said. She urged members to contact their local branch officials, or the Association office, to make sure fit testing is rolled out within their facilities.

A fit test is more reliable than a fit check; the latter doesn’t take into account movement-based tasks. A fit check is “where you just don your mask and you blow in and you blow out and feel for any sort of gross leakage around your face”.

Because faces come in different shapes and sizes there is no one-size-fits-all solution.

Duckbill masks tend to be the ones that fail fit tests on the majority of people, even though they are among the most commonly offered to health workers.

“About 70 to 80 per cent or more will fail. And yet for all of my career, the duckbill is the only thing I’ve ever been given.”

Research has found that “when you have a reasonable range [of] masks or respirators, you can actually fit test most of your staff,” she said.

A South Australian study found that offering four different types of respirators would successfully fit test about 90 per cent of staff. An important qualifier is that the study found that while there was no difference in the failure rates between male and female faces, “Asian faces failed at a higher fail rate than Caucasian faces”.

“An experienced fit tester is able to look at your face and pick a respirator that is more likely to fit you.” n

THE LAMP DECEMBER 2020 / JANUARY 2021 | 13

COVER STORY

A champion for safety A violent incident on the day Fadi Ramadan started a nursing position sparked a passion for workplace safety.

“On my first day, a patient came from behind me and tried to strangle me with a TV cord,” Fadi said.

“This wasn’t an isolated incident. We are a small hospital and it includes some patients with dementia. It’s challenging as you don’t know where or when aggression will occur.”

Fadi’s experiences led him to become a champion of workplace health and safety in his hospital.

“I don’t want similar issues happening to others, as the result could be tragic. I became a health and safety representative (HSR) because I’m passionate about the wellbeing and safety of my workmates.”

While in some workplaces becoming an HSR involves nominations from staff and a ballot, it was a simpler process in Fadi’s workplace.

“I had already been involved in health and safety work, so I was chosen by my colleagues to take on the role in an official capacity.”

Fadi takes care to involve his work colleagues and consult with them regularly in his role.

“Being part of a larger organisation means that we have got to work together to be safety conscious.

“As an HSR I help with the workplace inspections that we do at Bulli Hospital & Aged Care Centre (BHACC). We don’t wait for something to happen, we try to be proactive, not reactive.”

14 | THE LAMP DECEMBER 2020 / JANUARY 2021

Fadi added that his role is to “give staff a voice to express their concerns. We then work to come up with a solution to fix an issue. If an issue comes up, I try to solve it straight away, and if I can’t, I’ll speak to the line managers.”

The NSWNMA also provides Fadi with resources and support.

“It gives me confidence knowing that if a colleague has a question, I can either answer them or point them in the right direction or ask an official in the association.”

He added: “It’s really nice to meet awesome people who support me across the NSWNMA organisation as well.”

Under the Work Health and Safety Act 2011 (WHS Act), Health and Safety representatives are entitled to five days’ paid training per year.

Fadi says he would “like to develop my environmental health and safety knowledge, including equipment tagging, fire safety, hazardous substances, security and personal protective equipment”.

When asked what advice he would give someone considering becoming an HSR, Fadi says: “I would say go for it! It brings confidence working in an environment that is safe for staff and patients, and knowing you are helping the organisation in a role that helps ensure that safety.” n

‘I became a health and safety representative (HSR) because I’m passionate about the wellbeing and safety of my workmates.’

— Fadi Ramadan

COVER STORY

How to improve safety at your workplace There are strong reasons for NSWNMA members to become HSRs: • to represent members of your work group when it comes to health and safety matters in your workplace and have those views considered • to help keep your employer compliant with their WHS obligations under the WHS Act • to improve staff safety, which is directly linked to patient safety in the workplace.

FORM A WORK GROUP A work group consists of workers who share similar workplace health and safety interests and conditions, for example, nurses on a unit. Work groups are established through negotiations with the employer.

NSW workers have a legal right to seek the establishment of a work group and to negotiate an agreed number of HSR positions to represent those work groups.

The NSWNMA can help you with this process.

ELECT A HEALTH AND SAFETY REPRESENTATIVE It is up to the members of the work group how they will elect HSRs or Deputy HSRs. The process may be informal (a show of hands) or follow a more formal process (ballot papers and ballot box).

If more than one employee is nominated for a vacant HSR or Deputy HSR position, an election needs to take place within the workplace.

All employees in the work group are eligible to vote in this election.

GET HSR TRAINING An elected HSR is entitled to attend SafeWork NSW-approved training of their choice, including a five-day HSR training course and a one-day refresher training course once a year.

HSRs are entitled to time off work with pay and the costs associated to attend the course to be paid by the employer, in accordance with the WHS Act. The NSWNMA runs SafeWork NSW-approved and HSR training to help you learn to become an effective HSR. HOW THE ASSOCIATION CAN HELP The NSWNMA has a team of dedicated WHS professionals and experienced industrial officers and organisers, who can provide you with support and guidance.

Contact the NSWNMA about HSR training courses or for other support:

8595 1234 (metro) 1300 367 962 (non-metro)

Become a Health and Safety Rep

Create change in your workplace. www.nswnma.asn.au

FIND OUT MORE If you want to find out more about becoming a Health and Safety Representative, download our guide from the NSWNMA website: https://www.nswnma. asn.au/wp-content/ uploads/2019/09/ BecomeHSRv1.pdf THE LAMP DECEMBER 2020 / JANUARY 2021 | 15

COVER STORY

Voices for our safety Health and Safety Representatives have the backing of strong health and safety policies and procedures to enforce workplace safety.

M

ental health nurse Danica Ivankovic knows from first-hand experience why nurses need to be able to speak up about workplace safety.

In 2019, Danica was assaulted and injured by a patient at Bungarribee House acute mental health unit.

A 20-year veteran of Bungarribee, she had long been concerned about deteriorating safety conditions.

“Our safety was going downhill but staff were scared to report issues. I knew we needed to speak up more,” she said.

After time off work, Danica became a workplace health and safety representative (HSR) for Blacktown Mental Health Service, which covers three units including Bungarribee.

Soon after she took on the role in 2020, four nurses were injured when a Bungarribee patient became violent and the duress alarm failed during an afternoon shift.

One nurse suffered broken ribs, however the injured were initially denied permission to attend the emergency department 16 | THE LAMP DECEMBER 2020 / JANUARY 2021

‘Our safety was going downhill but staff were scared to report issues. I knew we needed to speak up more.’ — Danica Ivankovic because the unit would have been left short-staffed.

They are backed by HSRs specific to each unit.

When Danica came on night shift she debriefed and advised injured staff as they wrote IIMS (Incident Information Management System) reports.

“We are supposed to be talking to management about staffing but they are used to coming and telling us what they are going to,” she said.

An investigation by SafeWork NSW recommended that staff in future be allowed to immediately go off duty to get treatment.

Danica is able to attend to safety issues as they arise. She is paid if she has to attend to WHS matters on her days off.

Other recommendations included a review of staff numbers.

“I encourage staff to report safety incidents because it’s everyone’s right and responsibility to be safe.

It is Danica’s role to help monitor implementation of the recommendations. She and a fellow HSR cover health and safety at all three units within the service.

“Some staff won’t file incident reports because they don’t want to be seen as a trouble maker or they believe that it doesn’t go anywhere and is either changed or

COVER STORY

HSRs have legal rights and powers Health and safety representatives (HSRs) are nurses, midwives and assistants in nursing who create change to improve the health and safety of their workplaces.

HSRs HAVE FIVE KEY POWERS UNDER THE WORK HEALTH AND SAFETY ACT:

For more information on the NSWNMA Violence App visit https:// www.nswnma.asn.au/nswnmamembers/ nswnma-app-for-smartphones/ deleted. As a HSR I’m happy to speak up if others feel they might be bullied or harassed.”

Danica is also Blacktown City Mental Health Branch President of the NSWNMA. She says she gets strong support from the NSWNMA which offers training to HSRs. She has learned that NSW Health policies and procedures on work health and safety are actually very strong.

“All nurses have a right to be safe at work whether it be in mental health, emergency, in-patient units or out in the community and the role of HSR teaches you your legal rights and responsibilities.

“We are entitled to tell management when they are going against their own policies and the law. The job of HSR has given me more confidence to raise these issues.” n

They can: • inspect any part of the workplace after giving reasonable notice, or immediately in the event of an incident • accompany a SafeWork NSW inspector during an inspection at your workplace • require a health and safety committee to be established and be a member of the committee • seek the assistance of any appropriate person on health and safety matters whenever necessary • issue PINs (Provisional Improvement Notices) and directions to cease work.

FIVE RIGHTS OF HSRs UNDER THE WHS ACT 2011:

HSRs have the right to: • be consulted about WHS matters in your workplace and be provided with hazard-related information by your employer • request a review of control measures under regulations (such as manual handling, noise, prevention of falls and confined spaces) • take time off work with pay to attend training and to exercise HSR powers • be provided with necessary facilities and assistance in your role as HSR • ability to escalate an WHS matter that remains unresolved after consultation requirements have been followed.

Let us know If you are already an HSR or Deputy HSR let us know so we can provide you with support and advice in your role: Phone: 8595 1234 (metro) or 1300 367 962 (non-metro) Email: gensec@nswnma.asn.au

THE LAMP DECEMBER 2020 / JANUARY 2021 | 17

PHS PAY CAMPAIGN

Picking the pockets of nurses and midwives NSW Treasurer, Dominic Perrotet, thinks a miserly 0.3 per cent pay increase for the next 12 months followed by a pay cap of 1.5 per cent in following years is “completely fair and very generous”.

Nurses and midwives think otherwise.

T

he Berejiklian government has dealt a double whammy to nurses and midwives by taking fair wage increases off the table for the foreseeable future.

The government announced in the budget that a paltry 0.3 per cent pay increase over the next 12 months will be followed by a pay cap of 1.5 per cent in future years.

“I think if you look at our wages policy here in NSW compared to anywhere else in the country, it’s completely fair and reasonable and very generous,” the NSW Treasurer, Dominic Perrotet, told The Sydney Morning Herald.

NSWNMA General Secretary, Brett Holmes, rubbished this claim.

“If the NSW Treasurer thinks paying a pittance to the health workforce that stopped COVID-19 in its tracks is ‘fair and generous’, he must be living in a parallel universe to the nurses who have put their lives on the line for the wellbeing of this state this year,” he said.

The government’s latest wage policy comes after an attempt earlier this year to impose a public sector wage freeze.

