Lamp June 2019

COVER STORY

AGED CARE

CLIMATE CHANGE

REGULARS

National survey paints a bleak picture

Fewer RNs leads to more aggression and loneliness

The right to health

page 14

page 18

page 20

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

p.39 p.41 p.43 p.45

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 76 NO. 5 JUNE 2019

STAND UP FOR AGED CARE Print Post Approved: PP100007890

COVER STORY

Low fees and strong long-term performance, so I can retire with more The right support and advice to help you feel future ready

An industry fund first state super Consider our PDS at firststatesuper.com.au to decide if this is right for you before making a decision. Issued by FSS Trustee Corporation ABN 11 118 202 672, AFSL 293340, the trustee of the First State Superannuation Scheme ABN 53 226 460 365.

2 | THE LAMP JUNE 2019

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

Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au

VOLUME 76 NO. 5 JUNE 2019

Hunter Office 8–14 Telford Street, Newcastle East NSW 2300

8

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

COVER STORY Nurses impress at royal commission

Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary O’Bray Smith, NSWNMA President Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health 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

Evidence from nurses was well received at the inquiry into Australia's aged care system.

10 14

COVER STORY ‘No one seems to give a toss’

Aged care expert blasts ‘uncaring’ lawmakers and governments that leave residents ‘waiting to die’.

AGED CARE National survey paints a bleak

picture of aged care The ANMF’s 2019 National Aged Care Survey identifies a continued systemic failure to ensure safe and quality care to all aged care residents and an abrogation of duty by governments and providers.

Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, 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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Audit Period: 01/04/2017 - 31/03/2018

16 18

AGED CARE Fewer RNs leads to more aggression

and loneliness A decline in the number of RNs in aged care facilities is having a significant negative impact on people living with dementia, an NSWNMA report has found.

REGULARS

5 6 6 32 36 38 39 41 43 43

Editorial Your letters Competition News in brief At the Movies NSWNMA Education Ask Judith Nurse Uncut Facebook Nursing Research Online and Professional Issues 47 Crossword 49 Book Club 50 Diary Dates

AGED CARE Nursing home sanctioned after staff cut

Complaints by NSWNMA members have led the aged care regulator to impose sanctions on an understaffed nursing home.

20 26

CLIMATE CHANGE The right to health

A National Strategy on Climate and Health would not only deal with the threats to health from global warming; it would also be an opportunity to improve our health system.

COVER STORY

AGED CARE

CLIMATE CHANGE

REGULARS

National survey paints a bleak picture

Fewer RNs leads to more aggression and loneliness

The right to health

page 14

page 18

page 20

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

p.39 p.41 p.43 p.45

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 76 NO. 5 JUNE 2019

ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH

Do the right thing The Lamp spoke to Melanie Robinson, the new CEO of CATSINaM (Congress of Aboriginal and Torres Strait Islander Nurses and Midwives), about the issues faced by her members.

STAND UP FOR AGED CARE Print Post Approved: PP100007890

OUR COVER IMAGE: G. BADEN THE LAMP JUNE 2019 | 3

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4 | THE LAMP JUNE 2019

EDITORIAL

Brett

Holmes GENERAL SECRETARY

We choose fairness not fear The federal election result is a setback for the union movement but the issues and problems we have highlighted in aged care, public health and with workers’ rights are not going to just magically disappear.

There is no sugarcoating it – the federal election result was a blow for the union movement. As a movement we campaigned on issues relevant to our members.

Those issues required a change only offered by progressive political parties and in the end the Australian electorate chose not to change.

Although it was disheartening we must be clear – the federal election outcome was not a referendum on our issues.

Significant parts of the community listened to fear and chose tax cuts instead of fairness for all.

There is an important lesson for us in the outcome: it will require a lot more work to turn around 40 years of inequality and trickle down economics. The changes we need will not be achieved in one election cycle.

During the federal election campaign, not enough union members believed things had become bad enough to change the government or they didn’t believe that it could be changed. This means our work must continue.

We have to continue because there is no choice. Too many Australians – young and old – depend on us for their health and welfare and it is our duty to advocate for them, to stand up for them and to fight for them.

