The Lamp February 2020 by NSW Nurses and Midwives' Association

AGED CARE

SAFE STAFFING

LIVING WELL

REGULARS

Morrison wants private sector to assess elderly care

Worker safety comes first in mental health

Nutrition for the nurse

page 15

page 18

page 28

Your rights and entitlements at work Nursing research online Crossword Reviews

THE MAGAZINE OF THE NSW NURSES AND MIDWIVESâ&#x20AC;&#x2122; ASSOCIATION VOLUME 77 NO. 1 FEBRUARY / MARCH 2020

SPECIAL BUSHFIRES EDITION

A SERIOUS HEALTH EMERGENCY Print Post Approved: PP100007890

p.37 p.39 p.41 p.43

Edith Cavell (4 DECEMBER 1865 – 12 OCTOBER 1915)

“ I can’t stop while there are lives to be saved.” Edith Louisa Cavell was a British nurse, accomplished linguist, musician and artist. She was Matron in Belgium’s first training hospital and school for nurses. At the time, there was no established nursing profession in Belgium and her pioneering work led her to be considered the founder of modern nursing education. She is celebrated for helping hundreds of British, French and Belgian soldiers escape from German-occupied Belgium during World War I, for which she was arrested. She was court-martialled, found guilty of treason and executed. Authorised by B.Holmes. General Secretary, NSWNMA

CONTENTS Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including The Lamp subscriptions and change of address, contact our Sydney office. Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au Hunter Office 8–14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962 For all editorial enquiries, letters and diary dates T 8595 1234 E lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au

VOLUME 77 NO. 1 FEBRUARY / MARCH 2020

COVER STORY Bushfires create “a serious health emergency”

The health consequences of the bushfires are massive and long term.

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. Subscriptions for 2019 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $84, Institutions $140, Overseas $150.

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COVER STORY

Grieving for what you’ve lost – and grieving for your country After a bushfire, the mental scars can last for years.

AGED CARE

Morrison wants private sector to assess elderly care Despite growing opposition, the Morrison government appears determined to privatise Aged Care Assessment Teams that gauge the level of care required by elderly Australians.

SAFE STAFFING

REGULARS

5 6 30 34 37 39 41 43 45 46

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

Worker safety comes first in mental health The Industrial Relations Commission says modifications to mental health facilities must not put employee safety at greater risk.

SAFE STAFFING

More nurses for Blacktown ED Staff and union pressure achieved three extra nurses per shift for Blacktown Hospital’s emergency department.

SAFE STAFFING

Wyong ED campaigns for more staff Nurses are campaigning for more staff at Wyong Hospital’s emergency department, where waiting times are among the worst in the state.

AGED CARE

SAFE STAFFING

LIVING WELL

REGULARS

Morrison wants private sector to assess elderly care

Worker safety comes first in mental health

Nutrition for the nurse

page 15

page 18

page 28

Your rights and entitlements at work Nursing research online Crossword Reviews

p.37 p.39 p.41 p.43

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 77 NO. 1 FEBRUARY / MARCH 2020

LIVING WELL

Nutrition for the nurse Eating well when you have a job of stress and shifts is challenging but it can be done, says Kathryn Hawkins, an expert in women’s health.

SPECIAL BUSHFIRES EDITION

A SERIOUS HEALTH EMERGENCY Print Post Approved: PP100007890

THE LAMP FEBRUARY / MARCH 2020 | 3

TOP 10

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4 | THE LAMP FEBRUARY / MARCH 2020

EDITORIAL

JUDITH

Kiejda

ACTING GENERAL SECRETARY

It’s time to listen to the science and the experts Despite the warnings of experts backed by overwhelming scientific evidence, politicians left us unprepared and vulnerable to the fires that have ravaged our country. There are parallels of this modus operandi to be found in health and aged care. What can I say about the calamity that has devastated our country? The human, ecological and material costs of this spring and summer’s bushfires are staggering. Twenty-eight people dead. Ten million hectares of our natural heritage incinerated. The homes of 2000 families obliterated. Over a billion animals burned to death. The sheer scale and intensity of this carnage is barely believable. But through it all there is also the uplifting, inspiring human response. What stood out for me was the courage, commitment and selflessness of our emergency workers – firefighters, nurses, volunteers and others. And one can only admire the resilience and solidarity of the communities who have been devastated by these unprecedented infernos. The immediate dangers of some fires may now have passed with the onset of rain but the health consequences will persist for a long, long time. Studies from previous bushfires, in Australia and elsewhere, show that the physical and mental health consequences endure for years. There are many lessons to be learned, and it is imperative that they are learned, out of this catastrophe. A positive lesson is that Australia still has a sense of community, solidarity and altruism that can get us through the worst of times. But we can’t skate over the glaring deficiencies that the bushfires have exposed in the way Australia is governed.

‘ What point do we have to reach before there is a reckoning on this form of governance that ignores the advice and analyses of experts, and doubles down on failed policies when catastrophes are staring us in the face?’ WE DESERVE BETTER FROM OUR GOVERNMENTS As a country we were unprepared for the scale of these fires despite the alarm that had been raised by any number of experts: scientists, climatologists, firefighters and health clinicians over many, many years. It is unconscionable that their advice was not just ignored but often ridiculed by a significant and powerful faction of our political class and media. The lies, distortions and obfuscations that have been peddled about our changing climate have now been exposed as grossly irresponsible and a gigantic folly. The natural logic of this denial or scepticism, in the face of overwhelming empirical evidence, is the lack of preparedness that we have seen and the exposure of the Australian people to nature’s wrath. It is unacceptable that we have a government that only appears capable of acting after the fact and even then, only with reluctance and only when pushed. As nurses and midwives, maybe this should not surprise us. In health we know first hand how expertise, experience and insight from those who actually know what they are talking about can

be ignored, sidelined or contested by politicians or vested interests with their own agenda or by bean counters who fail to factor in the costs of inaction. Which brings us to aged care. In the fields of climate change and the environment we are used to the political art of doubling down in the face of a growing cataclysm. The privatisation of Aged Care Assessment Teams by the Morrison government (see p15) is another example of this way of operating. Late last year, the Royal Commission into Aged Care delivered an interim report, which described the aged care sector as “a shocking tale of neglect”. The commission heard countless, heart-rending tales of neglect and abject systemic failure and a lack of transparency and accountability by commercially driven facilities. Yet even before the royal commission has delivered its final report, the federal government is handing over these public sector assessment teams to a private sector with a rank record of failure. What point do we have to reach before there is a reckoning on this form of governance that ignores the advice and analyses of experts, and doubles down on failed policies when catastrophes are staring us in the face? n THE LAMP FEBRUARY / MARCH 2020 | 5

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Thanks from a bushfire victim This is what became of our water tank (sadly no insurance for our whole home and contents). Without water new construction cannot start!

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If the current government will not compensate for disaster, nor give more than a thought for us hardworking nurses, I know others who will! I want to thank my Union, the NSW Nurses and Midwives’ Association (NSWNMA), and my comrades who supported (people like) us affected by bushfires. Thanks to you I felt humbled. I felt solidarity. I thank you for thinking of me and my family without us asking! Today more than most days I’m proud to be a unionist. Our family thanks you from the very bottom of our hearts.

Martina Rosas

Sydney had its fireworks while Conjola Park went up in flames On 31 December 2019, our home, along with 88 other households in Conjola Park, was razed by fire. Other areas close by; YatteYattah, Little Forest and Conjola, endured the same catastrophe.

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To enter the competition, simply provide your name, address and membership number and email your entry with the subject: Canberra to lamp@nswnma.asn.au

*Conditions apply. Rooms subject to availability and valid for stays Sunday to Thursday nights. Prize must be redeemed by 13 April 2020. Not valid during long weekends, NSW school holidays, Public Holidays or major event periods. Voucher is not transferrable, non-exchangeable and not redeemable for cash. The offer is valid for two people only. Voucher must be presented on arrival. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 February 2020 and closes 29 February 2020. The prize is drawn on 1 March 2020. If a redraw is required for an unclaimed prize it must be held up to 3 months from the 6 | THE FEBRUARY MARCH 2020 original drawLAMP date. NSW Permit no:/LTPM/19/04224.

Despite incredible support from my family, friends, colleagues, local charities and businesses, the pain of losing everything you have toiled for, or losing cherished photos and family heirlooms, seems to grow each day. I am finding it difficult to be philosophical about what happened that day to my partner and I. Indeed it has been an all too familiar story for so many Australians. The only warning we received that day, was one message: “Take shelter as fire approaches”. Help finally came in the form of two exhausted RFS crews and two RFS trucks, with empty tanks due to fighting fires before Conjola Park. Nearly all resources were sent earlier in the day to the Bateman's Bay area, leaving our area with hardly any resources. The driver of one truck told me, as I made my way to the edge of Conjola Lake, “many houses in the area will burn today”. On the edge of the lake, I witnessed the very best of human nature and kindness. Residents, previously unknown to each other, offered support, shelter, toilets, food and water as well as putting out fires where possible. All around us flames were leaping into the air from trees, houses and grass.

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.

Then, the dreadful noise from exploding gas bottles and roofs and trees crashing down.

LETTER OF THE MONTH

We expected to be helped that day in the form of warnings, aerial support and firefighters on the ground. Instead we were left to fend for ourselves, as well as pulling elderly neighbours from their threatened homes.

ACAT privatisation digs a deeper hole for aged care

The cost of these events will be far greater than the cost of a properly equipped and resourced firefighting service. RFS crews should also be paid. We need far more aerial support; planes with retardant and Elvis helicopters. I am very grateful to the volunteers of organisations and charities who have helped us. Though this seems to be a very ad hoc and confusing method of helping, especially when you’re feeling exhausted and vulnerable. There really needs to be a more centralised system from charities and government for disaster relief. The federal and state governments were too arrogant to listen to fire safety experts and climate change experts. They need to be made accountable for their inaction. We all pay taxes, some of which you would think would be for the “privilege” of protection from fires. How can you put a price on all this misery that has been created? How do you replace the loss of environment and wildlife? My very best thoughts and wishes go out to anyone who has experienced a loss due to these fires. I would also like to thank the NSWNMA very much, for their support and generosity.

Jennifer McKnight RN, Milton-Ulladulla Hospital

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11:53 AM

The federal government made a quiet announcement last December that it will privatise the Aged Care Assessment Teams from April 2021. The ACATs are teams of registered nurses, geriatricians and allied health professionals who work at public hospitals to assess the level of care required by our elderly Australians. This is an independent organisation that provides an invaluable service to our older community. They assess their complex care needs and assist them and their carers to access appropriate levels of support, either at home or in a residential aged care home. How can the Federal Health Minister Greg Hunt and our Aged Care Minister Richard Colbeck allow the privatisation to go ahead while the Aged Care Royal Commission is yet to submit its recommendations in November this year? Privatisation and deregulation in the Aged Care sector has led to chronic understaffing. The Royal Commission has exposed the Aged Care sector as a “shocking tale of neglect!” Our elderly have paid an expensive price in this harrowing debacle. I fear that the privatisation of the Aged Care Assessment Teams will lead down the same pathway. Will lucrative companies that run nursing homes be in charge of the assessments of patients? Will the patients be sent to the companies’ own residential aged care facilities or in their homes? If at home, will the care be provided by their own “agencies”? Will the assessors be trained professionals or will the staffing be downgraded? A lack of assessors will lead

to long waiting times in hospitals. Will there be transparency and financial accountability? The Tax Justice Network has exposed (the tax avoidance of) the six largest for-profit companies in Australia, namely Bupa, Opal, Regis, Estia, Japara and Allity, who received over $2.17 billion annually in government subsidies for aged care services and we are yet to see the information on funding and staffing ratios in the aged care sector. Interestingly, One Nation and the federal government blocked the Aged Care Legislation Amendment Bill 2019 last December. This bill, moved by the Centre Alliance Senator Stirling Griff, would have required residential aged care providers to give annual financial statements – the actual costs spent on food, staffing and other costs spent on delivering care – to the Aged Care Quality and Safety Commissioner, who would then make them public. The Royal Commission into Aged Care Quality and Safety revealed that in 2018, 16,000 older Australians died waiting for a Home Care Package and 13,000 people were placed into aged care facilities while waiting for a package they never received. We have been told incessantly by this government that privatisation and the free market system will thrive on an assumption of consumer choice. Once the ACAT has been privatised, there will be no such thing as “consumer choice”. Sadly, decisions about their care will not be determined by themselves or by their loved ones, but by profit-seeking corporations. What kind of society have we become? Jocelyn Hoffman

THE LAMP FEBRUARY / MARCH 2020 | 7

COVER STORY

Bushfires create “a serious health emergency” The health consequences of the bushfires are massive and long term.

he Climate and Health Alliance (CAHA) has called bushfire smoke in NSW “a public health emergency” and has called for a whole-of-government response to protect health. The g r o up r e c om m e n d s measures such as text alerts conveying health advice to areas with high levels of air pollution and the supply of free P2/N95 face masks to affected communities. “There is no safe level of air pollution. The higher the level of pollution, the more hazardous the risks to people's health, yet many people are unaware of these risks or what to do about them,” CAHA Executive Director Fiona Armstrong said. “For months now the climatefuelled bushfire crisis has blanketed communities in dangerous air pollution, putting at risk the health of millions of Australians. “The smoke is believed to have directly contributed to the deaths of two people, and our health system is hard at work responding to more and more people who are experiencing ill-health from the high levels of air pollution.

A VIEW OF COOMA, NSW COVERED WITH SMOKE HAZE FROM BUSHFIRES.