In May, the Association along with other public sector unions brought the case before the NSW Industrial Relations Commission

18 | THE LAMP DECEMBER 2020 / JANUARY 2021

‘ At a time when the Berejiklian government should be investing in nurses and midwives’ wages and securing the future of our health workforce, they are locking NSW into a low-wage, low-growth future.’ — Brett Holmes, NSWNMA General Secretary after the government ignored members’ claims for a new Award and with a 2.5 per cent wages cap still in place.

After a campaign across the state, and with the support of local businesses in communities where the spending by public sector workers is vital for economic recovery, MPs blocked the freeze in the upper house.

The government consequently argued vigorously for a zeropercentage increase in the NSW Industrial Relations Commission.

The Commission ruled a 0.3 per cent wage increase for the next 12 months to 30 June after years of 2.5 per cent wage increases.

In 2021, members will be forced again to argue our case in the Commission for anything above zero up to 1.5 per cent.

A LOW-WAGE LOWGROWTH FUTURE Brett said the government’s new wage policy was flawed economics and ran contrary to the global trend to stimulate economies out of the COVID-induced downturn.

“At a time when the Berejiklian government should be investing in nurses and midwives’ wages and securing the future of our health workforce, they are locking NSW into a low-wage, low-growth future,” he said.

Brett said the NSW Government was an outlier in Australia, with other states boosting the wages and conditions of their nursing and midwifery workforces.

“Why wouldn’t a nurse or midwife want to f lee to Queensland or Victoria where they can work with better pay and legislated nurse-topatient ratios?

PHS PAY CAMPAIGN

The pittance Perrotet thinks you should be thankful for This is what a 0.3 per cent increase means for nurses and midwives in NSW:

$2.90 $3.60 $4.50 $5.20 Assistant in nursing Enrolled nurse 7 cents/hour or 9 cents/hour or $2.90/week $3.60/week

“Queensland, Victoria and South Australia have all managed to recognise the contribution of their public sector workforces with modest increases, yet the Berejiklian government refuses to acknowledge their worth in NSW.” NSW Opposition leader, Jodi McKay, said the government’s attack on public sector wages was an act of economic vandalism and a betrayal of public sector workers.

“The Treasurer is picking the pockets of workers to pay for his economic mismanagement,” she said.

‘ The Treasurer is picking the pockets of workers to pay for his economic mismanagement.’

— Jodi McKay

Registered nurse (5th year) 12 cents/hour or $4.50/week

Registered nurse (8th year) 14 cents/hour or $5.20/week

Other states reward their nurses and midwives

Taking the fight up to the government

NSW stands alone in the Commonwealth in targeting nurses and midwives to carry the brunt of the economic fallout from the coronavirus.

• In South Australia, nurses and midwives have reached agreement on two per cent increases per year over the next three years.

• In Victoria, nurses and midwives will receive a three per cent increase in December 2020.

• In Tasmania, public sector nurses and midwives received a 2.3 per cent pay rise from 1 December 2019, to be followed by a 2.3 per cent, a 2.35 per cent, and a 2.35 per cent increase in the following years to 2023.

• Queensland has delayed a 2.5 per cent pay rise for the public sector this year. But unlike NSW, Queensland is proposing to catch up by paying two increases next year.

Nurses, midwives and other public sector workers have not taken the government’s attack on our wages lying down. Over the past few months we have: • blocked the regulation in parliament, convincing most non-Coalition MPs to support us – a huge achievement • advertised on TV and radio throughout the state and received significant coverage in TV, radio, print and online news • secured support from over 300 businesses with our “Nurses and Midwives shop here” action • sent over 15,000 emails to local MPs and upper house backbenchers.

THE LAMP DECEMBER 2020 / JANUARY 2021 | 19

PHS PAY CAMPAIGN Two NSWNMA members tell The Lamp how devastated they are that their efforts and professional work to deliver safe patient care in public hospitals has been ignored, particularly during COVID-19.

The government’s “little trinket” is insulting Debbie Ross, Branch Secretary of the Sydney Hospital, Sydney Eye Hospital Branch, After Hours CNE. “The initial reaction from staff to the 0.3 per cent pay increase at our site is that they were gutted.

They felt there was no respect for the work that had been done during COVID. The government announced the agreed 2.5 per cent increase wouldn’t be passed on even after the police commissioner was given a wage increase of $87,000.

“A lot of nursing staff are now their family’s only breadwinner after their spouse lost their job because of COVID, so they were relying on that 2.5 per cent to come through.

It would have been a glimmer on the horizon.

“Now the government is telling us they will provide free tickets to frontline workers to attend the New Year’s Eve fireworks display.

But there are staff who will have to work on New Year’s Eve, and others who won’t be interested in attending a function where social distancing can’t be guaranteed. It is about giving a little trinket. And it’s highly doubtful you’re going to make a trip if you are in a regional area.

“I’ve spent more money travelling to and from work during COVID. Instead of catching public transport to work, I am driving my car because I just don’t feel safe going on public transport now, when train carriages are very empty after hours.

“Early in the pandemic I also felt ostracised when I wore my uniform outside work, and lots of nurses who were wearing uniforms were being accosted.

“Some people weren’t wanting to tell people where they worked because

20 | THE LAMP DECEMBER 2020 / JANUARY 2021

of the anxiety in the community when the virus first hit.

“Our branch has organised a rally outside Parliament House and we did a radio interview. On 16 November, we attended a rally with public sector unions, to protest under the Tree of Knowledge in the Domain.

“Nurses were feeling really angry.

There was a heightened feeling of a lack of respect for and acknowledgement of the work we’ve done; particularly fire fighters and health workers who lost their homes in the bushfires and still went in to look after people during the fires.

“At no stage did anyone say ‘We are not going to look after patients’.

“We still did it even though we were scared. Now we hear we are only going to get a 1.5 per cent increase in the future. It will affect our ability to pay off homes and save for retirement.

“At the end of the day, they had the money to pay the increase, but they chose not to. It’s an absolute slap in the face.”

‘At no stage did anyone say ‘We are not going to look after patients’.

We still did it even though we were scared.’ — Debbie Ross

PHS PAY CAMPAIGN

Give honour where honour is due Suzie Melchior, Branch Secretary of the Ballina Hospital Branch and RN in Emergency.

“My first thought when I heard the rumours going around that they might not honour the opportunity for us to achieve a pay rise was that I felt insulted.

“It’s not even about the pandemic; it is about the role we play in our communities and giving honour where honour is due. As Australians, we congratulate people and pat them on the back, and the only way the state government can do that is by honouring the pay increase to be in line with inflation and increased costs of living.

“Right at the beginning when we heard that we would have to go to arbitration, I spoke to reporter Joanne Shoebridge on ABC North Coast Radio one morning, and the Northern Star made us their second-last front page spread before they finished. Back then, no-one had heard that nurses and teachers who had been through one of the most stressful years of their lives weren’t going to get a pay rise.

“In the first six months of this year, there was a sense of uncertainty.

My own husband had to go back to his first trade as a baker for four and a half months during the period when his regular employer reduced his days from five to three.

“We’re just one example of many.

I feel embarrassed talking about not getting a pay rise when people have lost all their income, and campaigning for a pay rise when I know there are local cafes and musicians who have had no income and had to line up in the job queue.

“That is a situation I didn’t expect to be in, but our community supports one another, and I was making sure

‘It’s not even about the pandemic, it is about the role we play in our communities’ — Suzie Melchior that I put my money where my mouth is as one of the first to line up at local cafes when they opened.

“The farcical thing is that we are now going to get gift cards to spend $25 to go out. If the government just honoured the pay rise, they could start to talk about the impact they could have on the economy.

“We are a huge tourist area around Ballina, Byron Bay and the North Coast. Even though COVID wasn’t an immediate threat for us, as far as having local cases, we’ve been as busy as we’ve ever been at the Ballina Hospital and in emergency.”

THE LAMP DECEMBER 2020 / JANUARY 2021 | 21

SOUTHERN NSW LHD RESTRUCTURE

Senior positions saved in restructure Members got organised to influence a restructuring plan for the Southern NSW Local Health District.

N

SW NM A member s in the Southern NSW Local Health District (LHD) have mobilised to save senior nursing positions threatened by a proposed management restructure.

Memb er s s ou g ht to be involved in discussions over the restructuring plan and obtained major improvements.

The finished plan retains nine of the 12 nurse manager and nurse unit manager positions originally proposed to be deleted.

It also preserves the position of LHD Director of Nursing and Midwifery and several Deputy DON (director of nursing) positions, which were to be abolished.

The Southern NSW district has been under a restructuring cloud since plans were first announced in 2016.

A version released in August 2019 proposed to replace the position of District Director of Nursing and Midwifery with a ‘District Director of Quality, Safety and Patient Experience’.

It also proposed to delete several deputy DON positions and 12 NM (nursing manager) or NUM (nursing unit manager) positions.

Thirty-six other positions were affected by changes to gradings and reporting lines.

Opposition to these changes was led by the Southern NSW Nurse Managers’ Branch of the NSWNMA. A branch resolution said: “The 22 | THE LAMP DECEMBER 2020 / JANUARY 2021

nursing and midwifery workforce is the largest workforce within the LHD and to remove this (LHD DON) position demonstrates a total disrespect of our profession.”

Branch secretary Mona Timo said the branch decided to mobilise members to provide maximum input into discussions over the plan.

Organising discussions among members was difficult because the LHD incorporates 18 sites, including 12 hospitals, over a wide geographical area.

Southern NSW LHD hospitals include Bateman’s Bay, Bega, Bombala, Braidwood, Cooma, Crookwell, Delegate, Goulburn, Moruya, Pambula, Queanbeyan and Yass.

“There is no one-size-fits-all solution. The Monaro region is very different to the coastal areas and the northern area is different again,”

‘The NSWNMA gave strong support to our consultation efforts across the district and meetings were well attended.’

— Mona Timo

Mona said.

“However, through our branch teleconferences we were able to achieve a fairly united approach by the membership across the LHD. “ The branch was able to collect detailed feedback from members, which was put together

SOUTHERN NSW LHD RESTRUCTURE

NSWNMA gains in nursing management revamp NSWNMA members were heavily involved in consultations and negotiations over the Southern NSW LHD management restructure. In the final plan: with the help of NSWNMA staff.

The document summarising the issues from all the sites was very thorough.”

concerns and put forward realistic solutions. That got us over the line; we weren’t negative, we put forward ideas to improve the service.

LHD LISTENED TO A COORDINATED RESPONSE

“On the whole, I think the LHD listened because we got most of the things we asked for.

NSWNMA General Secretary, Bret t Holmes, sum ma r ised members’ concerns in a letter to the LHD executive.