Nowhere is that clearer than in aged care. In this month’s Lamp we report on the hearings of the Royal Commission into Aged Care.

There are the findings of the ANMF National survey and another report into aged care conducted by the NSWNMA.

‘ Irrespective of the election result tens of thousands of people are more aware of the need for better staffing in aged care’ There is a damning analysis by a prominent, well-respected specialist in geriatric medicine.

All these accounts reinforce what we have been saying publicly for some time: aged care is in a severe crisis. It has been in crisis for over a decade and things are getting progressively worse. It is a crisis that cannot just be wished away.

Fixing the crisis requires action by a government that cares about the elderly as much as we do.

We have to salute and support the NSWNMA members who fronted up to the Commission and gave personal testimonies from the frontline about the dire state of the sector. It tool real courage and it is obvious from the comments of the Commissioner that they made a difference. He was effusive in his praise of these brave nurses and their constructive contribution.

WE ARE BUILDING SUPPORT FOR BETTER AGED CARE While the federal election was an opportunity to get our perspective out to the community it never defined our aged care campaign.

It is much bigger than that.

Irrespective of the election result tens of thousands of people are more aware of the need for better staffing in aged care.

Our campaign led to a royal commission, an admission from the government of

non-compliance and failures in the aged care sector and the attention of the media and a country that is ready to support real change.

That is a solid base from which to continue our crusade for a better deal for our elderly.

The other issues we have campaigned on aren’t going away either. Wages stagnation remains a serious issue for our economy and as an obstacle to fairness in Australia.

The climate change emergency intensifies with each day without action and our health system remains woefully unprepared without a health and climate change strategy.

The public health system remains underfunded, understaffed and under resourced.

None of these issues are going away and neither are we. Although the outcome in the election was not what we wanted our strength and capacity as a union has grown for being in the fight.

And we are going to use that increased strength and capacity to continue the fight: for our members, for our patients, for the elderly, for public health, for aged care.

That is what we are. That is what we do. n

THE LAMP JUNE 2019 | 5

YOUR LETTERS

COMPETITION

Have your

Say

RELAX AND UNWIND WITH A THREE NIGHT STAY AT

Inappropriate content

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

*Conditions apply. Rooms subject to availability. Prize must be redeemed by 30 June 2020 and is valid for stays Sunday to Thursday nights (not valid during School Holidays, Public Holidays or Long weekends). Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 June and closes 30 June 2019. The is drawn on 1JUNE July 2019.

If a redraw is required for an unclaimed prize it must be held up to 3 months 6 prize | THE LAMP 2019 from the original draw date. NSW Permit no: LTPM/19/04224.

I was disappointed to see advertising material included with The Lamp Vol 76, No 4 that is diametrically opposed to the attitudes and directions of contemporary nursing.

The advertising material promoted T-shirts with the slogans ‘Feel safe at night, sleep with a nurse’ and ‘Educated drug dealer #nurse’, while other themes were aggressive in nature – ‘Nurses can’t fix stupid…but we can sedate it’ and dismissive – ‘Yes, I am a nurse, no, I don’t want to see it’.

While the intent is light-hearted, the message absolutely undermines what nursing and the NSWNMA have been trying to achieve for so very long. That is, the recognition that nursing is a profession whose members are clinicians with expert skills and knowledge, who act as patient advocates, innovators and collaborators, who are equal to any other discipline in healthcare and who are worthy of respect and equity. The NSWNMA represents nursing as a professional body and the inclusion of this advertising material with our journal gives tacit endorsement to the items and themes contained within.

Healthcare has one of the largest gender pay gaps. As well as long-standing, ingrained issues of stereotyping and a sexual discrimination and harassment culture. The NSWNMA has fought so hard for change – please don’t let this type of message undermine what we have been fighting for.

Jane Bourke EDITOR’S RESPONSE: The NSWNMA would like to apologise to our members for recent advertising in the eNurse catalogue in May’s The Lamp. The messages on the shirts do not positively reflect the achievements of the nursing profession and are in bad taste.