8 | THE LAMP FEBRUARY / MARCH 2020

‘ There is no safe level of air pollution. The higher the level of pollution, the more hazardous the risks to people’s health.’ — Fiona Armstrong “Governments should a lso issue advice to councils, schools, child-care centres and workplaces with high numbers of outdoor workers so they are aware of their responsibilities to the people under their care or employment.” CAHA members include the NSWNMA, ANMF, Public Health Association of Australia, the Royal Australian College of Physicians, Asthma Australia, Australian Hea lt hca re a nd Hospit a ls Association and more than 30 other healthcare organisations. CAHA says that without action on climate change, the health impacts of future bushfires and air pollution will only become more severe. “As global temperatures continue to increase, we will see more and more heatwaves, bushfires and smoke haze. We must take urgent action to reduce our contribution to

climate change if we are to preserve our health, landscape and wildlife from further devastating impacts,” said Fiona Armstrong. “The Australian Government must no longer ignore the warnings of climate and bushfire experts. It must ensure strong and urgent climate action is part of the response to the bushfire crisis.” Air pollution is linked to diseases throughout life including cardiac arrest, premature births, low birth weight babies, impaired lung development in children, asthma, heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer. Babies, young children and those who are elderly or already experience heart or lung disease are at higher risk, as are those without airconditioning or air purifiers. n

COVER STORY

P2 N95 PROTECTION RESPIRATORY MASK USED TO REDUCE AMOUNT OF BREATHING PM 2.5 PARTICLES FROM BUSHFIRE SMOKE.

Smoke kills

ABOVE, SMOKE PLUME AT MT SOLITARY IN THE BLUE MOUNTAINS, NSW, JANUARY 2020. THE AUSTRALIAN FIRES HAVE BURNED ACROSS AN AREA TWICE THE SIZE OF SWITZERLAND WHILE CLAIMING AT LEAST 28 LIVES AND DESTROYING THOUSANDS OF HOMES AND MILLIONS OF WILDLIFE.

The human, financial and ecological costs of bushfires The fires have burned more than 10 million hectares, killed 28 people, destroyed around 2000 homes and covered Sydney and Melbourne with hazardous smoke. In early January, the Insurance Council of Australia estimated the damage bill had reached $700 million, but said it expected the cost to rise significantly beyond that. Wildlife experts say over a billion animals have been killed in the bushfires in NSW alone. “The loss of life we've estimated for NSW is 800 million terrestrial animals, including birds and reptiles. But that figure doesn't include frogs, fish, bats and invertebrates,” ecologist Prof Chris Dickman from the University of Sydney told the ABC. “Combining these figures, it is likely well over a billion animals lost.” Experts say the fires have created risks to a range of factors critical to human survival, wreaked havoc on pollinator species like bees, threatened water security and posed risks to infrastructure. The costs of previous bushfires have been enormous but will be dwarfed by this summer’s fires. It has been estimated that major Australian bushfires during 1967–2013 resulted in over 8000 direct injuries and 433 direct fatalities, costing approximately $4.7 billion (source: The Lancet). However, this estimate did not consider indirect costs, which mainly come from the adverse health effects of bushfire smoke. According to the US Environmental Protection Agency, the indirect effects of air pollution from bushfires on excess premature deaths and morbidity in the USA during 2008–12 had an estimated cost of $US513 billion.

The best-documented hazardous components of bushfire smoke are particle pollution PM10 and PM 2·5 . Because of the bushfire, in most areas of Sydney, 24-hour average PM2·5 concentrations during December exceeded 100 μg/m3 (micrograms per cubic metre), which is four times the World Health Organization guideline value of 25 μg/m3. Concentrations could even have reached 500 μg/m3. By comparison, the daily average PM 2·5 concentration before the bushfire was around 20 μg/m3. Such an increase in daily PM 2·5 concentration is estimated to induce an increase of at least:

5·6% 4.5% 6.1%

per cent in daily all-cause mortality

in cardiovascular mortality, and

in respiratory mortality.

These estimates are close to a previous observation on the effects of bushfire events between 1997 and 2004, in Sydney. (Source: The Lancet)

THE LAMP FEBRUARY / MARCH 2020 | 9

COVER STORY

‘We were wearing masks in the hospital because the ash was so thick’

‘ Many of our staff live in those areas. At least four or five lost their homes.’

With roads closed by fires, nurse Diane Lang lived at her hospital and worked double shifts to treat people with burns and breathing difficulties. NSWNMA Councillor and RN Diane Lang was on nightshift at South East Regional Hospital in Bega on New Year’s Eve as firestorms ravaged towns on the NSW far south coast. “When the firestorms hit the towns of Cobargo and Quaama north of Bega, it was very traumatic because it was like a fire tornado,” Diane said. “It moved very quickly and people didn’t have time to plan. Many of our staff live in those areas. A least four or five lost their homes. Many others have damage to properties. “A lot of staff couldn’t get to the hospital because roads were closed, communications were down and lines were poor, so I just volunteered to continue working.” With fires out of control to the north, south and west of the hospital, Diane spent a week living out of her campervan in the hospital car park, working double shifts and using the hospital showers. “I live thirty minutes away, and for that whole week the smoke was so thick it was unsafe to drive at night, and it was better for the emergency workers not to have other people’s vehicles on the road.” Major roads out of the area were closed and fuel was rationed so that the 30,000 tourists in the area would have just enough petrol to get to Cooma. “I just went around my house and packed my suitcase with anything I thought was important to keep and went back to the hospital,” she said. “Staff who could get here were coming from everywhere to offer assistance. If they weren’t working at the hospital, they started working in the evacuation centres.” Most people arriving at the hospital had sustained burns while protecting

10 | THE LAMP FEBRUARY / MARCH 2020

their homes, Diane said. “We were very lucky that we had a burns specialist on holidays from Adelaide who presented to the hospital and offered his services. He did one emergency surgery before patients were airlifted out and he helped with triaging.” In the days after the New Year’s Eve fire – which burned out of control and returned in force a week later – the sky was dark red and smoke thick with ash was billowing into the hospital. “We were wearing masks in the hospital because the ash was so thick,” Diane says. “After the New Year’s Eve fire, most of the people that had been coming in had respiratory COPD issues that had been exacerbated.” Given the extent of the disaster the hospital staff managed incredibly well, she said. “The Ministry of Health has been very good, and they have actually brought down nurses from the RPA, Concord Hospital and Canberra.” But Diane is worried about what will happen when the initial disaster support ends. “We have always been short-staffed and underfunded. Our LHD always funds us to a certain amount of beds, and we are over that now that we are in an emergency mode, but the additional staff will go back to Sydney and Canberra. “Whenever we have to flex up, it is the existing staff who fill those gaps, but they are exhausted.”

ABOVE, SMOKE HAZE EN ROUTE TO THE SOUTH COAST. BELOW, UNHEALTHY LEVELS OF SMOKE HAZE IN THE SUBURBS OF SYDNEY.

COVER STORY

‘It was like Armageddon’ Grafton Base Hospital was surrounded by multiple bushfires this fire season. Remana Harris, an RN in Grafton Hospital’s emergency department, looked outside at 3 o’clock one afternoon and saw the sky was orange. “It was like Armageddon,” said Remana, who is president of the Clarence Valley NSWNMA branch. “We had quite an extensive period where the whole town was blanketed in smoke and we saw a lot more presentations because of smoke inhalation. “Some of the firefighters presented to the hospital, and we had workers who had smoke just blowing through their workplace and they had asthma.” Hospital presentations traditionally peak in winter. However, longer and more destructive bushfire seasons are now putting pressure on hospitals all year round. “A lot of people with co-morbid conditions had to come and stay in hospital because their homes were in jeopardy,” Remana said. “People who have extensive NDIS packages, and who normally only come in when they are unwell, came in when their normal services couldn’t reach them.” While demands on the hospital increased, some staff members had trouble getting to work. “At one point we only had one highway in and out of Grafton, and a lot of nurses couldn’t come to work because of fires closing roads. “Five hospital workers lived in Nymboida, where 85 homes were lost, and they were cut off from their properties.” The Clarence branch had already been campaigning for more staff in recent months, Remana said. “We have been asking for extra staff, for something as simple as the in-charge nurse not having a patient load, and for an extra nurse across each shift in emergency in Grafton and at Maclean, and extra nurses across the wards in Maclean.”

‘ A lot of people with co-morbid conditions had to come and stay in hospital because their homes were in jeopardy.’

ABOVE, SMOKE HAZE ON THE STREETS OF GRAFTON. LEFT, GRAFTON EMERGENCY DEPARTMENT TEAM . FAR RIGHT, REMANA HARRIS.

THE LAMP FEBRUARY / MARCH 2020 | 11

COVER STORY

Grieving for what you’ve lost – and grieving for your country After a bushfire, the mental scars can last for years.

ast experiences, both in Australia and overseas, tell us that the mental health impact of our bushfire emergency could last for up to five years. “We know that the impacts of natural disasters extend beyond the end of the emergency, with the mental impacts of the 2009 Black Saturday bushfires being felt up to five years post-disaster for some people,” Christine Morgan, the CEO of the National Mental Health Commission, told the Canberra Times. “Because of this, it is important that the mental health and wellbeing of Australians is supported immediately, as well as providing ongoing longterm interventions.” A study published in the Australian and New Zealand Journal of Psychiatry (May 2014) looked at fire-hit areas about three years after the Victorian Black Saturday bushfires killed 173 people and levelled huge tracts of land. The study found that more than 15 per cent of respondents in heavily affected areas reported probable PTSD associated with the fires, while 13 per cent reported depression and almost 25 per cent reported heavy drinking. “In Victoria, we know all too well that recovery is not as simple as rebuilding infrastructure. It’s something that can take us not

12 | THE LAMP FEBRUARY / MARCH 2020

just months, but years – and we need to support people and their mental health every step of the way as they deal with the trauma,” said Luke Donnellan, Victoria’s acting minister for mental health. D i a ne Ro s s - Gl a z er, a psychot herapist who ha s counselled disaster survivors and lived through bushfires herself in California told Time Magazine that as a result of the bushfires, Australia’s “psyche will change. You’re not only grieving what you lost; you’re grieving for your country”. She said it was important to bring people together as they grieve, and to keep that connection going for months or even years after a disaster via public support groups, memorials and ceremonies.

The dark epilogue After the Black Saturday bushfires in Victoria a study found:

15%

of respondents in heavily affected areas reported PTSD

13% 25%

reported depression

reported heavy drinking

Coping with bushfire stress and eco-anxiety The summer’s bushfires have left many Australians despairing over the devastation of the bushfires on lives and property. Experts say many people could now be vulnerable to “eco-anxiety” or what the American Psychological Association describes as “a chronic fear of environmental doom”. Writing in The Conversation, Professor James Scott, the head of Mental Health at the QIMR Berghofer Mental Institute and his colleague Fiona Charlson outlined some measures to help people build resilience: • Connect with friends and family and positively engage in your community • Support those who are vulnerable – it benefits both the giver and receiver • Seek to reduce your own carbon footprint. This can alleviate feelings of guilt and helplessness and make a positive difference to the environment • Join one of the many groups advocating for the environment • Assist bushfire relief efforts • Seek mental health support if you feel your mental health is deteriorating.

COVER STORY

Bushfire information for nurses and midwives Many of us have family, friends or colleagues who have lost homes or been forced to evacuate from their properties during the bushfires. For those members who have been impacted, the following support is available: FEE ASSISTANCE For members of the NSWNMA who have lost homes, property or livestock in these fires, or have been injured in the course of this catastrophe, the Association is offering fee assistance. To access this support, please email gensec@nswnma.asn.au, or call us on 1300 367 962. Please note that, due to the enormity of this event, each request for assistance will be determined on a case-by-case basis. INDUSTRIAL SUPPORT Members in affected areas may be experiencing issues with work, including being unable to attend work due to the fires, having to take time off work to support family and protect property or volunteer to

fight the fires. In the first instance, where possible, please ensure you contact your employer to notify them of your circumstances. If you need industrial advice or support, please do not hesitate to contact us on gensec@nswnma.asn.au. Please note that industrial rights and leave arrangements available in the current situation will vary between awards, agreements and employers. Your rights will also be in part determined based on your individual circumstances. Include as much information as possible about your situation in any contact with us. MENTAL HEALTH We also urge you to look after yourself, family, neighbours and friends, and to access mental health services if you need it. You can contact any of the following services to access this support, or you can contact your employer to access their Employee Assistance Program. Disaster Welfare Assistance Line: 1800 018 444 NSW Mental Health Line: 1800 011 511 Nurse Midwife Support: 1800 667 877 OFFERS OF HELP For those who are not directly impacted by the bushfires, but wish to assist the efforts, we urge

Your rights during bushfires For an outline of your industrial rights during a bushfire go to the Ask Judith page on page 37 of this Lamp.

you to make a donation to one of the many charities doing great work on the ground, including the Rural Fire Service: www. rfs.nsw.gov.au/volunteer/ support-your-local-brigade At this stage, regional health facilities have not sought volunteer medical assistance from us. However, we will advise members of any request from NSW Health if such a request does arise.

COUNSELLING FOR THOSE IMPACTED BY THE BUSHFIRES The federal government has relaxed the usual requirements to access counselling for those impacted by recent bushfires. Normally you have to get your GP to do an assessment that says you require counselling. You can now choose a service and make an appointment without first visiting a GP. You don’t have to live in a fireaffected area to access this counselling. Whatever the reason – if it’s bushfire related the need to see a GP first is waived. This initiative allows access to 10 counselling sessions.

THE LAMP FEBRUARY / MARCH 2020 | 13

COVER STORY

Climate breakdown turns a nurse into an accidental activist Deanna Hayes, a private hospital nurse and a mother of three including Ambrose, a school striker, spoke about the health implications of climate change when she addressed a recent Students for Climate Action rally.

“

When my son joined the school strike for climate movement just one year ago, I never imagined I would be standing here like this, an accidental activist. I have been aware of climate change for a very long time but have never been so frustrated as I am now, when the evidence of global warming and climate change is beyond dispute. We are already suffering the beginnings of the consequences of the climate crisis. I guess some of these beliefs rubbed off onto Ambrose, but I never imagined the time and effort a 14-year-old along with his fellow organising team, could (contribute) to follow the lead of another a ma zing teena ger in Gret a (Thunberg), and mobilise people into action for this movement. Meetings, speeches, liaison with police and council, and disappearing from home for hours, even days on end: I guess that’s the life of school striker. So I stand here today to ask, “Scomo, where the bloody hell are you?” Hawaii, I believe? Are you having a nice holiday while Australia burns? As a nurse I understand about health. I understand that bushfire smoke is toxic to us all. I now understand about air quality measurements and read that

14 | THE LAMP FEBRUARY / MARCH 2020

‘ As a nurse, I understand about health. I understand that bushfire smoke is toxic to us all.’ — Deanna Hayes last week in Sydney the PM 2.5 was the highest ever on record, and not only in Sydney but in country towns from Newcastle to Orange. I understand that the nasal symptoms, sore throats and sinus problems people are suffering are real.