He said the proposed move away from facility-based nursing management positions and the creation of sector DONs with remote responsibilities for several sites would create gaps in the management structure and impact service delivery.

He added that the erosion of nursing positions and structures would impact staff recruitment and retention.

The LHD agreed to form a consultative committee with the NSWNMA and set up a number of telemeetings for nurse managers.

“It was good that the LHD agreed to have these union-specific discussions and hear our issues,” Mona said.

“The NSWNMA gave strong support to our consultation efforts across the district and meetings were well attended.

“On the whole, our discussions with management were more mature and less antagonistic than in the past.

“Members appreciated the opportunity to discuss their

“Overall, the new structure is a great improvement on the earlier proposal and these gains were achieved by the active involvement of our members.”

Mona said the branch would meet to finalise its views when the LHD provided position descriptions and gradings.

The LHD executive has thanked NSWNMA members for their involvement in the restructuring consultations.

In a letter to the NSWNMA, Jill Adams, District Director People and Wellbeing, wrote: “Thank you again for your and the NSWNMA’s active involvement in the consultation process.”

In a message to staff, District Chief Executive Margaret Bennett said the LHD received more than 982 “pieces of individual feedback” and had input from more than 40 staff meetings across the district.

“I want to thank all staff and the industrial bodies for such an engaging final consultation. It was great to receive so much feedback from across the LHD,” she said.

“All of the feedback and the content of the discussions was carefully considered before finalising the document.” n

• the position of District Director of Nursing and Midwifery is secured • Deputy DON positions are secured; the LHD initially wanted to delete some of these positions and have one DON over several sites • the number of deleted NM and NUM positions has been reduced from 12 to three – two NMs and one NUM • staff whose positions are to be downgraded or phased out will have their salaries maintained for 12 months • some NM and NUM positions will be upgraded to reflect their roles and responsibilities • some positions that require clinical experience and skills and don’t fall directly under the nursing structure will be dual graded to broaden opportunities for nurses/midwives • nursing/midwifery reporting lines have been strengthened • the LHD has agreed to working groups to resolve day to day issues.

THE LAMP DECEMBER 2020 / JANUARY 2021 | 23

REGIONAL NURSING

Regional nurses have their say Nurses in country NSW will tell city-based decision makers how their local health services can be improved.

T

he NSWNMA will help members in rural and reg iona l NSW tell a pa rlia menta r y inquir y about their local health services.

The inquiry will investigate the condition of rural and regional healthcare, including barriers to services, staffing challenges, capital expenditure, planning systems and the gap in health outcomes depending on postcode across NSW. The NSWNMA will make a submission to the inquiry and has asked members to provide their experiences and views.

“Tell us about the challenges you and your colleagues face.

Your stories will help inform our submission,” said a union flyer distributed to members.

“Are there enough staff? Do you have access to quality health services? What are the wait times like? Do services accommodate for indigenous or culturally and linguistically diverse communities?

Is enough money being spent improving access to health services?”

Problems facing non-metropolita n nurses ca n include shor tages of bot h GPs a nd nursing staff, replacement of local GPs with remote video calls, no 24 | THE LAMP DECEMBER 2020 / JANUARY 2021

‘We’ve got a system that is really, really sick when it’s beyond the major cities.’

— Ryan Park

security services and police off duty late at night.

NSWNMA General Secretary, Brett Holmes, urged the Berejiklian government to fast-track the allocation of extra nurses and midwives across the state.

“The government must prioritise the roll-out of additional nurses and midwives it promised, instead of waiting until weeks out from the next state election in 2023,” he said.

“Our regional communities have faced ongoing battles with drought, severe water shortages, catastrophic bushfires and now further economic downturn thanks to COVID-19. They deserve access to the best health care possible, regardless of where they choose to live.

“For years, we’ve been calling for increased nurse-to-patient ratios across all public hospitals in NSW to improve safety and promote better patient outcomes, but the government continues to refuse to commit to mandatory

minimum staffing.”

Across NSW, thriving hospitals that were the largest employers in rural towns have lost vital services such as maternity and operating theatres.

While obesity, Type 2 diabetes and suicide are on the increase, diabetes services no longer exist at many sites, and community and mental health services have been scaled back.

Labor’s Shadow Minister for Health, Ryan Park, told Channel Nine’s 60 Minutes he wants all sides of politics to join forces to fix rural healthcare.

“We’ve got a system that is really, really sick when it’s beyond the major cities,” Park said.

“This is Australia in 2020; we should pride ourselves on having universal access to healthcare. At the moment, a postcode is determining the level of access to healthcare you get and that’s simply not right.” n

REGIONAL NURSING

Loss of doctor left nurses in the lurch Community angered over hospital’s reliance on telehealth Gulgong Multi-Purpose Service (MPS), 300 km northwest of Sydney, went without a doctor for more than four months this year after negotiations to renew his contract broke down.

News reports said Western NSW Local Health District wanted to reduce the doctor’s pay and make greater use of telehealth.

Nurses working two per shift were left to step into the breach.

With no medical support other than telehealth, they often had to choose whether to treat an acute patient in the emergency department, or answer a buzzer on the ward.

“We aren’t mind readers so we didn’t know whether the ward patient was lying in their own mess or whether they were lying on the floor,” said Gulgong’s NSWNMA branch president, Julie Hines.

MPS staff-to-patient ratios only apply to sub-acute beds, she said.

In September, 66-year-old Dawn Trevitt died at the MPS while being treated via telehealth, the ABC reported.

Her death prompted an outcry in the town and a petition to rehire the doctor received more

‘I told (Health Minister Hazzard) to come and talk to us nurses if he really wanted to understand the issues.’

— Julie Hines

than 3000 signatures.

The LHD agreed to rehire him in October.

Julie said nurses felt the brunt of the community’s anger following Mrs Trevitt’s death.

“Some people took it out on us because we are the only health staff they see. I went into a bakery with my nursing shirt on and I was verbally abused by customers and people behind the counter about when am I going to get a doctor for the MPS.” Julie wrote to NSW Health Minister, Brad Hazzard, after hearing him say he understood the problems facing rural health services.

“I told him to come and talk to us nurses if he really wanted to understand the issues.”

Julie says Gulgong nurses are fortunate compared to many of their rural colleagues.

“We have a brand new MPS, our general manager is very supportive of the nurses and our NUM comes onto the floor and works with us whenever possible.

“Dr Shannon Nott, Rural Health Director of Medical Services, came to see us and ask what he could do to help ease the pressure on us.”

Julie took the initiative to form a NSWNMA branch at Gulgong this year.

“We need the backing of the union and we will happily support other branches in dealing with their issues,” she said.

Have your say about

LOCAL HEALTH SERVICES A government inquiry is looking at health outcomes and access to health and hospital services in rural, regional and remote NSW. Input from local communities is encouraged. Now is your chance to share your experiences.

Are there enough staff? Do you have access to quality health services? What are the wait times like?

Do services accommodate for indigenous or culturally and linguistically diverse (CALD) communities? Is enough money being Submissions spent improving access to health services? close City-based decision makers need to hear your 13 December 2020 views to improve the delivery of health care.

Make a submission today, so your postcode stops determining your health outcomes.

Scan the QR code or go to

bit.ly/RRR-submission Authorised by B.Holmes, General Secretary, NSWNMA

THE LAMP DECEMBER 2020 / JANUARY 2021 | 25

COMPETITION

Season's Greetings FROM THE NSWNMA

Wishing our members a holiday season full of peace, joy, and happiness.

We invite you to be part of this year's giveaway.

Relax and unwind in luxurious accommodation at Château Élan at The Vintage Located in the heart of Hunter Valley wine country, the awardwinning Château Élan at The Vintage is Australia’s finest golf and spa resort. A destination as much for its breathtaking scenery as for its comprehensive offering, the resort offers luxury hotel style accommodation, four conference and event venues, an awardwinning spa and Greg Normandesigned golf 18-hole golf course.

Surrounded by vineyards and meandering cellar door wine trails, the hotel is perfectly positioned at just a short two-hour drive north of Sydney or 45-minute commute from Newcastle airport, making it as ideal for family holidays or a quick weekend away. To book visit www.chateauelan.com.au

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The Lamp is offering members the chance to win two nights’ accommodation in a Villa Studio with breakfast daily* *Conditions apply. Rooms subject to availability. Prize must be redeemed by 14 April 2021 (not valid between 12/12/20 - 15/01/21). Voucher is non-transferable, not redeemable for cash and must be presented on arrival.

eNurse – Australia’s leading online nurse shop

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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 to NSWNMA members!

Enjoy 10% off* all your purchases – 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 2021 for NSWNMA members.

26 | THE LAMP DECEMBER 2020 / JANUARY 2021

Experience the first floating bar and waterfront restaurant of its kind in Sydney

Forever change the way you eat, drink and play on Sydney Harbour.

We have partnered with Captain Cook Cruises and are offering you the chance to win one of two HARBOUR BAR double passes (Harbour Bar entry only) OR one of two HARBOUR RESTAURANT double passes (each pass includes 1 x main course).

Exclusive offer to NSWNMA members! Enjoy Harbour Bar entry for just $5pp (normally $29pp)* Simply use promo code L6EBL8A at checkout www.captaincook. com.au/sydney-harbour-cruises/ casual-dining *Conditions apply. Not valid in conjunction with any other offers / promotions and cannot be used on special event cruises (including but not limited to 25-31 December, 26 January and 14 February).

Offer valid until 28 February 2021 for NSWNMA members. Subject to availability.

enter o t How To be in the draw to win one of these fabulous prizes email your entry with subject: Christmas giveaway (prize title) to lamp@nswnma.asn.au including your name and membership number. A separate email is required for each prize.

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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. *Conditions apply. Competition entries from NSWNMA members only and limited to one entry per member per prize. All entries must be received by Thursday, 17 December 2020 with prizes drawn Friday, 18 December 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/20/05518.

Rest and relax in style on the banks of the Parramatta river – win an overnight stay at the PARKROYAL Parramatta

Get up close and personal with Australian wildlife at Featherdale Sydney Wildlife Park Located just outside of Blacktown, Featherdale Sydney Wildlife Park is home to the largest collection of Australian wildlife in the world.

With over 2,000 Australian animals across 260 species, it is testament to Featherdale’s mission to ‘always put animals first’. It's also home to the largest captive population of koalas in NSW, so you can enjoy personal Koala Encounters where you can pat a koala and learn more about this Australian icon.

Come and hand feed wallabies and kangaroos and so much more. Book today at www.featherdale.com.au Win one of 4 x family passes to Featherdale Sydney Wildlife Park* *Conditions apply. Family passes include 2 adults and up to 4 children. Tickets are valid for one single day use per family pass only. Unless otherwise stated, fees for food, merchandise, locker rentals, special concerts or events are not included in the passes. Prices and product offerings are subject to change without notice.