We have since been in contact with eNurse, who have agreed to discontinue the shirts.

There will be no further advertising of these shirts from us in any way.

If there’s something on your mind, send us a letter and have your say. The letter of the month will WIN a gift card

International Nurses Day and Mother's Day fell on the same day this year A nurse, thanks to mum My mum is a great inspiration.

She’s strong, caring and hardworking, and I always looked up to her. It’s one of the reasons why I wanted to be a nurse. To be as hardworking and passionate as her.

Brett Sutherland, EN

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.

Encouraging self reflection I’m retiring from nursing. I have had a wonderful career and have made many life long friendships. Lastly, I don’t think I would have survived without your continual support for all the battles I encountered on the way. With your help we achieved good results, not just for me and it made the hierarchy have a good look at themselves.

Maggi Cripps, RN

My mum and midwife!

My mum inspires me to be the best nurse I can be.

As a midwife, she is very passionate about the women she cares for. I strive every day to provide exceptional care to the patients I look after. She also delivered my baby, which was so special for us.

Kaitlyn Lord, EN

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What a role model I became a nurse because I watched my mum take amazing care of all the residents in her aged care facility. She worked so hard to make a difference to each and every one of her residents. Her passion and care is amazing, making her my biggest role model. Every day I am inspired to work harder and be the best nurse possible to make her proud.

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THE LAMP JUNE 2019 | 7

COVER STORY

Nurses impress at royal commission Evidence from nurses was well received at the inquiry into Australia’s aged care system.

A

Royal Commissioner has praised three NSWNMA members for their “very constructive” suggestions on how to improve aged care.

Commissioner Richard Tracey spoke at a hearing of the Royal Commission into Aged Care Quality and Safety in Sydney in May. His remarks followed evidence from a panel of aged care workers made up of two assistants in nursing, Susa n a nd Sue; a registered nurse referred to only as Elizabeth; and retired diversional therapist Maggie.

Commissioner Tracey said: “We’ve really heard the voice from the coalface this morning – what it’s really like in institutions that care for our elderly and we thank you for that, and for your very constructive suggestions about how aged care in this country can be improved, both as to quality and to safety. We’re very grateful. Thank you for coming.”

Under st a f f ing of nu r sing homes was a major theme of the panel’s evidence.

Witnesses said understaffing meant there was not enough time to provide care and led to episodes of missed care.

Workers could not provide 8 | THE LAMP JUNE 2019

‘ With current staffing levels, all you’re basically doing at the moment is warehousing people.’ individual care and were forced to work unpaid overtime in order to complete their tasks.

RATIOS Commissioner Tracey is one of two commissioners running the inquiry into Australia’s aged care system.

the moment is warehousing people.”

Accountants did not understand the consequences of insufficient staffing and there was a gap between “people trying to manage the money and the people trying to deliver the care”.

DEMENTIA

His fellow commissioner, Lynelle Briggs, said the inquiry had heard arguments from the industry that it was “virtually impossible” to specify staffing levels and staffing ratios.

Counsel assisting the commission, Paul Bolster, asked if one RN and two AiNs was sufficient to adequately care for 60 residents – half with dementia – on a night shift.

Commissioner Briggs asked: “Do you see a way or a means to increase or think about how staffing levels might be increased in a way that a government or a provider can relate to?”

Elizabet h sa id t hat wa s insufficient to take care of bedridden residents who needed to be turned every two hours to avoid bed sores as well as deal with medical problems affecting people with dementia.

Elizabeth said the nurses’ union had done a lot of research into aged care ratios and recommended a staff mix of 30 per cent RNs, 20 per cent ENs and 50 per cent AiNs, which would provide “reasonable care”.

“You’re then having to deal with the difficult behaviours that they can sometimes experience such as becoming agitated overnight, wandering, and if somebody falls, you’ve got to be able to assess them for a fractured neck or femur,” she said.

She said that with current staffing levels, “all you’re basically doing at

COVER STORY

‘Understaffing of nursing homes was a major theme of the panel’s evidence.’