“AS A MOTHER I AM TERRIFIED” As a mother, I am worried. Actually, I am terrified. I am terrified that my generation has not done enough to address the issues of climate change. I am terrified that my children will not be able to enjoy the natural world as I have. I am dreadfully sad for the loss of animal life that has been incinerated in these dreadful firestorms. I am dreadfully sad for the beautiful bushland we have enjoyed on our many camping trips as a family. Some of these rainforest areas are not fire adaptive so may never fully recover. I am furious at the silence and inaction of our government. Scott

Morrison can barely admit the link between climate change and our ongoing drought and fires. I am furious at Scott Morrison’s insensitive comments, which are all he seems capable of making about the bushfires. I’m sure those volunteers would love to be at home cheering at the cricket and not out day a f ter day bravely defending their communities. Our prime minister seems ready to pass the buck on the management of fighting these catastrophic fires to the state governments, instead of calling it a national emergency. Where is the urgency required to enlist help? These fires have already burned more land than any other in the last 25 years. And it’s only the beginning of summer. The burning of these fires has already released as much carbon into our atmosphere as half of our annual emissions. Isn’t that a national emergency? The little people like us see this. Why don’t those in power?” n

AGED CARE

he Morrison government is attempting to privatise the work of Aged Care Assessment Teams (ACATs) from April 2021, with tenders to be called this year. This latest privatisation move comes before the Royal Commission into Aged Care has had a chance to deliver its final recommendations this year. Health and aged care ministers from three states – including Liberalled NSW – have voiced concerns about ACAT privatisation and the Royal Commission has rebuked the Morrison government over the issue (see page 17). ACATs work in public health services to help elderly people access appropriate levels of support, either at home, hospitals or nursing homes. ACATs are made up of register e d nu r s e s , ger i a t r ic i a n s , community dementia nurses who are also ACAT assessors, and allied health professionals. They are employed by state health ministries with federal government funding. ACAT clinicians work closely with hospitals, geriatricians, GPs and Area Health hospital prevention programs. The proposed privatisation is an extension of the Abbott government’s 2014 part-privatisation of Regional Assessment Services, which assess people seeking home care packages.

‘ ACATs are independent of service providers and our assessments are purely based on the clinical needs of the client.’ — Lynne Williamson Now, half of all Regional A s se s sment Ser v ice s belong to NSW Health and work with ACAT. NSW NM A member Ly n ne Williamson is one of about 30 RNs who work at Hunter ACAT in Newcastle. She fears privatisation would have negative impacts on patients and clients needing approvals to access services. “Currently, ACATs are independent of service providers and our assessments are purely based on the clinical needs of the client,” she said. “How do you replicate that level of independent expertise in a new, privatised service?” Lynne said ACAT was already under pressure from providers to approve higher level home care packages (HCPs) when case management of the existing package would suffice. “HCPs are worth up to $50,000 per person per year and providers can keep up to 60 per cent in service

fees and profits,” she said. “Package funds are being used for whitegoods, swimming pool and home repairs, gym costs and ironing instead of meeting direct care needs.” She sa id non-government providers currently funded to provide only a single service are reluctant to encourage clients to use other services that have funding for the full suite of available government programs. “Instead, they pressure ACAT for higher level HCPs and an immediate increase in HCP provision, a strategy that would increase their profits. “It would be better to streamline the available programs, so that HCP providers currently funded to provide only a single service have access to flexible in-home respite to support their HCPs. “Flex ible in-home respite provides up to four hours a week extra care at a cost of $5–$15 an hour.” n

THE LAMP FEBRUARY / MARCH 2020 | 15

AGED CARE

ACAT nursing jobs at risk Privatisation threatens the jobs of highly skilled and experienced nurses who ensure appropriate care is provided based on individual needs.

SWNMA Acting General Secretary Judith Kiejda has warned that ACAT is being privatised with “a complete lack of transparency” and no assurances on staffing and skill mix to guarantee quality care and proper use of government funding. “Privatisation and deregulation in the aged care sector has led to chronic understaffing,” Judith pointed out. “The Royal Commission has described the aged care sector as a ‘shocking tale of neglect’. “The federal government’s move to privatise ACAT services will further degrade a system in dire need of more support.” Judith noted that ACAT teams work in conjunction with treating clinicians and are integral to a client’s journey. “Replacing key members of these teams with private contractors will sever these relationships.” She added that private companies do not have access to electronic medical records nor do they have the knowledge, skills and well-established relationships to provide comprehensive and accurate assessments. “ACAT assessors are currently employed by NSW Health and

many are rostered to attend hospital referrals, which ensures assessments are prioritised based on the flow of beds. “Not having ACAT teams on site may contribute to longer waiting times in our already-overstretched public hospitals and further delays on assessments. “Waiting for a private company to attend facilities will surely cause delays.” Judit h sa id privatisation could put for-profit nursing home operators (or subsidiaries) in charge of the assessments of elderly patients, leading to a conflict of interest and lack of accountability. “An RN working in our public health system makes no financial gain and only has the interest of their patients and clients at heart. “Private providers exist to make a profit and may pursue ‘ideal’ clients that are most likely to deliver a higher profit for aged care facilities.” Judith warned that introducing profit-driven competition into aged care assessment would ensure a race to the bottom as contractors tried to spend the least in order to maximise their taxpayerfunded profit. n

‘ The federal government’s move to privatise ACAT services will further degrade a system in dire need of more support.’ — Judith Kiejda 16 | THE LAMP FEBRUARY / MARCH 2020

‘A race to the bottom’ The Doctors Reform Society (DRS) says it is “deeply concerned” by the federal government’s announcement that it is starting the ACAT privatisation process. “A privatised ACAT will be a race to the bottom”, said DRS president Dr Tim Woodruff. “Poorly trained assessors will inadequately assess complex patient needs as they gouge government fees for their private owners and force the dedicated assessors out of the system because they will not be profitable. “More taxes wasted and gifted to private businesses. “Does this really sound like a way to improve the lives of our ageing population?” He said the government was moving ahead with privatisation despite its own Royal Commission into Aged Care preparing to deliver a full report with funding recommendations by November 2020. “Nothing in its interim report suggests that a way forward is to privatise anything. Indeed, the report has clear concerns about ‘the market’.”

AGED CARE

Hazzard disowns ACAT privatisation The NSW Liberal Party’s Health Minister joined State Labor ministers in criticising the ACAT privatisation. The Aged Care Royal Commissioner was not happy, either.

‘ My understanding is that there is not one state or territory leader who is in agreement with any involvement of the private sector in (these) complex and delicate decisions.’

S W He a lt h M i n i s ter Brad Hazzard has twice crit icised t he federa l gover n ment fo r it s determination to privatise Aged Care Assessment Teams. “NSW has major concerns,” Mr Hazzard said in December. “It seems pre-emptive and unreasonable to be effectively privatising health aged care services while the Royal Commission into Aged Care is still under way. Not a lot of logic there.” Mr Hazzard returned to the issue in January, saying it made no sense to involve a private service. “My understanding is that there is not one state or territory leader who is in agreement with any involvement of the private sector in making the complex and delicate decisions around our aged citizens’ assessments for support packages in their home,” he said. Mr Hazzard said the NSW Government was “not happy” there was no consultation with the Council of Australian Governments (COAG) before the decision was made. “There has not been any discussion whatsoever between state, territory and federal ministers at COAG’s health ministers meeting, which is where a major reform like this needs to be discussed,” he said. Mr Hazzard’s federal Liberal colleague, Aged Care Minister Richard Colbeck, hit back, claiming the royal commission supported the privatisation move.

— NSW Health Minister Brad Hazzard

This earned a rebuke from the chair of the royal commission, Gaetano Pagone, QC.

“It is a myth that aged care is an effective consumer-driven market,” the interim report said.

ROYAL COMMISSIONER RUBBISHES FEDERAL GOVERNMENT’S CLAIM

Victorian Minister for Disability, Ageing and Carers, Luke Donnellan, said his government was concerned by “the rush to privatisation”.

Commissioner Pagone said the commission’s interim report “did not endorse the government’s stated position” on privatising ACATs. “Public concern has been expressed about statements made by the Minister for Aged Care and Senior Australians that we had decided to support the privatisation of the Aged Care Assessment Teams in our interim report,” he noted. In an interim report last year, the Royal Commission voiced concern about the aged care system’s increasing reliance on “market forces”.

Queensland Acting Health Minister, Leanne Enoch, said privatisation “will not improve services for (elderly) Queenslanders and in fact could make the system more fragmented and harder to navigate.” Ms Enoch added: “The Commonwealth thinks a market-led solution is the answer to every problem.” “The reality is health systems are better placed to make the clinical assessments required to ensure people receive funding packages that reflect their needs.” n THE LAMP FEBRUARY / MARCH 2020 | 17

WORKPLACE SAFETY

Worker safety comes first in mental health The Industrial Relations Commission says modifications to mental health facilities must not put employee safety at greater risk.

ental health facilities must prioritise employee safety over measures to improve the therapeutic environment for patients, the NSW Indust r ia l Relat ions Commission has ruled. Commissioner John Murphy made the ruling when he dismissed an attempt by Sydney Local Health District (SLHD) to overturn a SafeWork NSW prohibition notice. SafeWork had ordered SLHD not to remove a counter inside the McKay Unit of the Concord Centre for Mental Health, in the absence of consultation. Management wanted to remove two 1.31-metre-high counters in the Intensive Psychiatric Care Unit (IPCU) and High Dependence Unit (HDU) and replace them with fixed “touch down” desks. A WorkSafe inspector told the LHD not to remove the IPCU counter because its removal would put staff in greater danger of violence from patients. Her notice said: “You must ensure that workers are not exposed to occupational violence, so far as is reasonably practicable, by having adequate systems of work including physical protection for workers from aggressive and violent patients that includes drug-affected patients.” The inspector noted that staff used the counter as:

18 | THE LAMP FEBRUARY / MARCH 2020

‘ The safety of employees (must be) preferred over the desire to enhance the therapeutic environment for the patients.’ — Commissioner John Murphy • A physical barrier to separate them from violent patients

notice but SafeWork upheld the inspector’s decision.

• a space from which they can try to de-escalate a situation

The LHD then asked the Industrial Relations Commission to authorise an external review of the SafeWork decision.

• a means to safely observe what is happening in the ward in the event of an emergency • a safe space to walk into from the nurses’ station, that permits workers to see the ward and identify risks prior before entering it (staff cannot see all of the ward from the nurses’ station). According to minutes of a meeting with management to discuss proposed capital works, the “mass majority” of McKay staff protested against the decision to remove the counters, which had “saved their lives during many incidents involving patients”.

COMMISSION REJECTS LHD’S APPEAL Commissioner Murphy noted that an NSW NM A workplace health and safety officer also raised safety concerns. The LHD applied to SafeWork for an internal review of the prohibition

In rejecting the application for an external review, Commissioner Murphy said SLHD wanted to remove the IPCU counter “to enhance the therapeutic environment for the patients.” He added: “Whilst this motivation is commendable, it cannot override the obligation that the Workplace Health and Safety Act places on SLHD to ensure, so far as is reasonably practicable, the health and safety of the staff on the unit.” Commissioner Murphy said subsections 19(1) and 19(2) of the WHS Act “certainly require that the safety of employees be preferred over the desire to enhance the therapeutic environment for the patients”. He said replacement of the counter with a “touch down” desk of lower height would make it easier for patients to get over or around and behind the desk and attack staff.

WORKPLACE SAFETY

Commission sets precedent for all mental health units Also, removal of the counter would “deprive staff, on exiting the nurses’ station, of the ability to look out and observe what is happening in the unit from a relatively safe position before proceeding further”. Commissioner Murphy said the LHD did not assess the risk of removing the counters until after SafeWork issued the prohibition notice. Furthermore, the risk assessment team comprised four managers, so it was “unsurprising that the risk assessment, when it was eventually conducted, concluded that the removal of the counter in the IPCU would not pose a safety risk to the staff who worked on that unit.” Consultation has now occurred. Management and staff are now working together on a safe resolution of the issue. n

Read the decision Commissioner Murphy’s decision can be downloaded via: https://www. caselaw.nsw.gov.au/ decision/5d899c8 6e4b0c3247d711f96

The Industrial Relations Commission decision on the McKay Unit sets a precedent that nurses aim to have applied at other mental health units. For instance, nurses at Campbelltown Hospital’s Birunji youth mental health unit have asked management to reverse a decision not to replace a counter that was demolished by an aggressive patient. NSWNMA delegate for Campbelltown mental health services, Mark Hardacre, said the counter had been an effective barrier between aggressive patients and staff. “It gave you an area to retreat to if there was a risk of violence,” he said. “Now, with the counter gone, you’ve got no defence. “It’s a safety risk and we want to use the IRC decision relating to the McKay Unit to get it fixed.” Since the counter was demolished in August, staff have reported several incidents connected to the absence of a counter. Some incidents have required the use of duress calls. In others, staff have had to remove aggressive patients from the main nurses’ station. At Concord Hospital, McKay Mental Health Unit nurses say management are more inclusive and transparent in their decision making following the IRC ruling. Management and staff are working together to come up with a mutually agreeable design for new counters for the Intensive Psychiatric Care Unit and High Dependence Unit. There have been several meetings involving staff and managementappointed architects.

‘ It’s a safety risk and we want to use the IRC decision to get it fixed.’ — NSWNMA delegate, Mark Hardacre

The meetings have examined 12 designs and chosen a shortlist of four. A risk assessment of the shortlisted designs is being done by a team comprising an NSWNMA workplace health and safety officer, a health and safety representative in the McKay Unit, a nurse unit manager and representatives of hospital management and allied health staff.