Holiday reading Relax with a three-book gift pack.

We have four gift packs (of three books each) to give away, including the following titles: Rising Heart by Aminata Conteh-Biger with Juliet Rieden. One woman’s journey from unimaginable trauma to a power for good.

7

5

The Lamp is offering members the chance to win one nights’ accommodation in a Deluxe Room including 3 course dinner for 2 (along with a bottle of house wine), breakfast daily and overnight parking* Go to www.panpacific.com/en/hotels-and-resorts/ pr-parramatta.html for more dining, event and accommodation details and bookings. *Conditions apply. Rooms subject to availability. Prize must be redeemed by 14 April 2021 (not valid on Public Holiday’s). Voucher is non-transferable, not redeemable for cash and must be presented on arrival.

Art-inspired gifts by Koh Living – the perfect gift this Christmas

6

Koh Living have created art-inspired gifts that are both meaningful and great value. When you give a loved-one a unique gift from Koh Living you can be sure it will be loved and used for years to come.

The Lamp is offering members the opportunity to win one of four beautiful care packs. We have two gorgeous ANNA packs, by Melbourne artist Anna Blatman valued at $154 each to giveaway and two FLOWERING GUM gift packs valued at $70 to giveaway.

Head to www.kohliving.com.au to discover gifts by established Australian artists and show your loved ones you care this Christmas.

The Bushfire Book: How to be aware and prepare

by Polly Marsden and Chris Nixon. A reassuring children book that teaches what they need to know about bushfires.

The Burnt Country by Joy Rhoades. An enthralling story of integrity, resilience and resistance.

The Last Voyage of Mrs Henry Parker by Joanna Nell. A missing husband, a failing memory, an unforgettable love story.

The Desert Midwife

by Fiona McArthur. An exciting adventure that leads to a terrible accident, with shattering consequences.

THE LAMP DECEMBER 2020 / JANUARY 2021 | 27

AGED CARE ROYAL COMMISSION

Time to reward aged care workers Royal commission lawyers call for mandatory staffing ratios, significant wage increases and a greater role for registered nurses in aged care.

S

enior lawyers assisting the aged care royal commission say it is “high time” the dedication and commitment of aged care workers was properly rewarded.

“The vast majority are women and the low pay they receive is nothing less than the aged care system exploiting the goodness of their hearts,” say counsel assisting Peter Rozen QC and Peter Gray QC. They argue that aged care workers “need better wages and conditions and enough colleagues to be able to complete their work safely and to the standard that they consider is appropriate”.

Rozen and Gray make the comments in a far-reaching plan to rebuild the aged care sector.

They recommend mandatory staff-to-resident ratios, significant wage increases and a greater role for registered nurses.

The recommendations are being considered by royal commissioners Tony Pagone and Lynelle Briggs, who will deliver their final report to the 28 | THE LAMP DECEMBER 2020 / JANUARY 2021

‘The low pay they receive is nothing less than the aged care system exploiting the goodness of their hearts.’ federal government in February.

Rozen and Gray’s 500-page submission says at least one in five residents have received “substandard care” under a system that “deprives people of their humanity”.

They cite a University of Wollongong report that on average, residents receive 180 minutes of care per day, of which 36 minutes are provided by RNs. Some nursing homes provide far less care time, particularly from registered nurses.

Their submission says the federal government must “exercise a leadership role in planning for the future needs of the aged care workforce. The sector has not done this and cannot be relied upon to do it in the future”.

PAY NEEDS TO INCREASE SIGNIFICANTLY They call for nursing homes to be required by law to deliver minimum adequate care standards.

On wages, the submission notes that governments have made several failed attempts to give additional funds to providers “in the hope that they would be passed on to aged care workers by way of increased wages”.

However, “Unless aged care workers have a legal right to be paid more, they won’t be. A new approach is needed. It will only succeed if all parties – providers, unions and government – work together.”

Rozen and Gray propose a “significant increase” to award pay rates through a step-by-step process.

By 2030, staff providing personal,

AGED CARE ROYAL COMMISSION

nursing and allied health care would be paid at “comparable levels to their counterparts working in the health and disability services systems”.

G over nment a ged ca re subsidies would be tied to “an explicit policy of increasing wages and improving working conditions for aged care workers”.

On training, the submission recommends an immediate injection of funds into the sector for education and training to meet “an urgent need for skills acquisition” among aged care workers.

By 2030, all personal care workers should be registered and accredited with mandatory Certificate III qualifications as a minimum.

All staff should receive better training in dementia care, and high-level infection control overseen by trained infection control officers “will be the norm”. n

Steps to better staffing

Listen to unions, lawyers say

The royal commission counsel’s proposed staffing recommendation is in two parts – a first step on 1 July 2022 and a second step on 1 July 2024.

The aged care sector “continues to undervalue the contribution” that unions can make, according to counsel assisting the royal commission Peter Rozen QC and Peter Gray QC. They point to several examples, including a lack of consultation with aged care workers’ representatives in April and May 2020 during the development of a visitors’ code for COVID-19.

They also cite the federal Aged Care Workforce Strategy Taskforce, which had 13 members, none of whom represented aged care workers.

“This lack of representation of aged care workers on bodies designed to make fundamental changes to their working lives is as self-defeating as it is perplexing,” they say.

“This sector and government blindspot stands in stark contrast with the experience of this royal commission, which has benefited greatly from a number of comprehensive submissions from unions with members working in aged care.

“A number of union officials have given evidence that has helped inform commissioners of the dayto-day challenges faced by their members who work in aged care.”

Step 1 would require providers to employ registered nurses, enrolled nurses, and personal care workers for at least 215 minutes per resident per day for the average resident, with at least 36 minutes of that staff time provided by a RN. In addition, the “minimum staff time standard” should require each facility to have at least one RN on site for the morning and afternoon shifts (16 hours per day).

In Step 2, the minimum would range from 215 to 264 minutes per resident per day for the average resident, with at least 44 to 36 minutes of that staff time provided by an RN. An RN would be employed on every shift.

These minimum standards would result in average staff increases of 20 per cent from 1 July 2022 and 37.2 per cent from 1 July 2024.

The final report is to be handed down in February 2021.

Read the counsel assisting the Commission’s final report

Read the Royal Commission’s special report on COVID

https://agedcare. royalcommission.gov.au/ hearings-and-workshops/ final-hearing

of COVID-19 on aged care, held in Sydney in August. https://agedcare.royalcommission.gov.au/sites/ default/files/2020-10/aged-care-and-covid-19-aspecial-report.pdf

Royal Commission into Aged Care Quality and Safety

Aged care and COVID-19: a special report

THE LAMP DECEMBER 2020 / JANUARY 2021 | 29

AGED CARE ROYAL COMMISSION

Pandemic fight needs more staff The Aged Care Royal Commission criticised the federal government’s lack of planning and leadership over COVID-19.

T

he a ge d c a re roya l commission has called on the federal government to im mediately f und additional staff in nursing homes to cope with the COVID-19 pandemic.

The commission criticised the government’s lack of a dedicated plan or clear leadership in the aged care sector’s handling of the emergency.

The commission delivered its special report on COVID-19 and aged care to the government in October.

The report called for more funding for staff so families could visit loved ones in care, and measures to provide allied and mental health services to residents.

The Morrison government said it accepted the recommendations and announced an initial $40.6 million in extra funding.

It also announced an additional $10.8 million “to enhance skills and leadership of aged care nurses” by expanding the Australian College of Nursing scholarship program, establishing an aged care practice program and creating “skills development programs for nurses and personal care workers in aged care”.

The government said it would further respond to the special report by 1 December.

Royal Commissioners, Tony Pagone and Lynelle Briggs, said they had decided to produce a brief report on COVID-19 in advance of

30 | THE LAMP DECEMBER 2020 / JANUARY 2021

‘It is clear to us that people receiving aged care services, their loved ones, those providing care and the aged care sector itself need immediate support and action.’

their final report to be delivered in February 2021.

They called the pandemic “the greatest challenge Australia’s aged care sector has faced. Those who have suffered the most have been the residents, their families and aged care staff”.

“It is clear to us that people receiving aged care services, their loved ones, those providing care and the aged care sector itself need immediate support and action,” they said.

T he y r e c om m e nde d t he government require providers to appoint “infection control officers” and said the government should arrange to put “accredited infection prevention and control experts” into nursing homes.

They said the government’s actions were “insufficient” to ensure the aged care sector was fully prepared for the pandemic.

They concluded: “There was not a COVID-19 plan devoted solely to

aged care. But there was a national COVID-19 plan that the Australian Government sought to adapt and apply to the aged care sector.”

All too often, the commissioners said, families, providers and health care workers “did not have an answer to the critical question: Who is in charge?”

The special report makes it clear that the government’s response to the pandemic in nursing homes was made largely without input from aged care experts.

For example, there was not a single aged care specialist among the 24 members of Communicable Disea ses Net work Aust ra lia, which is supposed to coordinate, lead and support best practice in the prevention and control of communicable diseases.

The special report makes it clear that authorities were too slow to recommend or mandate the use of face masks in aged care facilities. n

AGED CARE ROYAL COMMISSION

Championing education for COVID-19 Nursing home “infection control champions” are on the frontline of the aged care sector’s response to COVID-19.

R

egistered nurse Ai Tahara works for a major aged care provider that has ex per ienced COV I D -19 outbreaks at some facilities.

Ai’s own inner-Sydney workplace has escaped infection so far.

Her employer int roduced infection control champions last year, before the pandemic struck.

Ai describes them as “key re s ou rce s i n t he outbre a k management team. They conduct regular rounds to check that correct infection control procedures are being followed.”

Ai was appointed as an infection control champion three months ago and is about to start online infection control training for COVID-19.

T r a i n i n g for non- COV I D infectious diseases – gastro, scabies, pneumonia and urinary tract infections, for example – is limited to reading a manual.

Ai hopes her training will lead to improved observance of infection protocols.

“Infection control knowledge among staff, especially AiNs, is quite minimal,” she says.

The aged care royal commission has recommended the federal government deploy accredited infection prevention and control experts into nursing homes to provide training, assist with the preparation of outbreak management plans and assist with outbreaks.

It also recommended that all nursing homes have one or more

‘I don’t think education should only be for infection control champions. Providers know that education is vital, so why not extend it to all staff in some form?’ — Ai Tahara trained infection control officers as a condition of accreditation.

Ai believes all staff need some infection control training.