Mr Bolster asked the AiNs if they had enough time to “do all the things that you need to do in your ordinary shift at work? Does it happen often?”

Sue said she had to stay back most nights in order to finish caring for residents while Susan said she was never able to finish her shifts on time.

“If I’m on a floor with 40 people I don’t have a cleaner, a laundry person, a kitchen staff. I have to do all that, plus answer call buzzers, attend to people that are on the floor, in pain ... you can never get it done,” Susan said.

Both AiNs said they were given no extra staffing to deal with residents’ palliative care needs.

Susan said staff needed more training on how to deal with palliative care and current training was “just not good enough.”

SUNDOWNING The commission heard that residents with dementia often became more confused, restless or insecure late in the afternoon or early evening – a process known as “sundowning”.

M a g g ie sa id d iver siona l therapists were most needed

between 4.30pm and 7.30pm to help residents who experience sundowning.

panel members said it should not be acceptable and was used because too few staff were employed.

She was asked how managements reacted when she sought to change hours to meet the needs of the people with dementia.

Elizabeth said instead of employing “specials” to provide one-to-one care, nursing homes resorted to chemical restraint, “because ... everyone looks fine, everyone looks, you know, they’re all clean and tidy and they’re not crying out. But they’re not actually getting the care they need and being treated like a person with needs.”

She replied: “To be perfectly honest, management don’t want to know about it. They don’t seem to understand the need for people with dementia requiring the space to walk, yes, just to be themselves, really.”

Sue said her workplace had had a successful trial of afternoon activity officers “but that just faded out and went back to normal 8.30am to 4pm.”

She agreed that this was “a fault in the system”.

Susan said: “We don’t get any help at all, usually, on night shift with problem behaviours.

“Sundowners can happen, as they said, any time but mostly from about 4 o’clock because they’re frightened, they want to look for their family, nothing looks the same, they’re not feeling the same.

“They’re not eating the same, nothing is familiar.”

She said: “I can’t think of a time where it (chemical restraint) actually should be happening at all. So then rather than give proper care, you just sedate people so then they’re not annoying you. And it’s just not acceptable.” ■

More information To find out more about our Make Ratios Law in Aged Care Now campaign go to www. ratiosforagedcare. com.au.

Asked about chemical restraint, THE LAMP JUNE 2019 | 9

COVER STORY

‘No one seems to give a toss’ Aged care expert blasts ‘uncaring’ lawmakers and governments that leave residents ‘waiting to die’.

A

ustralia’s aged care system would be a “complete catastrophe” if not for the efforts of nurses, a leading geriatrician has said.

Professor Joseph Ibrahim, a consultant specialist in geriatric medicine and head of the Health Law and Ageing Research Unit at Melbourne’s Monash University, made the comments when giving evidence to the Royal Commission into Aged Care Quality and Safety.

He said aged care workers did not have enough resources to do their jobs properly.

“If it was a group of doctors, the AMA (Australian Medical Association) would be banging on about the need for resources, more pay for doctors, more resources for residents, and the situation is not good enough.

“When the ANF (Australian Nursing and Midwifery Federation) say the same thing, they’re predominantly met with silence.

“If it wasn’t for the nurses in the aged care system ... the whole thing would just be a complete catastrophe.

“If they walk away I’m not quite sure what we would be left with. But things are not good enough and it’s not acceptable the way it is now.”

Commissioner Richard Tracey 10 | THE LAMP JUNE 2019

‘If they truly care, they would do something, or they would at least say something. They don’t say anything, they don’t act.’ assured Professor Ibrahim the Commission was “very conscious” of his concerns “and the need to have something done about them.”

Commissioner Tracey asked if current training programs were sufficient to produce “a skilled group of geriatricians who can look after the ageing generation in the decades to come”.

Professor Ibrahim said the training of specialists in geriatric medicine rarely involved any attachments or work in residential aged care.

NURSE PRACTITIONERS BETTER OPTION THAN DOCTORS He said nurse practitioners working in collaboration with a senior medical officer were a better option for residential aged care than doctors.