THE LAMP FEBRUARY / MARCH 2020 | 19

SAFE STAFFING

‘Under-resourced, shambolic and at times, dangerous.’ Blacktown Hospital ED staff tell minister the human cost of understaffing.

“

Mr Hazzard, our department is in crisis and can only be described as underresourced, shambolic and at times, dangerous.” That’s how nurses and other health workers at Blacktown Hospital’s emergency department described their new facilities in an open letter to NSW Health Minister Brad Hazzard. The letter was signed by more than 100 employees and sent by NSWNMA General Secretary Brett Holmes. The letter said Western Sydney Local Health District had promised a staffing review, but failed to make any progress. It called on Mr Hazzard to urgently intervene. It said: “While the new facilities are undoubtedly attractive and contain state-of-the-art equipment, our department is dangerously understaffed, which puts members of our community at risk. “ W it h i nc re a s e d p a t ient presentations and acuity, inadequate staffing and inappropriately skilled replacement staff, we have been stretched beyond breaking point… it beggars belief that more thought was not given to the department’s staffing requirements.” The letter said understaffing had, “on occasion, led to catastrophic outcomes for patients under our care.”

20 | THE LAMP FEBRUARY / MARCH 2020

‘If you cannot assist us, we will be forced to act to ensure our patients receive appropriate care.’ It said insufficient staffing had caused scheduled mental health patients to abscond from care and “there is concern that some of these patients may have self-harmed or harmed others.” Patients in the resuscitation bay “are sometimes not receiving adequate care because of staffing and design issues”, the letter warned. “These are our sickest patients and at times we cannot care for them. “This has contributed to a number of serious patient incidents and must be addressed.”

PATIENTS WAITED 24 HOURS FOR A BED The letter said staff had been directed to offload patients from ambulances into beds that have no staff allocated to them. “Patients are not assessed in a timely manner, which may be a matter of life and death in some circumstances.” Patients already admitted to hospital were having to wait for a bed for more than 24 hours, Mr Hazzard was told. T hey included paed iat r ic patients, psychiatric patients,

cardiac patients waiting without monitoring and patients awaiting surgical admission. “While in our waiting room, they do not have adequate care and support, are uncomfortable and under a great deal of strain,” the letter added. “This has led to a number of violent outbursts, which have required the intervention of hospital security and the police. “This is an impossible situation… If you cannot assist us, we will be forced to act to ensure our patients receive appropriate care.” In reply to Brett Holmes, Mr Hazzard said he appreciated the NSWNMA’s advocacy on behalf of hospital staff. He said the LHD had agreed to give the department three additional nurses per shift for six months while a staffing review took place. He acknowledged that patients had absconded from the ED and added: “There is no evidence that scheduled mental health patients who have absconded, have selfharmed or harmed others.” n

SAFE STAFFING

More nurses for Blacktown ED Staff and union pressure achieved three extra nurses per shift for Blacktown Hospital’s emergency department.

estern Sydney Local Health District agreed to roster three extra nurses per shift at Blacktown Hospital’s ED for six months while a staffing review takes place. The NSWNMA led a push for more staff after the ED moved to a new, expanded area in August 2019. Nurses found that the larger workspace added to existing workloads pressures. Blacktown emergency presentations have increased by almost 15,000 since 2012, when the ED had its last significant staffing increase. NSWNMA representatives put a case for three extra nurses per shift to management, but the LHD said no. Blacktown Hospital branch then resolved to impose an overtime ban unless management agreed to a formal staffing review. Management agreed to a review and members backed by the union pressed NSW Health Minister Brad Hazzard for further action. More than 100 nurses and other ED staffers signed an open letter to Mr Hazzard. The letter warned the ED was “dangerously understaffed” and said understaffing had already “led to catastrophic outcomes for patients under our care”.

THREE EXTRA STAFF WON After the letter appeared, LHD CEO Graeme Loy and other senior executives met with representatives from the NSWNMA and other

ERWIN ALFONSO AND QUENNIE DOUGLAS

‘The extra hands at front of house have made caring for patients in the waiting room safer and more efficient.’ — Erwin Alfonso hospital unions. Following the meeting, Mr Loy agreed to an additional three nurses, 24 hours per day, for six months starting in November 2019. The LHD expects to finish the staffing review by March. ED nurses have welcomed improvements resulting from the additional staffing. “The extra staffing has made a huge difference, particularly in ‘resus’”, said NSWNMA member Quennie Douglas. “Having that extra nurse to cover meal breaks and give support during

times when patients deteriorate is a massive load off our backs. “Patients are better cared for as well. They are neat and comfortable because we have the extra hands to attend to their basic needs.” NSW NM A member Er w in Alfonso said: “The extra hands at front of house have made caring for patients in the waiting room safer and more efficient. “There is also room for us to be able to implement a more structured approach to deliver care in the waiting room as a result of appropriate staffing.” n THE LAMP FEBRUARY / MARCH 2020 | 21

SAFE STAFFING

Wyong ED campaigns for more staff Nurses are campaigning for more staff at Wyong Hospital’s emergency department, where waiting times are among the worst in the state.

n the past six months, NSWNMA members have held two lunchtime rallies outside Wyong Hospital to highlight inadequate staff levels in the emergency department. The rallies have received support from Central Coast Labor MPs and favourable coverage in local media. The NSWNMA is calling for three extra nurses to be rostered on each shift in ED, and an urgent staffing review. More than one third of Wyong ED patients wait more than four hours to receive treatment, according to the Bureau of Health Information. The NSWNMA’s Wyong branch has been reporting unreasonable workloads in the ED since 2016. Branch assistant secretar y Jacinda Farrell said members received union t ra ining in how to document workloads during 2019. “We hope management will come forward with a solution because nurses are overwhelmed and genuinely concerned about not being able to provide adequate care to their patients,” she said. “It’s incredibly stressful not to be able to give your patients the care they deserve.” Jacinda said excessive workloads left senior staff with little time to mentor junior nurses in the ED. NSWNMA General Secretary Brett Holmes said members were distressed by the lack of

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ED presentations break records

WYONG HOSPITAL BRANCH ASSISTANT SECRETARY JACINDA FARRELL

support from the Central Coast Local Health District. “Our members know firsthand that staffing levels are inadequate to meet the local growth in population, which is putting patient safety constantly at risk,” Brett said. “E D pr e s e nt a t ion s h ave continued to rise and the patients presenting are very unwell. The hospital’s own data shows this, and management knows this, yet they continue to expect their nursing staff to do more with less. “Our members are reporting increased levels of overtime, sick leave not being replaced, senior nurses being unable to fully support their junior counterparts, as well as high levels of exhaustion and fatigue due to understaffing.” Brett said patient aggression towards nurses was a major issue and long waiting times were a contributing factor. n

Presentations to NSW public hospital emergency departments hit an all-time high last winter, vindicating calls by the NSWNMA for urgent extra nursing staff. According to the Bureau of Health Information (BHI), emergency presentations rose in all 15 Local Health Districts during July to September. There were more than 760,000 ED presentations across the state – an increase of 6.6 per cent compared with the same quarter in 2018. The timeliness of care provided in EDs was down across key measures in July to September. For instance, 31.9 per cent of patients spent more than four hours in ED – an increase of 3.3 percentage points. Central Coast hospitals were high on the list of the percentage of patients waiting more than four hours. Gosford was among the worst five in the state, with 42.9 per cent and Wyong registered 35.1 per cent. Data obtained by the NSWNMA shows that presentations to Wyong hospital ED increased by 10,102 patients between 2014 and 2018. That represents an average increase of 28 patients per day.

ADVERTORIAL

An accurate weight can help save a life Now every patient can be weighed quickly & easily Obtaining accurate patient weight – especially for immobile patients - is a global problem. While safe practice protocols tell us an accurate weight measurement is important to avoid adverse drug events and ensure effective patient care, in practice it’s difficult and time consuming to achieve. There have been numerous studies both in Australia and internationally that identify the difficulties in accurately weighing patients. These include: •

Inability to access appropriate weighing equipment

•

Clinical status – including physical or cognitive impairment

•

Time – with hoist weighing taking up to 20 minutes per patient

•

In fact, nurses rank lifting and weighing patients among their 8 most stressful handling tasks. No wonder medical staff estimate a patient’s weight or ask the patient what they weigh.

Perceptions that weighing patients is invasive THE LAMP FEBRUARY / MARCH 2020 | 23

ADVERTORIAL

How important is accurate patient weight? The Australian Commission on Safety and Quality in Healthcare recommends weighing all patients on admission to hospital. It also recommends ongoing weekly (for acute patients), monthly (for other streams) and/or when a patient’s condition changes. Timely and accurate patient weight informs a variety of patient interventions which include: •

▪ Safe prescribing practices

•

▪ Radiation and chemotherapies

•

▪ Manual handling

•

▪ Skin integrity management

•

▪ Identifying nutritional risk

Gillian Taylor, Inventor of the Patient Transfer Scale

Yet data collected from Australian hospitals identifies a widespread problem with obtaining and recording accurate patient weight. While suboptimal, the general practice is to visually estimate patient weight. Studies (Menon S, Kelly AM) found medical personnel all inaccurately estimated patient weight with an error rate ranging between 7.7 - 11%. In fact, only 59% of physicians made weight estimates to within 10% of actual weight. Even when asked to provide their own weight, patients provided inaccurate information with an error rate of 3.9%. In a paper written by Alison Evans {RN, RM, BN, GradDip Acute Care Nursing, MNursing (Clinical)} and published in the Australian Journal of Advanced Nursing, she states there is a “large and unacceptable variance and inaccuracy in estimates when individual practitioners estimated the same patient’s weight … Furthermore, the significance of overestimating weight is the potential risk of over dosage and related clinical consequences of a medication related adverse event.”

The Patient Transfer Scale is essentially a transfer board with built-in weighing scale so it can weigh patients as they are moved from trolley to trolley, trolley to bed or bed to bed.

phone: 1300 970 111

24 | THE LAMP FEBRUARY / MARCH 2020

One ED nurse decided to find a solution. Frustrated by the difficulties of gaining accurate patient weight and its importance to determine dosage, former UK emergency department nurse, Gillian Taylor, decided the weighing process had to change. So, with help from UK scale manufacturers, Marsden, Gillian developed the Patient Transfer Scale. Using the existing process of transferring a patient from trolley to bed, trolley to trolley or bed to bed, the Patient Transfer Scale quickly and accurately measures a patient’s weight. When asked why she designed the Patient Transfer Scale, Gillian said:

“With some medicines, there’s a narrow window for them to be given, but weighing a patient can take quite a bit of time. While for illnesses like sepsis or strokes, it’s vital to get an accurate weight for safe medication management. One day I thought, why can’t we have a full-body sliding board with a built-in scale so we can weigh patients during the transfer process?” In hindsight, it’s such a simple idea but it took an experienced ED nurse to come up with it. Now the Patient Transfer Scale is changing patient outcomes around the world. It recently arrived in Australia and is exclusively available from Wedderburn.

enquiries@wedderburn.com.au

www.wedderburn.com.au

Patient Transfer Scale

Weigh patients during the lateral transfer process With the Patient Transfer Scale, weighing patients becomes part of the existing lateral transfer process as a patient is transferred from trolley to trolley, trolley to bed or bed to bed.

It provides highly accurate weight measurements at 500g increments and can handle obese patients with a capacity of 250kg. It measures 1800mm x 510mm in size. Its many features include: •

Battery power offering 50 hours of continuous use from full charge

To weigh a patient, staff simply place the Scale between the trolley and/or bed and then move the patient across in line with normal manual handling/ patient transfer policies. It only takes 3-4 seconds to register the weight as the patient passes over the Patient Transfer Scale. The large digital display includes a “Hold” function which can be used, if required, to freeze the weight measurement while staff continue to transfer the patient. This ensures staff aren’t reliant on memory if there is a short delay between weighing the patient and recording the weight on the patient’s chart.

•

Magnetic mains charger so the Scale can be quickly removed from its charging point in an emergency

•

Large, clear digital weight display

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“Hold” function to freeze the weight reading while the patient transfer is completed

•

Height guide

•

Portable design

•

Side grab handles

•

Wipe clean surface

The Patient Transfer Scale has been tested in 30 different hospitals to address a wide range of medical environments and requirements.

•

Wall hooks so it requires very little storage space

Importantly, the Patient Transfer Scale is TGA Registered. THE LAMP FEBRUARY / MARCH 2020 | 25

ADVERTORIAL

COVER STORY

Multiple benefits to staff, patients & the hospital system Obviously, there are many factors that contribute to patient outcomes, but accurate weighing is significant. For example, the correct dosage of treatments is often dependent on exact weight. With some, underestimating a patient’s weight can cause toxicity while overestimating a patient’s weight can lead to suboptimal therapeutic effects. Door to needle time is another factor that affects patient outcomes – especially for critical care patients. Globally door to needle (DTN) time policies range from 210 minutes in Bangladesh to 19 minutes in Japan with the average being 30 minutes. Yet these targets are consistently difficult to meet. In a recent study of 178 US hospitals, only 44.5% of patients were thrombolysed within the target time. Yet studies have found relative reductions in mortality of up to 50% have been observed when therapy was provided early (in reference to myocardial infarction) (Marsden).

phone: 1300 970 111

26 | THE LAMP FEBRUARY / MARCH 2020

When the Patient Transfer Scale is introduced, many hospitals find the speed and ease of weighing patients, along with the associated improvement in door to needle times and dosage accuracy, are helping to ease nursing workloads, improve patient outcomes and relieve some of the pressure on hospital systems.