“I don’t think education should only be for infection control champions. Providers know that education is vital, so why not extend it to all staff in some form?”

According to researchers Philip Russo (Monash University) and Ramon Zenel Shaban (University of Sydney), nursing home infection control officers should have access to expert resources and be capable of implementing infection prevention programs.

“Employers would be required to support these nurses to take the infection prevention ‘champion’ role, and under the close supervision and guidance of the accredited experts, they could prepare plans for outbreaks like COVID-19,” Professors Russo and Shaban wrote recently.

“These plans would include ongoing education around the use of PPE, procedures regarding how to manage residents who become infected, and trigger points for

escalating responses.”

They said a recent survey of aged care facilities found more than half reported a lack of staff with specialised qualifications and experience in infection prevention and control.

Ai says the heavy workload borne by aged care staff is a major barrier to improving infection control.

“Our aged care minister said numbers are not the only issue with aged care, but he should know that staff increases are essential.

“Even without COVID, when you look into an incident at a nursing home, such as a fall, it often happens because of understaffing – no one is available to attend to the resident.”

Ai welcomes the call by counsel assisting the royal commission for nursing homes to be required by law to deliver minimum adequate care standards.

Counsel assisting urged the commissioners to recommend minimum staffing standards would result in average staff increases of 20 per cent from 1 July 2022 and 37.2 per cent from 1 July 2024. n THE LAMP DECEMBER 2020 / JANUARY 2021 | 31

AGED CARE ROYAL COMMISSION

Nursing homes told to open books Pressure is mounting on aged care providers to show how they spend taxpayer subsidies.

F

edera l M Ps who wa nt transparency in aged care funding are ma king a renewed attempt to force providers to reveal how they spend their huge government subsidies.

Centre Alliance party MP Rebekha Sharkie has introduced legislation known as the Aged Care Legislation Amendment (Financial Transparency) Bill 2020.

It would require providers to disclose their income, their spending on food and medication, the amount spent on staff and staff training, accommodation, administration, and how much they pay their parent bodies.

“This will enable families of loved ones, stakeholders and the public to have a clear view, for the first time, on the proportion of income that providers actually spend on costs of care and how much is just being pocketed or wasted,” Ms Sharkie said.

“Unlike hospitals and childcare centres, aged care facilities can employ as few staff as they like because there are no staff-to-resident ratios in nursing homes.

“We do not know how much they spend on staff, or what categories of staff they spend their money on.”

‘We do not know how much they spend on staff, or what categories of staff they spend their money on.’ — Rebekha Sharkie and National parties, with the support of One Nation, voted to defeat it.

Senator Griff said the federal government and One Nation were heavily lobbied by some aged care providers to block that “gamechanging” legislation.

“Sadly, it showed just how strong the ties that bind the aged care lobby and government really are. It was a deplorable act,” he said.

“The aged care industry has been successfully lobbying governments for years arguing against more transparency. The inf luence of the industry through government committees, think tanks and policies is well known and is being rightly questioned at the royal commission into aged care.”

TAXPAYERS’ MONEY – WITHOUT ACCOUNTABILITY

The bill mirrors legislation introduced by fellow Centre Alliance MP Stirling Griff last year.

In 2018–19, governments spent over $20 billion on aged care, with about 66 per cent of this going to residential care.

The ALP, Greens and Centre Alliance supported this 2019 attempt to legislate for financial transparency and accountability but the Liberal

Senator Griff says more funding is needed to fix aged care, but governments cannot simply pour money into the system without

32 | THE LAMP DECEMBER 2020 / JANUARY 2021

getting more accountability and transparency from providers.

“Currently, providers can spend their taxpayer subsidies pretty much as they choose,” he said.

“When it comes to food, a study of 800 nursing homes shows the average spend is just $6 a day.

“My office has heard firsthand accounts from people who work with and for aged care providers, highlighting that dodg y financial decisions and profiteering takes place.

“For instance, there is a hundredbed provider that has made $2.5 million in profit three years running, but this profit is only shown as $500,000 on its financials, because they pay $2 million in rent to the parent company, which already owns the building.

“There is a 50-bed, not-for-profit facility where the salaries for three managers exceeded $500,000 at a time when the home could not meet basic minimum standards and was also sanctioned.

“Other providers have used subsidies to help send senior staff to overseas award ceremonies and lavish conferences.”n

AGED CARE ROYAL COMMISSION

‘ The aged care industry has been successfully lobbying governments for years arguing against more transparency.’ — Stirling Griff

Nurse unions back transparency law

Queensland opens the books

Legislation to make the aged care system more transparent is backed by the Australian Nursing and Midwifery Federation (ANMF), a national body which represents statebased nursing unions including the NSWNMA. ANMF Federal Secretary, Annie Butler, said that when deciding on a nursing home, residents and families have the right to know what the facility spends on basic care needs.

This includes items such as food, medicines, medical products, continence aids, management wages, staff wages, and staffing numbers and categories.

“Families and residents cannot make informed decisions without knowing the composition and qualifications of the workforce and the training provided to them,” she said.

“Providers are currently able to spend taxpayer subsidies as they choose and, as the royal commission has exposed, this is not delivering in some cases even basic standards of care.

“Large for-profit aged care providers in particular are, like many businesses, using complex corporate structures and tactics to maximise earnings and profits and avoid tax while taking advantage of generous government subsidies.”

When Earle Haven Retirement Village on the Gold Coast suddenly closed over a contract dispute in July 2019, almost 70 residents were left abandoned by management.

This led the Queensland Labor Government to legislate for a new standard of transparency for private and public health and aged care facilities.

The new law gives Queenslanders information about the aged care facility they choose, the number of staff, qualifications of staff and skills mix.

Private aged care facilities can opt out of disclosing this crucial information, because they are regulated by the federal government, but the Queensland Government can publicly disclose that a facility has chosen not to provide this level of transparency.

THE LAMP DECEMBER 2020 / JANUARY 2021 | 33

NSWNMA

LIVE WEBINARS

NMA

onNSW i t a c u d e / y .l bit

PROFESSIONAL EDUCATION Ethics in Nursing and Midwifery Practice Tue 1 December, 12-1pm

Ethics in Nursing and Midwifery Practice Fri 12 March, 10-11am

Medications: High-risk medications and medication regulation Fri 4 December, 11am-12pm

Communication: Clinical Handovers and Assessments Tue 16 March, 11am-12pm

Social Media and Your Professional Obligations Tue 8 December, 10-11am

Medications: High-risk medications and medication regulation Mon 22 March, 4-5pm

Assertive Communication Fri 11 December, 11am-12pm

Continuing Professional Development (CPD) – your annual obligations Tue 30 March, 12-1pm

Communication: ISBAR and Workplace Communication Tue 19 January, 7-8pm Medication Principles Fri 29 January, 11am-12pm Law in Nursing and Midwifery Practice Thu 4 February, 7-8pm Documentation Thu 11 February, 4-5pm Professional Obligations for nurses and midwives Mon 22 February, 7-8pm Assertive Communication Thu 25 February, 7-8pm Nursing and Midwifery Board of Australia (NMBA) – Code(s) of Conduct Wed 3 March, 12-1pm

We also have webinars that we have developed specifically for newly graduating nurses and midwives: Student to New Graduate Wed 16 and Thu 17 December, 10am-12pm Student to New Graduate Tue 16 and Wed 17 February, 10am-12pm These webinars are held in 2 parts over 2 days

Keep an eye out for additional speciality webinars as we’ll be adding some interesting one-off topics between January and March

Search the date and times for the range of upcoming webinars at

bit.ly/educationNSWNMA

CPD hours for these courses can be calculated by the time you spend actively learning. This will vary between individuals, as further 34 | THE LAMP DECEMBERself-directed 2020 / JANUARY 2021 can be included (e.g. reviewing the associated resources and completing the reflective questionnaires). learning

YOUR RIGHTS

Ask

Judith How many times can you use the word extraordinary?

Can it really be 12 months since my last Christmas message, written as unprecedented fires ravaged Australia, unaware that we would soon become gripped by a pandemic crisis hereto unknown in scale since, arguably, the Spanish Flu. Extraordinary is a word used repeatedly and consistently over the last year. Often it remains the only word that can possibly describe the desperate and unprecedented situations we have confronted. And in relation to the pandemic, it is a societal cost that will continue to be felt for many years to come, and well after any possible vaccine is developed and made available.

But, amidst all this tragedy, whether caused by fire or virus, or the more expected vagaries of life, I wish to call out what has truly been the most extraordinary thing – the efforts of nurses and midwives everywhere.

Regardless of classification or setting, you have, as always, been the cornerstone of any response, of any support, of any assistance to the community. The sick, the old, the frail, those scarred by disease or trauma; it was the professionalism of nurses and midwives that made the real difference, and often at great peril to your own wellbeing.

For your efforts you are labelled as heroes by those in power (who seek to bask in your reflected lustre) but in tangible (money) terms, rewarded as if laggards. What a thank you ...

Be sure, though, that we at the Association, and I as one of your elected leaders, will commit to continuing in 2021 to work with all nurses and midwives to ensure you are safe, you are paid fairly, that you have enough colleagues to provide the best possible care and support. We must and will prevail ...

On that note, I wish all members, their families and friends, a very merry Christmas and a happy New Year. Take care, hopefully enjoy a little celebration if you can, and I look forward to catching up with you all again next year.

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

Increasing part time hours I work part time in an aged care facility run by Bupa.

I have been working extra hours and wondered if these could be made permanent?

Clause 10.3(e) of the Bupa Aged Care Australia, NSWNMA, ANMF (NSW Branch) and HSU NSW Branch, New South Wales Enterprise Agreement 2018 sets out the circumstances and mechanism for having contracted hours of a part-time employee increased. The initial step is to identify that you have been working more than your specified contracted hours continuously for more than 12 months. For these to be made permanent, the additional hours worked cannot be due to backfilling other workers on leave or a temporary need to increase hours for a resident.

Any increase recognised in your contracted hours should be worked within the roster cycle and shift configuration used at the facility.

Public holidays and maternity leave How are public holidays dealt with while I am on paid maternity leave from my public hospital employment?

Clause 34 A (viii) of the Public Health System Nurses’ and Midwives’ (State) Award states that when a public holiday occurs while on paid maternity leave, payment is at the rate of maternity leave being received, i.e. if on full pay then it will be paid at the full rate, on half-pay it will be paid at the half rate.

Replacement of staff I work at a hospital owned

by Healthe Care. How should they approach absences in the roster?