“A lot of the issues that we current ly face require nonpha r macolog ic a l te ch n ique s, particularly for dementia, which would be better applied through

nurse practitioners, rather than medical specialists.

“W hat we need is more cross-training in aged care for the allied health side, speech pathologists, physiotherapists, occupational therapists.

“The people that speak best with the larger part of the workforce would be nurse practitioners who understand the nature of a nurse’s work and how to fit that in. ” Professor Ibrahim said residential aged care should be a place where older people can enjoy life.

However, residents are left “stateless” in a system that is waiting for them to die, and “no one seems to give a toss”.

He said they are stateless because federal parliament did not care about people in residential aged care and had failed to act despite 20-plus reports on the sector and now a royal commission.

“If they truly care, they would do something, or they would at least

COVER STORY

‘If it wasn’t for the nurses in the aged care system ... the whole thing would just be a complete catastrophe.’

— Professor Joseph Ibrahim

say something. They don’t say anything, they don’t act.”

He said aged care residents are citizens of the state “but the state doesn’t provide care because the federal government is supposed to.”

“The federal government doesn’t provide care because the states are supposed to.”

THE AGED DESERVE BETTER Referring to a typical aged care resident, Professor Ibrahim said the result of being stateless was “an 80to 90-year-old woman who had a hard time, sacrificed her life for the betterment of everyone else and is still doing it, and no one seems to give a toss”.

“If you have to go to residential care, it usually means you’ve survived to 80. You’ve usually got three to five diseases. You’ve lost your home, you’ve left your family behind.

“You’re coping with having dementia or severe arthritis. You’re

coping with having people support you with your day-to-day living and toileting.

prematurely because we believe they’re old and have no benefit to society, and that’s just wrong.

“I would have thought at that point in life you deserve to have something decent happen to you, and so I think that residential aged care should have the goal that it’s a place where people can at least enjoy their last few months or years before they die.

“In residential care, it seems to me no one has been angry for a long time.

“What currently happens is most of us sit around waiting for them to die, and if they die quickly then it’s a good job done.”

He said that approach would not be acceptable in paediatric palliative care “and it’s not acceptable anywhere else”.

He said a death from an injury was a premature death, which meant someone had died before their time.

“If they’re 90 or 95, I don’t care.

What I care about is they’ve died before they were supposed to.

“We

accept

people

“The product of residential aged care is death, and deaths occur one third every year and so it seems that residential aged care is working well because every year 50,000 people die and that’s what we expect so things are happening smoothly.”

Prof Ibrahim said residential facilities provided a list of activities “from bingo to completing a jigsaw puzzle to book reading to watching the midday news”, but never asked residents, “What do you actually want?” and, “Can we help you achieve that?”

“And we get away with it because the generation that’s in residential care at the moment .... had a hard life, made do, compromised, selfsacrificed and don’t complain.” ■

dying THE LAMP JUNE 2019 | 11

AGED CARE

Family trusts “designed to avoid tax” in aged care A new report commissioned by the ANMF highlights the lack of transparency and accountability for public funding for the aged care sector.

M

ore scrutiny is required of public funding in the aged care sector before there is any increase in funding, according to a new report by the Centre for International Corporate Tax Accountability and Research (CICTAR).

“Measures must be put in place to ensure that money is directly spent on improving staffing levels and the quality of care,” it says.

Australia’s six largest familyowned aged care providers receive over $711 million in annual federal funding – $60,000 per year per resident – and operate 130 facilities, with almost 12,000 beds.

The report finds these family-owned companies have ‘complex corporate structures, intertwined with trusts, that appear specifically designed to avoid tax’.

They a re, t he repor t concludes, ‘clear examples of why simple reforms are needed to restore public integrity in

12 | THE LAMP JUNE 2019

‘ The fundamental question is whether care is being compromised for the sake of increasing profits.’ both aged care and the broader tax system’.

ANMF Federal Secretary, Annie Butler said: “This report shows why aged care providers must be made accountable for the millions of dollars they receive in government subsidies, particularly those such a s t he compa nies highlighted in this report, making significant profits.