Now available in Australia The Patient Transfer Scale recently arrived in Australia. To arrange a demonstration to investigate how easily it will fit into your existing lateral transfer processes, contact Australia’s exclusive supplier, Wedderburn by calling 1300 970 111 or email enquiries@wedderburn.com.au. They have offices around Australia.

enquiries@wedderburn.com.au

www.wedderburn.com.au

SAFE STAFFING

Stronger branch helps win more staff At Shoalhaven Hospital, getting management to employ more nurses has gone hand in hand with building a stronger branch of the NSWNMA.

llawarra Shoalhaven Local Health District has agreed to fund additional nursing positions in Shoalhaven Hospital's emergency department – something the branch had sought for two years. The hospital is at Nowra on the NSW South Coast. The breakthrough came after more nurses joined the NSWNMA and got involved in branch activities. Greater membership involvement s t r e n g t he ne d t he b r a nch’s bargaining power. It felt confident enough to discuss action to close unfunded beds in the ED’s rapid assessment zone (RAZ). However, industrial action was not needed because management agreed to recruit 2.4 additional FTE (full-time equivalent) nurses to staff the RAZ 24 hours per day. “This is a good win which came about because the branch positioned themselves to be able to put an action in place if the LHD did not agree to approve the new positions,” said NSWNMA General Secretary Brett Holmes.

‘ We are recruiting more members, we’re more active on social media, and nurses contact us more readily about problems we sometimes aren’t aware of.’ — Michael Clarke workloads committee. "As a result, management agreed to staff the RAZ 24 hours per day. But staff would be drawn from the existing roster rather than new recruitment," Michael said. “That created gaps in the roster, which were filled by casual staff. Then, when people went on leave there were not enough casual staff available to backfill positions. “After the branch discussed possible industrial action, NSWNMA head office wrote to management, who agreed to fund new positions. “The branch believes all nursing positions should be promptly recruited to and funded accordingly."

MORE MEMBERS MAKE A MORE EFFECTIVE BRANCH

The RAZ was added two years ago but was staffed for only 12 hours per day.

Shoalhaven is a level B2 hospital with 143 beds and, as of late last year, 594 staff including casuals.

Shoalhaven branch president Michael Clarke said the branch passed resolutions and lobbied management for 24-hour staffing.

Beginning in March 2019, NSWNM A orga nisers and Shoa lhaven bra nch members planned a union membership drive and an education program for members wishing to get involved in union activity.

The dispute went to the Industrial Relations Commission, which recommended talks at the hospital’s

As a result, union membership increased to 100 per cent in some wards. By January 2020, the branch had 24 executive members including 20 stewards – between one and two stewards from each ward or department. Half the stewards have done NSWNMA training and the other half are booked in. An average of 15–20 members attend regular branch meetings. Branch officials have set up more effective communication with members through WhatsApp. Hospital management now deal with the branch directly rather than trying to go through union head office. Michael said greater membership involvement meant the branch was better able to represent nurses’ interests. “We are recruiting more members, we're more active on social media and nurses contact us more readily about problems we sometimes aren’t aware of. That helps us to get good outcomes for our members.” n THE LAMP FEBRUARY / MARCH 2020 | 27

LIVING WELL

Nutrition for the nurse Eating well when you have a job of stress and shifts is challenging but it can be done, says Kathryn Hawkins, an expert in women’s health.

‘ There is no ‘flight’ when you’re a nurse. You get in there and you deal with it.’

athryn recently spoke to NSWNMA delegates at the Future Ready conference about the unique challenges nurses and midwives face in maintaining healthy lifestyles. Stressful environments and shift work with few breaks make healthy eating more difficult than usual, Kathryn said. In nursing and midwifery “you see things, unfortunately, that people shouldn’t really have to deal with, and on a fairly regular basis,” she said. In a highly stressed situation the sympathetic nervous system kicks in and the flight or fight response is activated, but there is no “flight” when you’re a nurse, Kathryn notes. “You get in there and you deal with it.” “You have adrenaline surging through your body, then you have a blood sugar response to [the adrenaline], then you have an insulin response to that … this state of stress can go on for hours, but you can end up slowing your digestion right down. “You can end up in this constant state of upheaval and not even notice that you’re in that anymore because it’s become your new 28 | THE LAMP FEBRUARY / MARCH 2020

— Kathryn Hawkins

normal. You will become fatigued to that adrenaline.” An environment of constant stress impacts your body’s ability to absorb nutrients, and is also linked to poor decision making, and yet for nurses “pretty much your entire shift is making decisions”.

TRAUMA AND ITS IMPACT ON EATING “When people go through a trauma at work, they may not feel hungry for a long time or they might feel quite shaky, while other people’s response might be to go home and indulge. “But the immediate impact of trauma might be that you stop eating and drinking properly for a while, and you need to be aware of that and make sure you stay hydrated.” Studies of nurses at the end of their shift have found that they are

often very dehydrated, Kathryn said. “Anecdotally, they will say, ‘I didn’t want to drink too much because I don’t want to pee because I don’t have time’.” Kathryn recommends drinking two to three litres of water a day. “Managing shift work is really hard,” she added, noting that the research shows the best approach is to try to “maintain a regular eating pattern regardless of your shift, and have your three main meals and your snacks within a 24-hour period”. For night shift she recommends taking enough healthy snacks from home so you don’t resort to the biscuits or the vending machines. “Soups are great; everybody’s got access to toast at work. So you can bulk freeze small portions … Put in your bag and by lunchtime you can just stick it in the microwave.” ■

LIVING WELL

Kathryn’s seven tips to healthier eating

P ay attention to your gut “We know that we’ve got a lot of serotonin receptors down in the gut and they talk to the serotonin receptors in our brain. So good gut health usually equates to good mental health,” Kathryn says. Improve your gut health – and reduce the risks of all kinds of disease – through eating lots of fruits and vegetables, probiotic and fermented foods. “Foods that are high in fibre that are giving the good bacteria a chance.”

2 3

Reduce red meat intake Buy a can of tuna and throw it on the top of some salad and add some balsamic vinegar. Take boiled eggs to work to eat with toast and a quarter of an avocado. Make a batch of falafels and freeze them and get them out and put them with a salad wrap. Reduce your intake of processed meats to reduce your salt intake too.

Don’t focus on weight “Weight really doesn’t equate to health at all,” Kathryn says. “I often will have a patient sitting opposite me that might be in a larger body. And I look at their blood work and it’s perfect. Their diet is healthy and everything that they’re doing is great. I can have someone sitting across from me in a body we deem to be a ‘normal size’ and their blood work’s atrocious and they’re eating very poorly with very poor lifestyle choices.”

Mindfulness is key “Be aware of what you’re eating and consciously sitting down and enjoying a meal. If I pour a wine and sit down and do some reading, I’ll think ‘I didn’t even taste that, I’ll have to have another glass.’ But it’s because I’m distracted.

6 7

Check in with your hunger keys After a meal stop and ask, ‘Am I full or do I need seconds?’ Kathryn suggests. “When you go back for seconds, get seconds of everything. Don’t just get seconds of the good bit. Get seconds of the vegetables as well.” “A good way of thinking about hunger is on a zero to five scale, where zero is I’ve never been hungrier in my life and five is I’m Christmas day full. You need to be sitting around a three after a meal.” Throughout the day aim to stay between a two and a four so that you don’t end up so hungry you overeat. Reduce alcohol intake “The standard government guideline is two to three alcohol-free days a week. Make those alcohol-free days in succession and give yourself a real break from alcohol. If you drink every night, your drinks slowly start to get a bit bigger. After a couple of days without alcohol, when you pour a drink it’ll go back to just being a nice small manageable glass of wine.”

Use this visual cue “When it comes to lunch and dinner, look for half a plate of fruits and vegetables, a quarter of a plate of protein, and a quarter of a plate of carbohydrate.”

THE LAMP FEBRUARY / MARCH 2020 | 29

NEWS IN BRIEF

UNITED KINGDOM

Historic strike by Northern Irish nurses Unsafe staffing and poor pay in the absence of a functioning government in Northern Ireland led to 9000 nurses from the Royal College of Nursing (RCN) going on strike for the first time in the union’s 103-year history. Another 6,500 nurses from the Unison union also joined pickets for the one-day strike on December 19. The striking nurses were undeterred by miserably cold weather, with driving wind and rain. It is believed to be the biggest industrial action of its kind ever in Northern Ireland. Northern Ireland has the worst hospital waiting lists in the UK, according to figures from the Department of Health. And according to the RCN, nurses’ pay in Northern Ireland has fallen in real terms by 15 per cent over eight years. There is a shortage of about 2,800 nurses. Northern Ireland nurses want pay parity with their counterparts in England, Scotland and Wales who won a 6.5 per cent pay rise last year. But the pay rise did not apply to Northern Ireland because of the absence of devolved government. “Northern Ireland hasn’t had a functioning government for almost three years. Patients and nurses need … health ministers to be appointed again to take charge of this crisis,” said Donna Kinnair, RCN general secretary. “I hope this first-ever industrial action by RCN nurses will provide the shock politicians and health and social care management need to take action.”

‘ I hope this firstever industrial action by RCN nurses will provide the shock politicians and health and social care management need to take action.’ — Donna Kinnair, RCN general secretary

30 | THE LAMP FEBRUARY / MARCH 2020

UNITED STATES

Pentagon: climate change will lead to “all hell breaking loose” The US military views climate change as an existential threat to human society and has already started implementing mitigation plans. Climate scientists, environmentalists, and health experts have been loudly proclaiming the need for urgent action to prevent climate breakdown for years. Now another organisation is ringing the alarm bells: the US military. Although the Pentagon has been discrete about its analyses and plans for climate change, it has been implementing strategies for some years. “Climate change is an urgent and growing threat to our national security, contributing to increased natural disasters, refugee flows, and conflicts over basic resources such as food and water,” the US Department of Defense told Congress in a 2015 memorandum. “These impacts are already occurring and the scope, scale and intensity of these impacts are projected to increase over time.” In a recent book, “All Hell Breaking Loose”, professor emeritus Michael Klare outlines the Pentagon’s perspective on climate change. “The generals’ view is the likelihood that climate change will cause grave harm to the homeland,” he writes. Klare says the US military contemplates what may be called an “all hell breaking loose” scenario – “a situation in which key US allies are begging for American troop support to avert collapse while the homeland is reeling from several major climate disasters and vital military installations are incapacitated by storms or wildfires”.

‘The generals’ view is the likelihood that climate change will cause grave harm to the homeland.’

NEWS IN BRIEF

AUSTRALIA

Australian teens rank 140th out of 146 in the world for physical activity Australia ranked dismally in a study using World Health Organization guidelines to measure physical activity among teens. The study, published in The Lancet (Nov 2019), looked at how 1.6 million adolescent school students, aged from 11 to 17, from 146 countries benchmarked against WHO’s physical activity recommendations.

SWEDEN

Swedish success in reducing antibiotic use Experts say Australia can learn an important lesson from the Swedish experience with antibiotics: only prescribe them when absolutely necessary. Antibiotic use rose in Sweden during the 1980s as it did in many countries including Australia. Then in 1995 a Swedish Strategic Programme Against Antibiotic Resistance (STRAMA) was formed leading to dramatic reductions in antibiotic use. Between 1992 and 2016, the number of antibiotics prescriptions decreased by 43 per cent overall. Among children under four, antibiotic prescriptions fell by 73 per cent. Levels of antibiotic use in Sweden are now among the lowest of all OECD countries, both in humans and animals. Australia is among the highest users of antibiotics. Researchers at Bond University, writing in the online journal The Conversation, outline several Swedish initiatives that could reverse antibiotic resistance in Australia including: • Using an “audit and feedback” to give GPs a summary of their antibiotic prescribing rates over a specified period of time • Strengthening restricted access to specific antibiotics • Stop default repeat prescriptions which leave patients believing another course of antibiotics is needed when this is not always the case • Delaying prescribing – a GP provides a prescription during the consultation, but advises the patient to see if the symptoms will resolve first before using it. The researchers say it is important to change public attitudes around antibiotic use. “It’s important to communicate the negative effects of the unnecessary use of antibiotics and the risk of antibiotic resistance for the individual as well as the community. “Continuous awareness campaigns are essential to keep the public tuned into the issue”.

‘ It’s important to communicate the negative effects of the unnecessary use of antibiotics.’

These guidelines recommend a minimum of one hour of moderate to vigorous physical activity each day. That’s a jogging-like intensity that gets you sweating and puffing. Australia came in seventh from the bottom when it came to the proportion of adolescents not getting enough physical activity. This placed Australia ahead of only Cambodia, Philippines, South Korea, Sudan, Timor-Leste and Zambia. Research continues to show a child’s physical activity participation has often peaked in primary school, before they transition into secondary school. In high school, there tend to be fewer areas conducive to outdoor physical activities, like playgrounds. High school students are often exposed to more spaces for sitting and socialising, and research shows they can start to develop negative attitudes towards physical education. Sedentary behaviour also increases during secondary schooling, with a higher proportion of students using electronic devices for longer than the recommended two hours per day for recreation and entertainment.

‘Research continues to show a child’s physical activity participation has often peaked in primary school, before they transition into secondary school.’ POSITION VACANT

LEGAL OFFICER We are recruiting a Legal Officer to join our Professional Services Team on a permanent full-time basis. For more details, please visit

www.nswnma.asn.au/jobs-at-nswnma THE LAMP FEBRUARY / MARCH 2020 | 31

NEWS IN BRIEF

AUSTRALIA

Smoke exposure presents unique risks for pregnant women There’s no safe level of air pollution and the health hazards tend to be greatest for vulnerable groups like pregnant women. Research shows prolonged exposure to bushfire smoke increases the risk of pregnancy complications including high blood pressure, gestational diabetes, low birth weight and premature birth (before 37 weeks). These conditions can have short-term and lifelong effects on a baby’s health, say researchers from the Robinson Research Institute at the University of Adelaide. AUSTRALIA

Bushfire threat to drinking water safety Bushfires pose serious short- and long-term impacts to public drinking water quality and the consequences could last for decades, say experts. “(Bushfires) can damage water supply infrastructure and water catchments, impeding the treatment processes that normally make our water safe to drink,” Stuart Khan, Professor of Civil and Environmental Engineering, UNSW wrote in the online journal The Conversation. Several areas in New South Wales and Victoria were issued with warnings about the quality of their drinking water during January. In the short-term, bushfires can damage or disrupt water supply infrastructure as they burn. And the risks can persist after the fires are out, says Prof Khan. “A loss of power, for example, disables important water treatment processes such as chlorine disinfection, needed to kill microorganisms and make our water safe to drink.” Drinking water for the towns of Eden and on the NSW south coast was affected in this way. Residents were advised to boil their water before drinking it and using it for cooking and brushing their teeth. Other towns, including Cobargo, received similar warnings on New Year’s Eve. In the long-term bushfires can damage drinking water catchments, which can lead to longer lasting threats to drinking water. Drinking water catchments are typically forested areas, and so are vulnerable to bushfire damage. “Severe impacts to waterways may not occur until after intense rainfall. Heavy rain can wash ash and eroded soil from the fires into waterways, affecting drinking water supplies downstream,” says Khan. “Impacts to catchments from bushfires and subsequent erosion can have long-lasting effects, potentially worsening untreated drinking water quality for many years, even decades.”