Clause 40(iv) of the Healthe Care Pty Ltd (New South Wales Hospitals) and the NSWNMA/ ANMF NSW Branch Enterprise Agreement 2017 sets out that all rostered and unplanned leave will be replaced with a nurse/midwife of at least the same classification wherever reasonably practicable.

Accordingly, the default position is a like-for-like approach.

Changing rosters I am a registered nurse in a public hospital. Recently we were told that the hospital wants to change the times of our rostered shifts, as well as varying the changeover times.

Can they do this?

Clause 6 of the Public Health System Nurses’ and Midwives’ (State) Award requires the employer to consult with staff and their representatives about such change. Examples of a change requiring consultation under the Award includes: the alteration of (working/rostered) hours of work for a class or group of employees.

Additional public holiday What’s the additional public holiday in NSW Health this year?

As per public health awards, an additional public holiday for NSW Health staff is to be observed during the Christmas/ New Year period. After consultation, NSW Health staff will observe the additional public holiday on Thursday 31 December 2020. However, NSW Ambulance staff will observe the additional public holiday on Tuesday 29 December 2020.

These arrangements are set out in Information Bulletin IB2020_034.

THE LAMP DECEMBER 2020 / JANUARY 2021 | 35

There are some things you shouldn’t handle alone.

Contact the NSWNMA if you are: Asked to attend a disciplinary or fact finding interview with your employer Threatened with dismissal Instructed to provide a statement for any reason Contacted by the Health Care Complaints Commission or the Nursing and Midwifery Council of NSW Contacted by police or solicitors in relation to a Coronial Inquest

Call us on 8595 1234 (metro) or 1300 367 962 (non-metro) Email gensec@nswnma.asn.au www.nswnma.asn.au 36 | THE LAMP DECEMBER 2020 / JANUARY 2021

PROFESSIONAL EDUCATION

TAE Academy and NSWNMA have formed a partnership to offer NSWNMA members the TAE40116 Certificate IV in Training and Assessment at a discounted rate The program is delivered in 12 days over a period of 9 months. Alternatively we have an online program available to those that cannot attend the face-to-face workshops.

LOCATION: 50 O’Dea Avenue, Waterloo NSW 2017 COST FOR ONLINE PROGRAM: $1,520 (or 4 x $380 installments) COST OF FACE-TO-FACE PROGRAM: $2,760 (6 x $460 installments) Face-to-face program commences 8 March 2021

REGISTER YOUR INTEREST TODAY, VISIT

taeacademy.edu.au/nswnma

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THE LAMP DECEMBER 2020 / JANUARY 2021 | 37

NEWS IN BRIEF

AUSTRALIA

After the pain, pride Victoria dealt with its second wave of COVID-19 extremely well by international standards.

Only Vietnam and Hong Kong did as well as Victoria in defeating a second coronavirus wave.

Of the 215 nations and territories that have reported COVID-19 cases, 120 have experienced clear second waves or late first waves that began in July or later according to data from national ministries of health and the World Health Organization.

Of these 120, only six have definitively emerged from their second wave: Australia, South Korea, Japan, Hong Kong, Vietnam and Singapore.

UNITED STATES

North Dakota governor asks COVID-19 positive nurses to keep working Last month, North Dakota’s governor, Doug Burgum, asked nurses who had tested positive for coronavirus but did not display symptoms to still report for work.

North Dakota has been devastated by COVID. In one week in November, one out of every 42 people in the state tested positive for the coronavirus. Of 6869 total tests in a single day, 68 per cent were COVID-positive.

Lesley McKamey, an emergency department nurse in Bismarck, North Dakota, told The Guardian she was shocked by the governor’s call.

“We are willing to break our backs and work as hard as we physically can. But then to ask us to come in as a potential infectious source, is just stunning,” she said.

A recent survey from National Nurses United, revealed more than 70 per cent of US hospital nurses said they were afraid of contracting COVID-19 and 80 per cent feared they might infect a family member.

More than half said they struggled to sleep and 62 per cent reported feeling stressed and anxious. Nearly 80 per cent said they were forced to re-use single-use, PPE, like N95 respirators.

Lost on the Frontline (a joint effort by The Guardian and Kaiser Health News), is investigating the deaths of 1375 healthcare workers who appear to have died of COVID-19 since the start of the pandemic.

Nearly a third of those were nurses.

More information https://www.theguardian.com/us-news/nginteractive/2020/aug/11/lost-on-the-frontline-covid-19coronavirus-us-healthcare-workers-deaths-database

38 | THE LAMP DECEMBER 2020 / JANUARY 2021

In other parts of the world the severity of the second COVID wave has been grim. By late October, the worldwide tally of cumulative cases was adding one million new cases every three or four days. Just seven countries reported fewer than 50 new cases: Australia, China, Nigeria, Singapore, Ivory Coast, Zambia and Senegal.

At the same time, France and the United Kingdom each reported more than 26,000 new cases, and 20 European countries posted all-time daily record numbers.

Some European countries have reported daily case numbers 25 to 30 times higher than during their first wave.

Stephen Duckett, Director of the Health Program at the Grattan Institute says Victoria’s achievement in getting down to zero or near-zero community transmissions is unprecedented.

“No other place in the world has tamed a second wave this large. Few have even come close.”

‘No other place in the world has tamed a second wave this large. Few have even come close.’ — Stephen Duckett, Grattan Institute

NEWS IN BRIEF

AUSTRALIA

80 per cent of employees want to continue working from home

An ACTU wants a charter of rights for employees working from home.

AUSTRALIA

WHO launches global strategy to eliminate cervical cancer For the first time ever, the world has committed to eliminate a cancer.

A global strategy to accelerate the elimination of cervical cancer was launched on 17 November by the WHO Health Assembly. The Australian Government was one of the co-sponsors of the event.

Cervical cancer is the fourth most common cancer in women. In 2018, an estimated 570,000 women were diagnosed with cervical cancer worldwide and about 311,000 women died from the disease.

Effective primary (HPV vaccination) and secondary prevention approaches (screening for, and treating precancerous lesions) will prevent most cervical cancer cases.

When diagnosed, cervical cancer is one of the most successfully treatable forms of cancer, as long as it is detected early and managed effectively. Cancers diagnosed in late stages can also be controlled with appropriate treatment and palliative care.

With a comprehensive approach to prevent, screen and treat, cervical cancer can be eliminated as a public health problem within a generation, says WHO. Australia played a critical role in the development of the World Health Assembly resolution.

While striving to eliminate cervical cancer within its borders by 2035, the country is also supporting the global community in achieving the strategy’s targets.

More people want to work from home but want better protections according to a survey of 10,000 Australian workers conducted by the ACTU. The survey found that: • 80 per cent of workers want to continue to work from home • 40 per cent are working longer hours • 90 per cent are not being paid overtime or penalty rates for extra hours worked • 47 per cent said they were more productive at home.

Working from home has imposed an average $530 in additional expenses on each worker and about a third reported an increased workload.

The ACTU is proposing a working from home charter that ensures “the rights and benefits of those working at home not be less favourable than when they were prior to the move to home-based work, and that working from home not be grounds for discrimination”.

The charter of rights proposes that employers will have to commit that all workers’ time and expenses should be compensated, and workers should have the “right to disconnect” to preserve work-life balance.

ACTU secretary, Sally McManus, said the union movement “will be working to support our members … to ensure we lock in fair working from home arrangements”.

“We also need to be aware that working from home has particular impacts on women and carers, and we don’t want to see existing gender inequality entrenched through new forms of work.”

‘ We also need to be aware that working from home has particular impacts on women and carers.’

Greg Hunt, Australia’s federal minister for health, said: “We now stand ready to work with the international community to take these commitments forward.”

‘ We now stand ready to work with the international community to take these commitments forward.’

— Greg Hunt, Federal Minister of Health THE LAMP DECEMBER 2020 / JANUARY 2021 | 39

NEWS IN BRIEF

UNITED KINGDOM

NHS suspends 1:1 ICU rule as COVID admissions soar England’s chief medical officer warns that COVID second wave could overwhelm the NHS. The NHS has abandoned the 1:1 rule in intensive care as the number of very sick COVID patients soars in England’s hospitals.

Professor Chris Whitty, England’s chief medical officer, told the British Medical Journal that the combination of COVID and usual cold season surge in illnesses will bring “an extremely difficult winter for the NHS – one that I suspect, unfortunately, will be unlike any we’ve seen in recent memory”.

The NHS-wide lack of critical care nurses was a key factor in the decision to increase the ratio in ICUs to 1:2, Dr Alison Pittard, dean of the faculty of Intensive Care told The Guardian.

UNITED STATES

Florida voted for Trump – and an increase in the minimum wage More than 60 per cent of voters in the conservative state supported an increase in the state’s minimum wage to $15.

The referendum was held simultaneously with the presidential election and will see the state minimum wage raised from $8.56 to $10 an hour beginning in September 2021, increasing by $1 annually through to 2026.

The measure makes Florida the eighth state in the US with a $15 minimum wage. The federal minimum wage is $7.25 and has not increased since 2009.

Support for a stronger minimum wage transcended party politics in Florida.

Donald Trump rejected the policy of increasing the minimum wage in one of the presidential debates. Joe Biden strongly supported it.

But in Florida, support for the increase surpassed the 60 per cent needed in a state where Trump got 51.2 per cent of the vote and Biden only got 47.9 per cent.

Florida is the first state to achieve an improved minimum wage through a ballot initiative rather than congressional legislation.

The distinction is important with Florida’s amendment being viewed as a nationwide test for voter support, and it passed with flying colours.

“You know, we had a lot of naysayers out there, such as big companies and politicians. But we proved them wrong,” said Alex Harris, an organiser for the group Fight For $15.

‘We had a lot of naysayers out there, such as big companies and politicians. But we proved them wrong.’ — Fight For $15 40 | THE LAMP DECEMBER 2020 / JANUARY 2021

“The [revised] guidance is needed because we do not have enough critical care staff to support the increase in beds required to care for all the patients with COVID and those with other conditions needing admission,” she said.

“The main issue is the longstanding failure to expand the workforce, and that is doctors, nurses and allied health professionals.”

Susan Masters, the Royal College of Nursing’s director of nursing, policy and public affairs, said: “Reducing the ratio of nurses-to-patients must be a temporary measure and only when it is absolutely necessary.

“This change means increasing the workload of intensive care nurses and there must be consideration of the physical and emotional toll this will take.”

‘The main issue is the longstanding failure to expand the workforce.’

NEWS IN BRIEF

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Protecting the wellbeing of the health workforce is key to providing quality care during a pandemic, say experts.

A study by researchers from the University of Lausanne, Switzerland published in the journal BMC Public Health (August 2020) shows that exposed health care professionals working with patients during an epidemic or pandemic are at heightened risk of mental health problems – both in the short and longer term.