“The fundamental question is whether care is being compromised for the sake of increasing profits. The stories being told currently to the royal commission and the stories we have heard from thousands of aged care workers suggest that it is. But without any accountability for the use of taxpayers’ money in aged care it’s almost impossible to tell.”

The report points out that there are large, family-owned aged care companies, such as Thompson Health Care, that “can operate transparently, pay a fair share of taxes and still make significant profits”.

Others, however, such as Tricare, one of the largest residential aged care providers in Queensland, operate in a more opaque way. Tricare is owned through Norfolk Island, which was a tax haven and overseas territory of Australia until 2016.

“Pre-existing Norfolk Island companies may continue to be exempt from capital gains ta x, which may partially explain the use of at least three unlisted public companies and a dazzling array of related party transactions,” says the report. ■

AGED CARE

‘This report shows why aged care providers must be made accountable for the millions of dollars they receive in government subsidies’ — Annie Butler, ANMF Federal Secretary

Key recommendations from the Report • All entities receiving over $10 million in annual federal funding, must file full and complete financial statements with ASIC, with no exceptions; • Immediate formation of a public register of ownership, including trusts; • A minimum tax of 30 per cent on distributions from discretionary trusts and an examination of further trust reforms to bring Australia in line with global standards.

ALL IN THE FAMILY: TAX AND FINANCIAL PRACTICES OF AUSTRALIA’S LARGEST FAMILY OWNED AGED CARE COMPANIES MAY 2019

Read the report http://cictar.org/all-in-the-familytax-and-financial-practices-ofaustralias-largest-family-ownedaged-care-companies/

By Jason Ward, CICTAR Principal Analyst

A Tax Justice Network – Australia and Centre for International Corporate Tax Accountability & Research (CICTAR) Report

April 2019

New aged care minister needs to hit the ground running The ANMF has welcomed Senator Richard Colbeck into the crucial role of federal Minister for Aged Care and has urged him not to wait until the Royal Commission is over to start fixing the crisis in aged care.

Federal Secretary Annie Butler says unless the Minister addresses chronic understaffing as a matter of urgency, older Australians will continue to suffer in nursing homes.

“The new Minister cannot ignore the feedback about understaffing from our members working in aged care, or the residents and their families who have already provided their harrowing stories of abuse and neglect to the Royal Commission. He must act now.”

THE LAMP JUNE 2019 | 13

AGED CARE

National survey paints a bleak picture of aged care The ANMF’s 2019 National Aged Care Survey identifies a continued systemic failure to ensure safe and quality care to all aged care residents and an abrogation of duty by governments and providers.

I

n 2016, National Survey participants described the situation in aged care as approaching despair.

In 2019, the despair has arrived.

“Indifference and lack of respect for aged care residents and the staff that work there are increasingly prevalent while workloads, staffing levels, skills mix and pay remain unchanged or worse,” says a report of the 2019 findings.

ANMF Secretary Annie Butler says the survey of more than 2700 aged care workers “paints a bleak picture of aged care in Australia and points to a clear abrogation of duty by governments and aged care providers”.

“Nurses and carers believe many aged care employers, managers and executives lack the necessary skills to run aged care facilities effectively, so quickly resort to blaming staff for their own inadequacies,” she said.

“Staff also level this criticism at the government, which they describe not only as unskilled but worse, uncaring and without empathy. And the perverse lack of transparency permits all this to continue.”

14 | THE LAMP JUNE 2019

‘ Australian aged care staff want to see Australian society take a moral and compassionate approach to our elderly.’

Participants in the survey were asked to outline their main concerns about the current situation in residential aged care: • 90 per cent nominated inadequate staffing to provide basic care to residents; • 61 per cent said lack of experience/ qualifications of staff; • 51 per cent said current Commonwealth funding; • 38 per cent said greater transparency/accountability for Commonwealth funding; • 36 per cent said quality/amount of food for residents.

Annie Butler says nurses and carers describe in heartbreaking detail “the lack of value they feel they have to their employers and to society”.

“Right now, aged care workers are the only thing holding this broken system together and they want to be able to take pride in the work that they do.