‘Drinking water catchments are typically forested areas, and so are vulnerable to bushfire damage.’ 32 | THE LAMP FEBRUARY / MARCH 2020

“Importantly in pregnant women, environmental pollutants can cause inflammatory damage to the placenta’s blood supply. This can interfere with the placenta’s development and function, which can in turn compromise the growth of the foetus. “Many studies have linked poor air quality, particularly with high levels of PM 2.5 (ultra-fine particles), to poor pregnancy outcomes. Data from 183 countries showed in 2010, an estimated 2.7 million premature births, 18 per cent of the total, were associated with PM 2.5 pollution,” they wrote in The Conversation. A 2019 study of more than 500,000 pregnant women from Colorado looked at the effect of bushfire smoke on pregnancy outcomes. The study found PM 2.5 due to bushfire smoke was linked to spikes in premature birth, especially in women exposed during the second trimester. For every 1 microgram/m³ increase in average daily exposure to PM 2.5 during the second trimester of pregnancy, the risk of premature birth increased by 13 per cent. To put this into context, in Canberra in the first week of January, PM 2.5 levels averaged more than 200 micrograms/m³, compared with the typical background concentration of 5 micrograms/m³.

‘These conditions can have short-term and lifelong effects on a baby’s health.’

NEWS IN BRIEF

UNITED KINGDOM

Giving calories an exercise context to reduce obesity New research suggests that saying how much consumers need to exercise to burn off calories could change eating habits. SALLY McMANUS

AUSTRALIA

Anti-union bill shot down

The defeat of the Morrison government’s grotesquely named “ensuring integrity” bill is a victory for union members and a humiliation for the government. The Morrison government’s union-busting bill – backed by employer groups – was voted down in the senate late last year when crossbenchers joined Labor in opposing the bill. The bill would have given the government new powers to deregister unions and disqualify their officials. Chris Brodsky, an official with the Queensland branch of the CFMMEU, is credited with persuading the One Nation senators to oppose the bill. He said they were persuaded after “taking the time to understand what the bill would do to unions”. He said the accusation Westpac had breached anti-money laundering provisions 23 million times highlighted the hypocrisy of the government’s bill. The ACTU also conducted intensive lobbying of the crossbenchers bringing union members to Canberra to explain how unions were at risk of deregistration for campaigns such as advocating nurse-to-patient ratios or fighting asbestos company James Hardie. The crossbench senators received 45,000 emails from workers asking them to block the bills in the days before the vote. ACTU secretary Sally McManus said members from unions all over the country campaigned to stop the law. “Without the efforts of hundreds of thousands of working people across Australia a law designed to hurt the rights of working people would now be law,” she said. “Working people have stood up against an attack on democratic rights and won. ”

A new study by researchers at Loughborough University supports an approach to food product labelling that would display small symbols showing how much physical activity is needed to compensate for consuming the item. For example, a fizzy drink containing 138 calories could have a small symbol of a person showing it would take 26 minutes of walking or 13 minutes of running to burn off these calories. The researchers say the approach puts calories in context and may help people to avoid overeating, or spur them to move about more in a bid to burn off the energy they have consumed. They also suggest it might encourage food producers to make products with less calories. Published in the Journal of Epidemiology and Community Health, the study found that participants selected on average about 65 fewer calories per meal when exercise-based labels were present on food or menus. While this might not seem a lot, researchers say with each meal this mounts up. “People think that obesity is caused by gluttony. It isn’t. Obesity is caused by all of us eating just a little bit too much,” one of the researchers, Prof Amanda Daley, told The Guardian.

‘ Obesity is caused by all of us eating just a little bit too much.’

‘ Working people have stood up against an attack on democratic rights and won.’ THE LAMP FEBRUARY / MARCH 2020 | 33

PROFESSIONAL EDUCATION

SYDNEY METRO

February to May 2020 Education Waterloo

Medications: How we do it better, Wed 5 February, $95 / $190, 6 CPD Hours Your Annual CPD Obligations, Thur 20 February, $50 / $100, 3 CPD Hours Alcohol and Other Drugs: The Current situation. An update for all nurses, Wed 11 March, $95 / $190, 6 CPD Hours Introduction to Suicide Assessment and Management for nurses and midwives – NEW, Thur 12 March, $50 / $100, 3 CPD Hours Know where you stand with Law, Ethics and Professional Standards in nursing and midwifery, Thur 19 March, $95 / $190, 6 CPD Hours Combatting Stress and Burnout – NEW, Fri 27 March, $95 / $ 190, 6 CPD Hours Writing for Publication – NEW, 3 day course (do one or all days), Weds 1 April, 6 May, 10 June, $95 / $190 or $270 / $540 for 3 Workshops, 6 CPD Hours per session Environmental Health Seminar, Fri 3 April, $60 / $120, 5 CPD Hours

Goal Setting: How you create the outcomes you are after – NEW, Wed 8 April, $95 / $190, 6 CPD Hours Leadership in Practice – NEW, Wed 15 April, $95 / $190, 6 CPD Hours Wound Debriding Workshop – NEW, Wed 22 April, $95 / $190, 6 CPD Hours Skill Set for new managers and senior nurses and midwives, Fri 24 April, $95 / $190, 6 CPD Hours Perioperative Workshop – NEW, Wed 29 April, $95 / $190, 6 CPD Hours Enrolled Nurses Seminar , Fri 1 May, $60 / $120, 6 CPD Hours Professional and Public Health Ethics, Ethical Decision Making and Leadership – NEW, Thur 7 May, $95 / $190, 6 CPD Hours Medications: How we do it better, Wed 13 May, $95 / $190, 6 CPD Hours Deteriorating Patient Workshop – NEW, Thur 21 May, $95 / $190, 6 CPD Hours Clinical Communication & Documentation, Wed 27 May, $95 / $190, 6 CPD Hours

Blacktown

Student to New Grad, Thur 6 February, $30 / $60, 6 CPD Hours, New Grad / Final Year Nursing and Midwifery Students Clinical Communication and Documentation, Tue 25 February, $95 / $190, 6 CPD Hours Mental Health First Aid, 2 day course, Tue 12 & Wed 13 May, $190 / $360, 12 CPD Hours

Dee why

Know where you stand with Law, Ethics and Professional Standards in nursing and midwifery, Wed 25 March, $95 / $190, 6 CPD Hours Resourcefulness for Combatting Stress – NEW, Thur 14 May, $95 / $190, 6 CPD Hours

Gymea

The Deteriorating Client (Aged Care), Wed 18 March, $95 / $190, 5 CPD Hours Perioperative Workshop – NEW, Wed 27 May, $95 / $190, 6 CPD Hours

Hornsby

Emotional Intelligence Training, Thur 16 April, $95 / $190, 6 CPD Hours

TAE Academy and NSWNMA have formed a partnership to offer NSWNMA members the TAE40116 Certificate IV in Training and Assessment at a discounted rate This joint venture will allow nurses and midwives to undertake the Certificate IV program in a contextualised manner. 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 Ave, Waterloo NSW 2017 Cost for online program: $1,431 (or 4 x $357.75 installments) Cost of face-to-face program: $2,765 (6 x $460.95 installments) Face-to-face program commences 11 March.

34 | THE LAMP FEBRUARY / MARCH 2020

For Forfull fulldetails detailsofofcourses coursesincluding includingcourse coursecontent, content,venue venueand andtimes, times, please pleasego gototothe theAssociation Associationwebsite websitewww.nswnma.asn.au www.nswnma.asn.au

CPD CPD

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

February FebruarytotoMay May2020 2020Education Education Taree Taree

Clinical ClinicalCommunication Communication&& Documentation, Documentation,Wed Wed1212February, February, $95 $95/ $190, / $190,6 6CPD CPDHours Hours

Clinical ClinicalCommunication Communication&& Documentation, Documentation,FriFri2727March, March, $95 $95/ $190, / $190,6 6CPD CPDHours Hours

HUNTER HUNTERNEW NEWENGLAND ENGLAND Armidale Armidale

Foot FootCare: Care:AANurses NursesRole, Role, Mon Mon9 9March, March,$95 $95/ $190, / $190,6 6CPD CPDHours Hours

Maitland Maitland

Dementia DementiaManagement, Management, Thur Thur2323April, April,$95 $95/ $190, / $190,7 CPD 7 CPDHours Hours

ILLAWARRA ILLAWARRA SHOALHAVEN SHOALHAVEN Shoalhaven ShoalhavenHeads Heads

Wound WoundCare: Care:Negative NegativePressure Pressure Wound WoundTherapy, Therapy,Tue Tue3131March, March,$95 $95/ / $190, $190,6 6CPD CPDHours Hours

Wollongong Wollongong

Introduction Introduction toto Mental Mental Health Health for for nurses nurses and and midwives midwives – NEW, – NEW, Thur Thur 55 March, March,$95 $95/$190, /$190,6 6CPD CPDHours Hours

Clinical ClinicalCommunication Communication&& Documentation, Documentation,Wed Wed2626February, February, $95 $95/ $190, / $190,6 6CPD CPDHours Hours

NEPEAN NEPEAN/ / BLUE BLUEMOUNTAINS MOUNTAINS Penrith Penrith

Introduction IntroductiontotoMental MentalHealth Healthfor for nurses nursesand andmidwives midwives– –NEW, NEW,Tue Tue 2121April, April,$95 $95/ $190, / $190,6 6CPD CPDHours Hours

Springwood Springwood

Palliative PalliativeCare CareWorkshop, Workshop,Mon Mon 2323March, March,$95 $95/ $190, / $190,6 6CPD CPDHours Hours

Clinical ClinicalCommunication Communication&& ‘Leaning ‘Leaninginto intoHealth Healthand andHarmony’ Harmony’ Documentation, Documentation, Thur Thur2828May, May, – –AAVision Visionand andSelf-Care Self-Careworkshop workshop $95 $95 / $190, / $190, 6 6 CPD CPD Hours Hours for forNurses Nursesand andMidwives, Midwives,Mon Mon1818May, May, Dementia DementiaManagement ManagementTraining, Training,Tue Tue $95 $95/ $190, / $190,6 6CPD CPDHours Hours 2626May, May,$95 $95/ $190, / $190,7 CPD 7 CPDHours Hours NORTHERN NORTHERNNSW NSW

Muswellbrook Muswellbrook

MID MIDNORTH NORTHCOAST COAST

Byron ByronBay Bay

Foot FootCare: Care:AANurses NursesRole, Role,FriFri2121 February, February,$95 $95/ $190, / $190,6 6CPD CPDHours Hours

Port PortMacquarie Macquarie

Tweed TweedHeads Heads

NSW REGIONAL REGIONAL NSW

CENTRAL CENTRALCOAST COAST Gosford Gosford

Medications: Medications: How How we we dodo it it better, better, Leaning Leaninginto intoHealth Healthand andHarmony: Harmony: Coffs CoffsHarbour Harbour Thur Thur 2626 March, March, $95 $95 / $190, / $190, 66 CPD CPD Hours Hours Aged Visioning Visioning and and Self-Care Self-Care Workshop, Workshop, AgedCare CareSeminar, Seminar,Thur Thur2727February, February, Wed Wed4 4March, March,$95 $95/ $190, / $190,6 6CPD CPDHours Hours $60 $60 / $120, / $120, 6 6 CPD CPD Hours Hours Newcastle Newcastle

Know Knowwhere whereyou youstand standwith withLaw, Law, Ethics Ethicsand andProfessional ProfessionalStandards Standards ininNursing Nursingand andMidwifery, Midwifery,Wed Wed4 4 March, March,$95 $95/ $190, / $190,6 6CPD CPDHours Hours

Medications: Medications:How Howwe wedodoit itbetter, better, Thur Thur 16 16 April, April, $95 $95 / $190, / $190, 6 6 CPD CPD Hours Hours Mental MentalHealth HealthFirst FirstAid, Aid,2 2day daycourse, course, Thur Thur1212& &FriFri2727March, March,$190 $190/ $380, / $380, MURRUMBIDGEE MURRUMBIDGEE 1212CPD CPDHours Hours

CPD CPD 66

SOUTHERN SOUTHERNNSW NSW Goulburn Goulburn

Medications: Medications:How Howwe wedodoit itbetter, better, Thur Thur7 May, 7 May,$95 $95/ $190, / $190,6 6CPD CPDHours Hours

Clinical ClinicalCommunication Communication&& Documentation, Documentation,FriFri8 8May, May,$95 $95/ $190, / $190, CPDHours Hours Medications: Medications: How How we we dodo it it better, better, Tue Tue 6 6CPD 2525 February, February, $95 $95 / $190, / $190, 66 CPD CPD Hours Hours WESTERN WESTERNNSW NSW

Wagga WaggaWagga Wagga

Clinical ClinicalCommunication Communication&& Documentation, Documentation,Thur Thur1414May, May, $95 $95/ $190, / $190,6 6CPD CPDHours Hours

Coffs CoffsHarbour Harbour

Wound WoundCare: Care:Venous VenousInsufficiency, Insufficiency, FriFri2020March, March,$95 $95/ $190, / $190,6 6CPD CPDHours Hours

Bathurst Bathurst

Aged AgedCare CareSeminar Seminar $$

Thur Thur2727February February2020, 2020,9am 9amtoto4pm 4pm C.ex C.ex Coffs, Coffs, 2-6 2-6 Vernon Vernon St,St, Coffs Coffs Harbour Harbour Members Members$60 $60| Non-members | Non-members$120 $120 Lunch Lunch && refreshments refreshments provided provided

PROGRAM: PROGRAM: • Consumer • Consumer Consultation, Consultation, Risk Risk Management Management and and the the new new Standards Standards – what – what does does it mean? it mean? • Assessment, • Assessment, Planning Planning and and Care Care forfor Residents Residents with with Sensory Sensory Loss Loss – New – New Standards Standards Approach Approach • Elder • Elder Abuse Abuse • The • The New New Charter Charter ofof Aged Aged Care Care Rights Rights • Legal • Legal Guardianship, Guardianship, Enduring Enduring Power Power ofof Attorney. Attorney.