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Clinicians are particularly vulnerable to psychological distress, insomnia, alcohol or drug misuse, and symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, burnout and anger, they say.

Their analysis was based on evidence from healthcare professionals working during the 2002–2004 SARS and the 2014 Ebola outbreaks.

Dr Anita MY Goh and Professor Briony Dow, from the National Ageing Institute at the University of Melbourne, say these lessons need to be applied to the aged care workforce.

LISA WILKINSON

CROSSWORD SOLUTION

“We need to keep aged care staff safe – safe from infection, but also safe from the psychological effects of caring for people in the midst of a highly communicable global pandemic.

“Wellbeing for the aged care workforce is key to prevent burnout, fatigue, and for workers to provide quality care, particularly with the additional stress and pressures they face in providing care during this pandemic.

“Just as we don, doff, and monitor our physical PPE, we need to check our and others’ ‘psychological PPE’,” they wrote in the Melbourne academic journal Pursuit.

‘ Just as we don, doff, and monitor our physical PPE, we need to check our and others’ “psychological PPE”.’

THE LAMP DECEMBER 2020 / JANUARY 2021 | 41

Australian Nursing and Midwifery Federation New South Wales Branch Summary of Financial Information for the Year Ended 30 June 2020

T

he financial statements of the Australian Nursing and Midwifery Federation New South Wales Branch have been audited in accordance with the provisions of the Industrial Relations Act, 1991 and the following summary is provided for members in accordance with Section 517(2) of the Act, as applied by section 282(3) of the Industrial Relations Act, 1996.

A copy of the Financial Statements, including the independent Audit Report, will be supplied free of charge to members upon request. Certificates required to be given under the Act by the Committee of Management have been completed in accordance with the provisions of the Act and contain no qualifications.

SUMMARY STATEMENT OF PROFIT OR LOSS OR OTHER COMPREHENSIVE INCOME FOR THE YEAR ENDED 30 JUNE 2020 Service fee – NSW Nurses and Midwives’ Association (NSWNMA) Interest income Other income Total income Less total expenditure Result for the year Remeasurement of retirement benefit obligations Total comprehensive income for the year

2020 ($)

2019 ($)

23,845,455

22,770,065

119,242 182,271 254,769 55,355 24,219,466 23,007,691 (24,069,648) (22,734,230) 149,818 273,461 139 (195,104) 149,957 78,357

SUMMARY BALANCE SHEET AS AT 30 JUNE 2020 Total equity 393,686 Represented by: Current assets 6,381,732 Non-current assets 3,868,608 Total assets 10,250,340 Current liabilities 8,716,601 Non-current liabilities 1,140,053 Total liabilities 9,856,654 Net assets 393,686 INFORMATION TO BE PROVIDED TO MEMBERS OR REGISTRAR In accordance with the requirements of the Industrial Relations Act, 1991 [NSW] the attention of members is drawn to the provisions of Sub-Sections (1) and (2) of Section 512 which read as follows: (1) A member of an organisation, or the Industrial Registrar, may apply to the organisation for specified information prescribed by the regulations in relation to the organisation.

(2) An organisation must, on the making of such an application, make the specified information available to the member or the Industrial Registrar in the manner, and within the time, prescribed by the regulations.

42 | THE LAMP DECEMBER 2020 / JANUARY 2021

243,729 9,500,359 9,500,359 8,279,732 976,898 9,256,630 243,729

REPORT OF THE INDEPENDENT AUDITOR ON THE SUMMARY FINANCIAL STATEMENTS TO THE MEMBERS OF THE AUSTRALIAN NURSING AND MIDWIFERY FEDERATION NEW SOUTH WALES BRANCH Opinion

The summary financial statements, which comprise the summary balance sheet as at 30 June 2020 and the summary statement of profit or loss and other comprehensive income for the year then ended are derived from the audited financial report of Australian Nursing and Midwifery Federation New South Wales Branch for the year ended 30 June 2020. In our opinion, the accompanying summary financial statements are a fair summary of the audited financial report.

Summary Financial Statements

The summary financial statements do not contain all the disclosures required

by Section 510 of the Industrial Relations Act, 1991 [NSW] or Australian Accounting Standards. Reading the summary financial statements and the auditor’s report thereon, therefore, is not a substitute for reading the audited financial report and the auditor’s report thereon.

The Audited Financial Report and Our Report Thereon

We expressed an unmodified audit opinion on the audited financial report in our report dated 13 October 2020.

Our Independent Auditor’s Report to the members on the Financial Report did not contain any particulars of any deficiency, failure or shortcoming as referred to in the Industrial Relations Act 1991 [NSW], as applied by Section 282(3) of the Industrial Relations Act, 1996.

Committee of Management’s Responsibility for the Summary Financial Statements

The Committee of Management is responsible for the preparation of the summary financial statements.

Auditor’s Responsibility

Our responsibility is to express an opinion on whether the summary financial statements are a fair summary of the audited financial report based on our procedures, which were conducted in accordance with Auditing Standard ASA 810 Engagements to Report on Summary Financial Statements.

Daley Audit

Stephen Milgate

Partner

13 October 2020, Wollongong Liability limited by a Scheme approved under Professional Standards Legislation

A copy of the Financial Report, including the Independent Audit Report, is available to members on the Member Central portal accessed via www.nswnma.asn.au. Members can obtain a hard copy by emailing the Branch Secretary, ANMF (NSW Branch) at gensec@nswnma.asn.au or calling 1300 367 962.

NURSING RESEARCH AND PROFESSIONAL ISSUES Failure to meet the necessary standard of clinical documentation is one of the most frequently identified problems among NSW nurses and midwives who are required to appear before the Nursing and Midwifery Council for performance issues.

Future Leaders Communique

healthcare professional.

October 2020

A well-kept record can protect the practitioner in instances where the legal defence of their actions is required. Documentation also ensures a matter of professionalisation and proof of the improvement of practices.

The health care system is a complex maze of examinations, procedures, medications and people. Although the health system is a collective hub, we each work with relative autonomy. The cornerstone of communication between each health professional is the medical record and handover.

In each hospital or clinic, the medical record may be a hard copy, electronic file, or a combination of both. As the current difficulties with the My Health Record demonstrate, these systems have varying levels of security and efficiency and are subject to user error. Deficiency in clinical documentation and handover is known to lead to errors in care, misdiagnosis, increased morbidity and mortality.

Documentation is inherently important in medical practice; so much so that it is imbued in the good medical practice guidelines and national standards for quality and safety. https://www.thecommuniques. com/post/future-leaderscommuniqu%C3%A9-volume-5issue-4-october-2020

Record-keeping and Documentation May 2018 Good record-keeping is an important aspect of a health and social care professional’s role, and it is a fundamental part of nursing (NMC 2010).

An accurate written record detailing all aspects of patient monitoring is important, not only because it forms an integral part of the of the provision of care or nursing management of the patient, but because it also contributes to the circulation of information amongst the different teams involved in the patient’s treatment or care.

In a legal sense, documentation and record-keeping is also there for the protection of the nurse or

https://www.ausmed.com.au/ cpd/articles/record-keepingdocumentation

The Coroner’s Court: extracting tips for improved documentation Linda Starr, July 2019, Part 1 The primary purpose of a coronial inquiry is to identify the person, the circumstances, cause and manner of their death.

However, the Coroner’s office also has a broader role in prevention which is achieved through making recommendations aimed at reducing or preventing a recurrence of a similar event that was the subject of the inquest.

This is achieved by identifying shortcomings or failures of individuals or organisations in connection with a person’s death rather than assigning blame or fault.

That said, a coroner will not hesitate to identify system failures and name poor conduct and practice where evidence suggests these contributed to the death of a patient. Such comments create opportunities to reflect upon practice and workplace systems and perhaps question longstanding practices.

One important area of practice that frequently attracts the attention of the Coroner is record keeping. Documentation in patients’ case notes whether in paper or electronic form continues to be a major concern and feature in coronial inquiries.

Comments from cases such as coronial inquests help to provide organisations and practitioners with a framework of what is good

documentation and what you should avoid when writing in the patient’s notes. https://anmj.org.au/thecoroners-court-extracting-tipsfor-improved-documentation/

The Coroner’s Court: extracting tips for improved documentation Linda Starr, July 2019, Part 2 The most frequent criticism concerning documentation made during an inquest is the failure of practitioners to document care and decisions in the patient’s case notes.

Not only does this reduce effective communication, it often leads to adverse outcomes for the patient.

In one case, a 42-year-old woman committed suicide whilst detained in a mental health facility. A major concern was the lack of supervision the patient received whilst detained as it became apparent that she had left the ward on two previous occasions without staff missing her.

The third and final time she left followed a review by her MO who was concerned about her deteriorating mental health and asked that she be closely supervised.

There was no documented evidence that this concern was communicated to the nursing staff, nor evidence of close supervision being provided.

The coroner described the case notes in relation to her treatment as ‘grossly inadequate’ and reflective of inadequate communication amongst the nursing staff about concerns over the patient’s safety.

The coroner held the view that had there been appropriate documentation the patient would have been more closely supervised and wouldn’t have been able to leave the ward undetected. https://anmj.org.au/thecoroners-court-extracting-tipsfor-improved-documentationpart-2/

THE LAMP DECEMBER 2020 / JANUARY 2021 | 43

New Member Benefit

ACCESS TO ONLINE PROFESSIONAL EDUCATION

FREE

for NS memb WNMA ers!