“They want to give our elderly the best standard of care possible, and they want to be able to deliver that care in environments that are safe and supportive for themselves. But we’re not letting them do that,” she said.

“Australian aged care staff want to see Australian society take a moral and compassionate approach to our elderly, which would ensure them safe, dignified and respectful care at the end of their lives.

“They are pleading for change.” ■

AGED CARE

Nurses and carers cop the flak

Damning testimonies

The ANMF National Aged Care survey reveals how nursing home workers are unfairly harassed and bullied as a result of shocking evidence exposed in the royal commission and on Four Corners.

“Overworked nurses and carers are being spat at in the street, abused in shopping centres and physically and emotionally harassed and vilified, and being made the ‘scapegoats’ for the crisis in aged care”, says the ANMF. They also cop it from their employers.

In the survey, nurses and carers recount the suffering of elderly residents, who aren’t given basic care due to chronic understaffing. Staff say they are unfairly blamed by their employers – for the providers’ own inadequacies, with government offering little, or no support.

Annie Butler says staff are paying a personal price for this pressure.

“Deteriorating staffing levels and overwhelming workloads are having terrible consequences on their physical and emotional health and professional safety, she said.

“Despite their best efforts and intentions, staff simply cannot manage the workload demanded of them. They also identified feeling the increasing pressure of being held responsible for the failings of the aged care system rather than the system itself and the authorities who are meant to be responsible for ensuring its safety and quality being held accountable.”

The ANMF report contains many harrowing accounts that, together, paint a sector in crisis:

‘Deteriorating staffing levels and overwhelming workloads are having terrible consequences on (nurses and carers’) physical and emotional health and professional safety.’

“Violence and aggression towards staff, especially towards carers by residents with dementia and mental illness.”

“Bullying, intimidation and scapegoating from management, which reduces everyone’s confidence, which in turn can also affect how we work for our residents.”

“Staff are being intimidated by management … often I am requested to lie when I do clinical paperwork so we get more funding.”

“Three carers and just one RN for more than 140 residents overnight.”

“Residents missing out being fed, toileted … residents being parked in front of TV in dementia wings.”

Download the report NATIONAL AGED CARE SURVEY 2019 - FINAL REPORT

— ANMF Secretary Annie Butler

You can read the whole report and survey results at: http://bit.ly/ ANMFAgedCare Survey19Report

May 2019

THE LAMP JUNE 2019 | 15

AGED CARE

Fewer RNs leads to more aggression and loneliness A decline in the number of RNs in aged care facilities is having a significant negative impact on people living with dementia, an NSWNMA report has found.

T

hirty per cent of respondents to an NSWNMA survey said shortfalls in staffing in their aged care facility had led to someone being injured because of an aggressive incident by another resident during the previous week.

Eig ht y-t wo p er c ent of respondents said insufficient staffing ratios increased the risk of abuse.

“Evidence suggests a deliberate and marked decline in the provision of RNs within the skills mix of residential aged care facilities (RACFs) has occurred,” the report says.

“Our survey findings suggest this has negatively impacted the care of people living with dementia in RACFs.” Around 50 per cent of all admissions to residential aged care facilities are for people with a diagnosis of dementia.

The NSWNMA survey of 1600 nurses working in aged care found that RNs employed in rural not-forprofit RACFs were the most likely to have specific concerns about the management of behavioural and psychological symptoms of dementia (BPSD) in their facility.

“We often have violent residents and have had several major incidents of elder abuse (resident-to-resident) where due to injuries, death has occurred,” one RN in a rural not-forprofit RACF reported.

“L ack of super v ision in dementia-specific wards results in falls, aggressive behaviours and dangerous situations with boiling

16 | THE LAMP JUNE 2019

‘ Lack of supervision in dementiaspecific wards results in falls, aggressive behaviours and dangerous situations with boiling water and kitchen utensils.’

— RN, rural not-for-profit RACF water and kitchen utensils,” said another RN.

Aged Care Quality and Safety Commission,” the report says.

The report says there is not enough staff to combat the loneliness of many residents, which contributes to the prevalence and symptoms of dementia.