Know Knowwhere whereyou youstand standwith withLaw, Law, Ethics Ethicsand andProfessional ProfessionalStandards Standards ininnursing nursingand andmidwifery, midwifery, Wed Wed11 11March, March,$95 $95/ $190, / $190,6 6CPD CPDHours Hours Medications: Medications:How Howwe wedodoit itbetter, better, Thur Thur1212March, March,$95 $95/ $190, / $190,6 6CPD CPDHours Hours

Orange Orange

Aged AgedCare CareSeminar, Seminar,Thur Thur2828May, May, $60 $60/ $120, / $120,6 6CPD CPDHours Hours

THE LAMP FEBRUARY / MARCH 2020 | 35

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

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

WHO MAY APPLY 1 Registered or Enrolled Nurses;

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

2 You must be currently working in aged care;

TO APPLY

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

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

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

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

DIABETES UPDATE EVENING for nurses

Your NDSS agent in NSW & ACT is

Learn while you earn CPD points Wednesday 12 February 2020 Coffs Harbour Wednesday 11 March 2020 Albury Thursday 19 March 2020 Miranda Thursday 2 April 2020 Rooty Hill

Ticke ts $20

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

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

YOUR RIGHTS

SPECIAL Ask

Judith The bushfires raise important questions We have watched in horror over the last few months at the devastation caused by bushfires raging throughout this land. Tragically, lives have been lost. A great many have suffered unimaginable distress and anguish, which will undoubtedly leave a mark on them as indelible as that made to the landscape. Some of us know family or friends who have been so touched by this disaster. We help out as families and friends do. But many of our members have been in the front line resisting the spread of fires or ensuring that the sick, infirmed, the elderly continue to receive the clinical care and support desperately required. Often this has occurred when they themselves, and their families and homes, have been under direct threat of encroaching fires. The acts of bravery, persistence and resilience demonstrated by the community, and by our members in spades, have been both breathtaking but also thought provoking. Is this the new normal? Are our systems – whether disaster and emergency management or health systems or support for citizens and employees – sufficient to cope with the breadth and extent of such a catastrophe? As many have noted, current systems in place are largely predicated upon the ‘traditional’ path of disasters: it comes; it wreaks havoc; it passes ‘relatively’ quickly; and then relief and repair move in. Life for most then generally goes back to normal. No more … When things do settle, and we start heading into the reconstruction phase, which will take many years to fully complete, questions will need to be asked. Some will be difficult and awkward. It will require a recognition that repeating or relying upon a ‘business as usual’ approach will not be enough. The Association and its members, on behalf of the nursing and midwifery professions and those they care for and support, will need to be near the centre of any such discussion. My thoughts and admiration goes out to all at this grave start to a new decade.

Your rights during the bushfires NSWNMA Assistant General Secretary Judith Kiejda has the answers.

Public Health Provisions relating to employee rights re the current disaster are largely set out in the Public Health System Nurses’ and Midwives’ (State) Award (‘Award’) and PD2019_010 Leave Matters for the NSW Health Service (‘Manual’). The following are general observations of some of the more commonly accessed rights, but each situation will turn on their own circumstances and associated events. USE OF FACS LEAVE Clause 32(iv)(b)(4) of the Award makes clear that FACS leave can be accessed “in a case of pressing necessity (e.g. where an employee is unable to attend work because of adverse weather conditions which either prevent attendance or threaten life or property …)” FACS LEAVE EXHAUSTED Under Section 12.8.2 of the Manual, where an emergency is declared, for example a declared natural disaster, employees directly affected by the emergency, and whose FACS leave is exhausted, may be granted up to five days’ special leave. Granting this leave is however, at the public health organisation’s discretion as to the necessity of the absence. During this current emergency, a further five days special leave may be granted. USE OF PERSONAL/ CARER’S LEAVE Clause 32 B(x) of the Award makes available sick leave to an employee who is required to provide care and support to, for example, a child or partner. LEAVE FOR VOLUNTEERS E.G. RURAL FIRE SERVICE Under Section 12.8.2 of the Manual, those health

employees who are volunteers with a designated organisation and assist in the emergency are to be granted leave with no upper limit to what may be granted. This is in addition to the five days’ paid leave in any period of 12 months made available to such volunteers.

Employees who have used all of their paid personal/ carer’s leave entitlement, and casual employees, are entitled to two days’ unpaid carer’s leave per occasion to provide care and support to a family or household member due to illness, injury or in the event of an unexpected emergency.

REST PERIOD FOR RETURNING VOLUNTEERS

COMMUNITY SERVICE LEAVE UNDER THE FW ACT

Under Section 12.8.4 of the Manual, an employee who has been on emergency duty for several days may be granted special paid leave to allow them reasonable time for rest before returning to their normal duties, except in situations where their days off coincide with the employee’s normal rostered days off duty.

Employees who are members of a recognised emergency management body can take unpaid community service leave for certain emergency activities such as dealing with a natural disaster. The amount of time that can be taken is not specified.

Private Sector It is almost impossible to list prescriptively the rights that may be available to members working under federal IR laws. Some entitlements may be available in your award or agreement. So checking your agreement and talking to your employer would be a good place to start. FAIR WORK ACT 2009 (‘FW ACT’) The FW Act provides some basic rights that will apply in the absence of any more beneficial terms in an agreement. PERSONAL/CARER’S LEAVE UNDER THE FW ACT Employees (other than casuals) affected by a natural disaster or emergency may have an entitlement to take paid personal/carer’s leave or compassionate leave. An employee is also eligible for personal/carer’s leave if their child’s school closed due to a natural disaster or emergency.

AGREEMENTS MADE UNDER THE FW ACT It is essential you check your agreement as some do contain more beneficial rights to assist in these situations. Some contain paid natural disaster leave for permanent employees affected directly by declared natural disasters and are unable to attend work. Provisions may also exist to access other forms of leave when disaster leave is exhausted. Other agreements contain various provisions for community service leave when engaged in eligible activity. The Association is aware that some private sector employers are stepping up and providing leave not usually made available. NOTE: If you are uncertain regarding your rights after checking out your award or agreement or dissatisfied with the response and/or actions of your employer, please contact the Association on gensec@nswnma.asn.au for further assistance.

THE LAMP FEBRUARY / MARCH 2020 | 37

OBITUARY

VA L E

Maria Davis 1 9 6 6 â&#x20AC;&#x201C;2 01 9

t is with great sadness that the staff of Urbenville MPS share the news of the passing of our colleague and friend, Maria Therese Davis. Starting work at Urbenville from 2005 as a hospital assistant, Maria said she found her true calling in her 40s, training as an AiN in 2008. Within months of starting her nursing role at Urbenville, she began her EN training through Ballina TAFE on a scholarship. After completing her training, she continued on at Urbenville, also doing shifts at the then Bonalbo Hospital. A bit of a scallywag, a shift with Maria was always entertaining. Never one to rest on her laurels, Maria soon began her RN training through Charles Darwin University in Darwin. We all have fond memories of Maria, bringing a bag of books to work with every shift, just in case she had a moment or two to study. On night duty she was regularly seen sitting cross-legged on a yoga mat with her books. It was during that time that Maria was diagnosed with cancer, and whilst having treatment, continued her studies, and as soon as she was able, returned to work. An active member of the Urbenville MPS Branch of the NSWNMA, Maria was always up for a letter

38 | THE LAMP FEBRUARY / MARCH 2020

drop, getting signatures on petitions or whatever was needed at the time. Family commitments saw Maria move to Grafton in 2017, where she worked in the surgical unit at Grafton Base Hospital, which she loved, but as her health began to deteriorate once more, the family decided to return to their home in Urbenville earlier this year. Maria was admitted to Urbenville MPS in September, where as her colleagues and friends, we had the honour of caring for her during her final weeks. It was a challenging task for those of us who had worked with her, but being the caring soul that she was, Maria was concerned about us. Always the nurse! We laughed and cried together, and with the support of Ingrid Hardy, Transitional NP Palliative Care for Richmond West, we came out the other side feeling that we had done the best we could possibly do for our friend. Maria loved her work and was proud to be a nurse. Her patients and the residents in turn delighted in her bright and bubbly charm. We will miss her deeply. Maria is survived by husband, Garry, sons Jacob, Lachlan and Flynn, and granddaughter, Gwendolyn. Gail Card, branch delegate

NURSING RESEARCH AND PROFESSIONAL ISSUES

Hot and bothered: heat affects all of us, but older people face the highest health risks Arnagretta Hunter, Physician & Cardiologist, The Canberra Hospital Australian summer temperatures have risen by 1.66°C over the past 20 years. In the past century we’ve seen a significant increase in the number, intensity and duration of heatwaves during our summers. Heat is the natural hazard associated with the highest mortality in Australia. When heatwaves occur, the death toll routinely reaches into the hundreds. For example, the 2009 heatwave across southeast Australia resulted in close to 500 deaths. Heat is more likely to endanger the health of people with pre-existing conditions, people who are socially isolated, and people who have limited access to air conditioning. These are often older members of the community. https://theconversation.com/ hot-and-bothered-heat-affects-allof-us-but-older-people-face-thehighest-health-risks-123769

Car accidents, drownings, violence: hotter temperatures will mean more deaths from injury Liz Hanna, Honorary Senior Fellow, Australian National University What we suspected is now official: 2019 was Australia’s hottest year on record. The country’s average maximum temperature last year (30.69°C) was a scorching 2.09°C hotter than the 1961–1990 average. For the whole planet, 2019 is expected to come in second (behind 2016) making the last five years the hottest on record since 1880. As we brace for increasingly hot summers, we are mindful extreme heat can pose significant health risks for vulnerable groups. But the effects of heat on the incidence of accidents and injury are less clear. In research published in Nature Medicine, researchers in the United

States looked at the impact warmer temperatures will have on deaths from injury. They found if average temperatures warmed by 1.5°C, we could expect to see 1600 more deaths each year across the US. Given Australia is ahead of the global temperature curve, we could see an even greater number of deaths from injury per capita as a result of rising temperatures. https://theconversation.com/caraccidents-drownings-violencehotter-temperatures-will-meanmore-deaths-from-injury-129628

Scientists calculated how much longer you can live with a healthy lifestyle Alice Park, Jan 2020 Study after study reminds us that as challenging as it can be, sticking with healthy habits – eating right, exercising regularly, not smoking, maintaining a healthy weight, and controlling how much alcohol you drink, can help us to live longer. But tacking on extra years isn’t so appealing if some or most of them are riddled with heart disease, diabetes or cancer. In a 2018 study, an international group of researchers led by scientists at Harvard T.H. Chan School of Public Health found that adopting five healthy habits could extend life expectancy by 14 years for women and by 12 years for men: • eating a diet high in plants and low in fats • exercising at a moderate to vigorous level for several hours a week • maintaining a healthy body weight • not smoking • consuming no more than one alcoholic drink a day for women and two for men To follow up on that data, the researchers wanted to know how many of those added years were healthy ones, free of three common chronic diseases: heart disease, type 2 diabetes and cancer. And in a study published on 8 January in BMJ, they report that a healthy lifestyle can

indeed contribute to more and more disease-free-years of life. The results suggest that women can extend their disease-free life expectancy after age 50 by about 10 years, and men can add about eight years more, than people who don’t have these habits. https://time.com/5761592/how-tolive-longer-and-healthier/

Human rights and technology: discussion paper Sophie Farthing, John Howell, Katerina Lecchi, Zoe Paleologos, Phoebe Saintilan, Edward Santow, Australian Human Rights Commission New technologies are emerging at extraordinary speed, with unprecedented social and economic consequences. Change is so pervasive that this era has been termed the ‘Fourth Industrial Revolution’. The Human Rights and Technology Project (Project) considers the implications for our human rights, and how we should respond to protect and promote those rights. Informed by extensive public consultation, this discussion paper uses a human rights approach to identify and analyse the challenges and opportunities for human rights protection and promotion in the context of new and emerging technologies. It considers what is needed in terms of regulation, governance and leadership, and makes concrete proposals to reform laws, policy and practice. The discussion paper is published at a critical time for Australia. There are several inquiries and consultations currently being conducted, with a view to shaping Australia’s response to the Fourth Industrial Revolution. There is a general consensus that this era presents risks and opportunities, and Australia needs to address both. https://www.humanrights.gov. au/about/news/human-rightsand-technology-discussionpaper-launches

THE LAMP FEBRUARY / MARCH 2020 | 39

INSURANCE BENEFITS

For NSWNMA Members

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

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

Unsure if you are financial?