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

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

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

Access to over 20 hours of FREE CPD* 61 topics including those modules that are deemed mandatory annual competencies by large health organisations and nursing agencies* Free professional development portfolio to provide evidence to the Nursing and Midwifery Board of Australia (NMBA) of participation in CPD annually Access free webinars on a range of topics * Nurses and midwives have various obligations in relation to CPD, which you can read more about on the NMBA website or here. The NMBA outlines that CPD must be relevant to your context of practice, and recommends nurses and midwives complete a range of CPD activities, e.g. – face-to-face, simulation, interactive e-learning, self-directed learning. The ANMF Education is developed for nurses and midwives working across Australia. For nurses and midwives practicing in NSW, it is important to ensure you follow relevant governance and legislative requirements.

bit.ly/NSWNMAMemberCentral 44 | THE LAMP DECEMBER 2020 / JANUARY 2021

CROSSWORD

test your

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ACROSS 1. A drug that reduces the body’s natural immunity by suppressing the natural functioning of the immune system (17) 10. Relating to the heel bone (9) 11. A small integrated circuit normally used for pet identification aid (9) 12. A public declaration of principles, policies, or intentions, especially of a political nature (9) 14. The study of the dietary requirements of the body (9) 16. Divergent squint, walleye (9) 18. Shaped like a rope (9) 20. A patient’s condition requiring immediate treatment (9)

22. To fall heavily; collapse (5) 23. A swelling (11) 26. The thin transparent plate covering the end of a toe's surface (7) 28. The cellular coverings of internal and external surfaces of the body (9) 29. Doctor, physician (5) 31. Relating to the yolk of an egg (9) 33. U-shaped or V-shaped (5) 34. Yellow nodules or plaques that clusters near joints and is associated with lipid disorders, cirrhosis of the liver, and thyroid disorders (8.9)

DOWN 1. A cervix that has an abnormal tendency to dilate and so may not be able to keep a foetus from being spontaneously aborted (11.6) 2. Antipsychotic drug used in the treatment of schizophrenia (9) 3. Nuclear Cerebral Angiogram (1.1.1) 4. Oozes (5) 5. A vertical fold extending from the hilus to the base of the lung (9.8) 6. Ransom; release (6) 7. Convert (a fat or oil) into soap (10) 8. A curved outline (4) 9. A bacterial species that causes syphilis in humans (9.8) 13. The coat of soft, fine hair of some mammals (3) 15. Methods of artificially inducing immunity against various infectious diseases (12) 17. A genus of fungi, some species are used in the production of antibiotics (11) 19. A distinctive odour (5) 21. Fish eggs (3) 24. Dampen (7) 25. A type of hormone which stimulates the growth of follicles in the ovary (1.1.1) 27. A dry scab or slough formed on the skin as a result of a burn (6) 30. Lacking in brightness (4)

THE LAMP DECEMBER 2020 / JANUARY 2021 | 45

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 46 |

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 2020 / JANUARY 2021

REVIEWS

book club

The Feelgood Pack from Melbourne University Publishers Melbourne University Press has curated a feelgood pack, filled with inspiring stories, nature, and steps to happiness. The individual RRP for the seven titles is $286 but is available for $160.

The Coast Chris Hammer Melbourne University Press: ISBN 9780522865974

Chris Hammer travels the length of the east coast of Australia on a journey of discovery and reflection, from the Torres Strait to Tasmania; from an island whose beach has been lost forever to the humbling optimism of the survivors of Cyclone Yasi; from the showy beaches of Sydney to a beautiful village that endures despite the loss of its fishing fleet.

Eight Steps to Happiness Anthony Grant and Alison Leigh Melbourne University Press: ISBN 9780349003627

Based on the hit ABC TV series Making Australia Happy, this practical, everyday handbook shows you how to become a happier person in just eight weeks. The simple exercises and activities in 8 Steps to Happiness are profoundly effective and scientifically proven, and can lead to measurable physiological changes, from improved immune function to better sleep and increased physical strength. The 8 steps program gives you no-nonsense tools to make real change in your life.

John Perceval Traudi Allen Melbourne University Press: ISBN 9780522868609

In this fully revised and updated analysis of his art in the

context of his life, Traudi Allen shows how, despite having been positioned as the younger follower of Arthur Boyd, Albert Tucker and Fred Williams, he was, in fact, sometimes the mentor.

The full complexity of his work and his personality is rigorously and engagingly analysed here, in a story that is as sweet and fascinating as it is tragic.

The Footy Lady Stephanie Asher Melbourne University Press: ISBN 9780522872576

When her first husband was killed by a truck, Susan Alberti took over their construction business, becoming a female pioneer in the building industry.

When her daughter was diagnosed with type-1 diabetes she embarked on a mission to find a cure. When her beloved football club the Western Bulldogs was threatened with annihilation she worked as vice-president to bring home the 2016 premiership flag. Confronted with the exclusion of women from AFL, she battled to open the game to all and kept up the fight with money and on-ground support when others were ready to signal defeat.

A Hostile Beauty

Mothermorphosis Monica Dux Melbourne University Press: ISBN: 9780522867831

In Mothermorphosis, some of Australia’s most talented writers and storytellers share their own experiences of motherhood. In telling their stories they articulate the complex internal conflicts, the exhilaration and the absurdity of the transformation that takes place when we become mothers.

Radical Heart Shireen Morris Melbourne University Press: ISBN: 9780522867831

Neither Indigenous nor white, Shireen Morris is both outside observer and instrumental insider in the fight for Indigenous rights. Shaped by her family's Indian and Fijian migrant story, Morris is a key player in what many consider the greatest moral challenge of our nation: constitutional recognition of Indigenous Australians.

Radical Heart is a challenge for all Australians to dream together of a fairer future and work as one to make it happen.

Alistair Dermer and Danielle Wood Melbourne University Press: ISBN 9780522855043

There are few places today that are truly wild. Macquarie Island is still one such place—a small, wind-blasted rocky outcrop between Tasmania and Antarctica. In exquisite pictures and words, A Hostile Beauty tells the story of this extraordinary Australian outpost teeming with life.

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

THE LAMP DECEMBER 2020 / JANUARY 2021 | 47

Sports Tee NSWNMA

$15

Get active with Cool-Dry-Fit NSWNMA Sport T-shirt

Sizes: ladies 8, 10, 12, 14 and unisex S, M, L. The fabric with its moisture management system and multifilament technology draws water away from the skin to the outer surface where it will quickly evaporate to leave you cool, dry, comfortable and fit.

$10

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$60

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Great deals for members at The Good Guys As a valued Union Shopper member you can now get exclusive access to a new online shopping site with The Good Guys Commercial.

You will be able to see ‘live’ discounted pricing on the entire The Good Guys range – that’s great deals on over 4,000 products!

And you will be able to make your purchases online – saving you time and money.

To register for online access to The Good Guys Commercial website, visit www.unionshopper.com.au/the-good-guys/ or phone 1300 368 117

1300 368 117 unionshopper.com.au 48 | THE LAMP DECEMBER 2020 / JANUARY 2021

REVIEWS

at the movies GIV E

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GIV E

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Keeping Faith, Box Set 1-2 The Dry

Award-winning actress Eve Myles (Torchwood, Broadchurch) reprises her iconic role as small-town lawyer Faith Howells in the Welsh mystery series that is “one of the most popular shows in Britain” (The New York Times).

Federal Agent Aaron Falk returns to his hometown after an absence of over twenty years to attend the funeral of his childhood friend, Luke, who allegedly killed his wife and child before taking his own life – a victim of the madness that has ravaged this community after more than a decade of drought.

Eighteen months ago, mother-of-three Faith had her cosy life thrown into chaos after the disappearance of her husband, Evan (Bradley Freegard, Doctors). Still striving to keep her family together, Faith must fulfil Evan’s debt to a vicious crime kingpin even as she fights her attraction to a former client (Mark Lewis Jones, Chernobyl).

When Falk reluctantly agrees to stay and investigate the crime, he opens up an old wound – the death of 17-year-old Ellie Deacon. Falk begins to suspect these two crimes, separated by decades, are connected. As he struggles to prove not only Luke’s innocence but also his own, Falk finds himself pitted against the prejudice towards him and pent-up rage of a terrified community.

Then a local farmer is found dead, and his wife, Madlen (Aimee-Ffion Edwards, Detectorists), is arrested for his murder.

Convinced of Madlen’s innocence, Faith decides to defend her, despite never having worked a homicide case before. But as Faith begins investigating the crime, she clashes with her own legal firm and a tenacious detective (Rhashan Stone, Agatha Raisin) determined to uncover her secrets.

See this Australian Crime Thriller in cinemas January 1!

In stores 2 December 2020.

Email The Lamp by 30 December to be in the draw to win one of 10 digital tickets to The Dry thanks to Roadshow. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

Email The Lamp by 30 December to be in the draw to win one of five DVDs of Keeping Faith Box Set 1-2 thanks to Acorn Media.

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

THE LAMP DECEMBER 2020 / JANUARY 2021 | 49

TRAVEL

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

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

50% OFF

45% OFF

25% OFF 1/

Sydney Hotel QVB – Sydney, NSW Stay in the heart of Sydney from $99 per night! This 4-star hotel is centrally located in the heart of Sydney’s CBD and just a short stroll to Darling Harbour, Pitt Street Mall, Queen Victoria Building and Town Hall.

Premium Queen with City views room – 1 Night $99* (2 ADULTS) • 12pm late checkout • Free WiFi during stay * All travel deals are subject to availability. For black-out dates, high season and peak season surcharges and rates and full T&C’s go to unionshopper.ubookdirect.com • Leisure Inn Spires: Valid until 31 March 2021. Rate based on 2 adults and subject to availability • Sydney Hotel QVB: valid for travel until 26 December 2020.

Rate based on 2 adults and subject to availability • Estate Tuscany, Pokolbin Hill: valid for travel until 15 September 2021. Rate based on 2 adults and subject to availability.

CAN’T FIND WHAT YOU’RE LOOKING FOR? 50 | THE LAMP DECEMBER 2020 / JANUARY 2021

Estate Tuscany, The Mill & Brokenback Bar, Pokolbin Hill – Hunter Valley, NSW Located in the Hunter Valley at Polkolbin, only a two- hour drive from Sydney. Estate Tuscany offers 4-star boutique accommodation set on 26 acres of lush, rolling countryside in the heart of Australia’s premium wine country.

Olive Grove Room – 2 Nights $299* (2 ADULTS) • Breakfast daily • Complimentary WiFi during stay • Late check out of 11am • Complimentary canapés in Brokenback Bar • $30 food credit each night in The Mill Restaurant • 30% off a Vineyard Shuttle Winery & Cellar Door Mini Bus Tour • Special offer: buy six bottles of wine and get one free at Allandale Winery

Leisure Inn Spires – Blue Mountains, NSW Set in 3 acres of hilly landscaped gardens just an hour from Sydney, this hotel offers peaceful accommodation close to attractions including the Three Sisters, Scenic Railway and Jenolan Caves.

Take a stroll into the charming village 3/ of Leura – full of boutiques, galleries,4/ restaurants, antique and book shops and quaint tea rooms.

One-bedroom apartment – 2 nights $299* (2 ADULTS) • Free cancellations permitted outside 3 days of travel

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

5/ For all other packages, head to unionshopper.ubookdirect.com

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

holiday in

Vanuatu Valued at over $5,000

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

21

Prize drawn 1 July 20

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

Conditions apply. Prize must be redeemed by 30 June 2022 and is subject to room availability. Block out dates include 1 July - 30 September 2021 and 1 December 2021 - 31 January 2022. The prize will be drawn on 1 July 2021. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/20/05518.

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