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

www.nswnma.asn.au 40 |

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

CROSSWORD

test your

Knowledge 1

10 11 12

20 21

25 27

ACROSS 1. Nutritional intake in excess of normal (17) 10. The process of eliminating waste products from the body. (9) 11. Promoter (9) 12. An instrument for measuring pressure (9) 13. Enjoys (5) 15. People in power (6.5) 17. Relating to obesity and weight control (9) 19. Chinese counting devices (5) 20. Observation (3) 21. A person who forms business

contacts through informal social meetings (9) 23. The muscles at the back of the neck (7) 24. Loud deep sounds (11) 25. A blow, especially with the hand (5) 27. Transcription-mediated amplification (1.1.1) 29. The plate covering the upper surface of the end of a toe (7) 31. The gullets (9) 32. Adolescence (5) 33. An erythroblast with iron granules (11)

DOWN 1. A disorder or disease caused by or associated with the presence of haemoglobins in the blood (17) 2. An artificial regulator of heart rate activity (9) 3. A mucous or watery discharge (5) 4. A spear with three or more prongs (7) 5. Any of the steroid hormones that regulate water and electrolyte equilibrium (17) 6. The functional anatomic unit of the kidney (7) 7. A defence, an excuse (5) 8. Prompting, incentive, encouragement (11) 9. A physician specialising in neuropsychiatry (17) 14. Radiograph (11) 16. Seborrhoeic dermatitis occurring in infants (6.3) 18. Lights, arouses again (9) 19. Helps (7) 22. Ministroke (1.1.1) 26. Chambers in the ruminant stomach (5) 28. Glandular fever (4) 30. A flightless Australian bird (3)

THE LAMP FEBRUARY / MARCH 2020 | 41

Join Us. Make a difference! We are looking for energetic and experienced Registered Nurses to join our specialist supported accommodation services across the Newcastle and Lake Macquarie region. Coordinate and deliver high quality nursing and support services to people living with a disability in the community. Ability Options is a not for profit organisation that offers flexible, person centred support for people with disability in the Sydney, Hunter, Newcastle, and Mid North Coast areas.

Special moments deserve a special rate Take advantage of our Classic Home Loan special interest rate^ for 12 months with a minimum loan amount of $250k. New Business Only. Membership eligibility, conditions and exclusions apply. Before you apply, please see over for terms and conditions.^

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We offer: • Comprehensive employee benefits, including Salary Packaging • Full-time, Part-time and Casual opportunities

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Apply today* hpbank.com.au/classic

For more details, please contact Carolyn Kerr on 0414 572 960 or P&CTeam@abilityoptions.org.au

See over for terms and conditions.

The Edith Cavell Trust is now able to receive non-tax deductable donations/bequests. The Trust – named in honour of Edith Cavell – assists in the advancement of NSW nurses, midwives and assistants in nursing/midwifery through further studies and research, made available through scholarship. The knowledge and expertise gained by nurses, midwives and assistants in nursing/ midwifery, supported by the Edith Cavell Scholarships, is an asset to the care of their patients and clients. Bequests to the Trust continue to support this important work. Edith, a British nurse serving in Belgium in WW1, is a hero to most nurses and midwives. She helped some 200 Allied soldiers escape from German-occupied Belgium. Her actions saw her arrested, accused of treason, found guilty by a court-martial and sentenced to death. Despite international pressure for mercy, she was shot by a German firing squad. NAME ADDRESS

Cavell Edith

TRUST BEQUESTS

PHONE

BEQUEST/ DONATION AMOUNT

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

Visa

Card no Signature of Cardholder 42 | THE LAMP FEBRUARY / MARCH 2020

Name on Card Expiry Date

REVIEWS

book club

S PE

Kerrie Eyers and Gordon Parker Black Dog Institute: bookdeposity.com.au RRP $24.99.00: ISBN 978174755466

INTE IAL

ST RE

Mastering bipolar disorder

SPE C

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.

IA Mastering Bipolar Disorder gathers personal stories from L IN T E the real experts â&#x20AC;&#x201C; people with bipolar disorder. They share inspiring and sometimes amusing accounts of their experiences of bipolar episodes and wise advice on ways of managing the highs and lows on a daily basis.

They cover all aspects of bipolar disorder, from first symptoms and diagnosis, to times when the disorder is more or less under control. They emphasis the importance of personal strategies such as exercise and support networks, alongside medication and professional assistance. With tips from clinicians and the latest research, Mastering Bipolar Disorder offers tested and proven solutions to help everyone with bipolar disorder and their families experience a better quality of life.

Journeys with the Black Dog Rachel Clarke Tessa Wigney, Gordon Parker and Kerrie Eyers: Black Dog Institute: bookdepository.com.au RRP $24.95 ISBN 9781741752649

Autobiographical stories written by sufferers of depression open the lid on this disease and chart the journal from first onset to successful management. Inspiring and insightful reading from people who know exactly what it means to bring the black dog to heel. In this book, people share their personal stories of first symptoms, the path to getting diagnosed, the confusion and frustration and all the many ways to keeping depression at bay, whatever it takes. Witten with raw honesty and sharp humour, these stories demonstrate it is possible to gain control over depression. Genuinely inspiring reading for anyone who suffers from depression and those who care for them.

Art and Science of Mental Health Nursing 4th Edition Ian Norman and Iain Ryrie

Open University Press: bookdeposity.com.au RRP $95.50: ISBN 9780335226900

This textbook is a must for all mental health nursing students and nurses in registered practice. Comprehensive and broad, it explores how mental health nursing has a positive impact on the lives of people with mental health difficulties. New to this new edition are physical health care of people with mental health problems; care of people who experience trauma; promoting mental health and well-being; support needed by nurses to provide therapeutic care and to derive satisfaction from their work and innovations in mental health practice.

A Country Nurse Thea Hayes

Allen & Unwin: Booktopia.com.au RRP: $29.99 ISBN 9781760877156

After spending twenty years on the station she left in 1979, she was married with four children and eager for her next adventure. And what twists and turns her new life in rural Queensland had in store. From a stint running a corner shop in the small town of Toogoolawah, to dairy and cattle farming and working as a nurse in hospitals and nursing homes, Theaâ&#x20AC;&#x2122;s life was eternally colourful. At the age of sixty-five, after losing her husband, Ralph, Thea moved to London to work as a nurse and travel around Europe. Back home in Australia, she found a second chance at love with a country boy from WA, and her new life with Bob began with a caravan, a dangerous farming floodplain and a swag full of laughs.

THE LAMP FEBRUARY / MARCH 2020 | 43

Registered Nurses working in NSW Public Mental Health Services

BOB FENWICK MENTORING GRANTS PROGRAM Can help towards your CPD hours

OPPORTUNITY FOR CAREER DEVELOPMENT What is it?

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

Who can apply?

Any registered nurse currently working in NSW public mental health services is eligible to apply. Mental health nurses with less than two yearsâ&#x20AC;&#x2122; experience or working in NSW rural and remote areas as well as Aboriginal or Torres Strait Islander nurses currently working in mental health are all strongly encouraged to apply.

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

Seeking mentors for the Program

APPLICATIONS OPEN 1 FEBRUARY 2020 CLOSE 15 MARCH 2020

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

44 | THE LAMP FEBRUARY / MARCH 2020

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

How do I apply?

More detailed information about the Program (including a video interview of past participants) can be found on the NSW Nurses and Midwivesâ&#x20AC;&#x2122; Association website www.nswnma.asn.au 2020 EXPRESSION OF INTEREST FORMS WILL BE AVAILABLE FROM 1 FEBRUARY 2020. If you require more information contact the Program Manager by email: mhmgrant@nswnma.asn.au or contact Matt West on 1300 367 962.

R BE

MEM AL

GIV E

RUR

WIN

MEM RO

R BE

at the movies

ME T

REVIEWS

GIV E

The Leunig Fragments Keeping Faith Series 2 With exclusive and intimate access to one of Australia’s National Living Treasures – Michael Leunig - this feature documentary entertains, engages and enlivens audiences with a revealing portrait of an enigmatic artist who just happens to be a household name. With an anarchic, playful and life-affirming heart, the film celebrates self-expression, friendship, life and death, and the power of the imagination to ignite, enrage, heal and inspire. Filmed over five eventful years, we observe Michael grappling with life, art and mortality. The reflections of a man nearing the end of his inimitable half-century career encompass the curious boy Leunig starting out; past, present and future hopes and dreams collide in this moving portrait of one of Australia’s most prolific and intriguing artists. In cinemas 13 February, 2020.

Eve Myles returns as Faith Howells, a lawyer, wife and mother whose life was turned upside down by the unexplained disappearance of her husband, Evan (Bradley Freegard). Now, 18 months later, Faith is drawn into a new mystery as she takes on the case of Madlen Vaughan (Aimee-Ffion Edwards), a local farmer accused of murdering her husband in cold blood. Madlen’s murder trial, the prospect of Evan’s return, and her conflicted emotions towards former criminal Steve Baldini (Mark Lewis Jones) force her to take a stand. She puts her children, her business and her life on the line to search for the truth, and finally emerges scarred yet stronger. Email The Lamp by 13 February to be in the draw to win one of 5 DVDs to Keeping Faith Series 2 thanks to Acorn Media. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

Email The Lamp by 13 February to be in the draw to win one of 10 double passes to The Leunig Fragments thanks to Madman Entertainment. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win! THE LAMP FEBRUARY / MARCH 2020 | 45

DIARY DATES

make a date

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

NEW SOUTH WALES Greater Western Sydney LGBTIQ+ Networking Forum 12 February 2020 Thomas Rachel Moore Education Centre, Liverpool Hospital bit.ly/LGBTIQNetworkingForum The RHW Midwifery Conference: Tales of the Unexpected 28 February 2020 Royal Hospital for Women, Randwick www.royalwomen.org.au/rhwmidwifery Australian and New Zealand Urological Nurses Society Annual Meeting 7–10 March 2020 International Convention Centre, Sydney https://10times.com/ anzuns-annual-meeting APNA National Conference 21–23 May 2020 International Convention Centre, Sydney https://10times.com/ apna-national-conference-sydney ACORN 2020 International Conference: Vision for the future 28–30 May 2020 International Convention Centre, Sydney https://www.acorn.org.au 5th National LGBTIQ Women’s Health Conference 4–5 June 2020 NSW Teachers Federation Conference Centre, Sydney https://lbq.org.au Enrolled Nurses Professional Association NSW Annual Conference 2020 17–18 September 2020 Rydges Parramatta https://www.enpansw.net Enhancing Practice 2020 Conference: 20:20 Vision – Transforming our future through person-centred practices 11–13 November, 2020 Sage Hotel, Wollongong http://www.enhancingpractice2020.com. au/ehome/index.php?eventid=492510& INTERSTATE AICG Inaugural Patient Safety and Quality Care Symposium: Connecting Clinicians 26 March 2020 Pitchers Partners, Melbourne, Victoria info@aicg.edu.au Australian Pain Society 40th Annual Scientific Meeting 5–8 April 2020, Hobart, Tasmania https://www.dcconferences.com.au/ aps2020/ 46 | THE LAMP FEBRUARY / MARCH 2020

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

Palliative Care Nurses Australia Conference 3–4 May 2020 Pullman Albert Park, Melbourne, Victoria kt@asnevents.net.au Global Academic Programs (GAP) Conference: New Frontiers – Leading inspire cancer care 11–13 May 2020 Melbourne Convention and Exhibition Centre, South Wharf, Victoria jodi@laevents.com.au 7th Rural and Remote Health Scientific Symposium: Shaping the future 25–26 May 2020 Alice Springs Convention Centre, Northern Territory http://www.ruralhealth.org.au/7rrhss/home 23rd Cancer Nurses Society of Australia Annual Congress: Precision care everywhere 18–20 June 2020 Brisbane Convention and Exhibition Centre, Queensland https://www.cnsa.org.au/congressevents/ cnsa-annual-congress Renal Society of Australasia Annual Conference: Unite and ignite renal care for the next decade 25–27 June 2020 Melbourne, Australia https://www.renalsociety.org/ education/2020-annual-conference/ 18th National Nurse Education Conference: Inspire, Motivate, Educate 28–30 October 2020 Gold Coast, Queensland https://www.ants.org.au Wounds 2020 4–7 October 2020 Brisbane, Queensland https://wounds2020.com.au INTERNATIONAL 5th Commonwealth Nurses and Midwives Conference 6–7 March 2020 London, UK http://www.commonwealthnurses.org/ conference2020 3rd World Congress on Nursing Education and Primary Health Care 13–14 April 2020 Osaka, Japan http://bit.ly/2Z3ONoM International Conference on Nutrition Research 18–20 June 2020, Rome, Italy https://magnusconferences.com/ nutrition-research/

AIDS 2020 6–10 July, 2020 San Francisco, CA, USA https://www.aids2020.org/ Men’s Health World Congress 2020: United for men’s health 9–11 July, 2020 Borneo, Indonesia https://www.mhwc.my/ Alzheimer’s Association International Conference 26–30 July, 2020 Amsterdam, Netherlands https://www.alz.org/aaic/overview.asp International Council of Nurses (ICN) Congress 2021 Abu Dhabi, UAE www.icn.ch/ REUNIONS 100 years of Celebration: Blue Mountains District ANZAC Memorial Hospital – Reunion of all past employees 6pm, 15 February 2020 $65 per head – Three course meal Carrington House, Katoomba RSVP: 10 January 2020 Janejohansen@y7mail.com Royal Prince Alfred Hospital Reunion – March 1970 Intake 5 March 2020 lyndallurquhart@yahoo.com Back to Singleton Hospital 2020: ‘Breakfast on the lawn’ 8:30am, 15 March 2020 Singleton District Hospital Wendy.mason-jones@health..nsw.gov.au Wayde.Walker@health.nsw.gov.au 1981-1984 Westmead Nurses 40-year Reunion January 2021, Date and Venue TBC Freda Tomkinson on 0417 289 980 CROSSWORD SOLUTION

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

THE 2019 – 2020

NSWNMA Member Recruitment scheme prize PRIZE DRAWN 30 JUNE 2020

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

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

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

Conditions apply. Prize must be redeemed by 30 June 2021 and is subject to room availability. Block out dates include all Australian and NZ school holidays and Christmas / New Year period. The Optimal Wellness Program commences Sunday through Friday each week. The prize will be drawn on 30 June 2020. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/19/04224.

Join the health fund that’s all about you. At Nurses & Midwives Health, we're all about you. We're not-for-profit, so it means we're focused on your health and the health of your family. The great news is, as a member of the NSWNMA, you're eligible to join Nurses & Midwives Health. And, because we know how important family is, they can join us too.

For your free, side-by-side comparison, and our latest offers, visit nmhealth.com.au or call 1300 344 000 Eligibility criteria and conditions apply. Nurses & Midwives Health Pty Ltd ABN 70 611 479 237 NMH-NSWNMA-02/20

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