“Instead, the industry sets the standards.” ■

“We have many dementia residents who are lonely and don’t have many visitors. Sadly we don’t have time to spend with them,” an AiN working in a metro not-for-profit facility said.

Understaffing also explained why “the most basic of care was not provided”.

“Failure to assist people to eat and drink, assist people to go to the toilet, or no time for stimulation leading to boredom were basic care needs reported as having been missed when staffing levels were inadequate.”

The report says many of the injuries from aggressive behaviour by other residents could have been avoided with better staff education on dementia care.

“D e spite dement ia-related conditions representing over 50 per cent of all admissions to RACFs, mandatory staff education on dementia is not a requirement for accreditation by the Australian

Unacceptable levels of violence • 61% of respondents had experienced resident-to-resident violence in the previous week • 62% experienced resident-tostaff violence • 82% said insufficient staffing ratios increased the risk of abuse • 73% of respondents had insufficient time to sit and talk to someone who was lonely • 56% of respondents had transferred a resident to hospital because they could not manage their behaviour in the RACF.

Download the report www.nswnma.asn.au/ publications/reports

COVER STORY

DIABETES UPDATE EVENING for nurses

Your NDSS agent in NSW & ACT is

Learn while you earn CPD points Armidale

Wednesday 12 June 2019

Lismore

Tuesday 18 June 2019

More dates and locations coming soon!

Ticke ts $20

For more details check 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.

“I want a super fund that puts more money in my pocket.”

Angie Monk, Midwife

Based on a starting salary of $50,000 and a starting account balance of $50,000, HESTA has delivered $56,437 more than the average retail

super fund over the past 15 years.*

Lower fees and higher investment earnings mean more money for your future. *Past performance is not a reliable indicator of future performance and should never be the sole factor considered when selecting a fund. Comparisons modelled by SuperRatings, commissioned by HESTA and show average differences in net benefit of the main balanced options of HESTA and retail funds tracked by SuperRatings, with a 3 (144 funds), 10 (73 funds) and 15 (45 funds) year performance history, taking into account historical earnings and fees – excluding contribution, entry, exit and additional adviser fees – of main balanced options. Outcomes vary between individual funds. Modelling as at 30 June 2018.

See hesta.com.au/superraterassumptions for more details about modelling calculations and assumptions. Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. This information is of a general nature. It does not take into account your objectives, financial situation or specific needs so you should look at your own financial position and requirements before making a decision. You may wish to consult an adviser when doing this. Before making a decision about HESTA products you should read the relevant Product Disclosure Statement (call 1800 813 327 or visit hesta.com.au/pds for a copy), and consider any relevant risks (hesta.com.au/understandingrisk).

THE LAMP JUNE 2019 |

17

AGED CARE

Nursing home sanctioned after staff cut Complaints by NSWNMA members have led the aged care regulator to impose sanctions on an understaffed nursing home.

T

he Aged Care Quality and Safety Commission has ordered a nursing home to make improvements after NSWNMA members reported that understaffing was contributing to resident violence, falls and unnecessary hospital admissions.

The commission found Pioneer House Aged Care at Mudgee in central western NSW had failed to meet accreditation standards.

The commission decided Pioneer House would not receive any government payments for new residents until 27 August this year, thereby limiting the number of residents it can accept into care.

It required Pioneer House to appoint an adviser to help it meet its ‘clinical responsibilities’ and said it must train staff to address any skill gaps identified by the commission.

Pioneer House is an 81-bed facility with a large dementia unit.

Members contacted the NSWNMA when management announced it would delete an assistant in nursing (AiN) position on all morning and afternoon shifts, resulting in a reduction in hours worked by casuals.

Members had complained of a high number of unreplaced absences, with staff having to miss breaks and leave work late, even before the announced cut.

In one 31-day period, shifts were not filled on 29 days, staff said.

18 | THE LAMP JUNE 2019

‘ Unsafe workloads, a lack of support from management and fears around resident safety are a recipe for disaster in any aged care setting.’

— Brett Holmes HIGH LEVEL OF VIOLENCE IN THE DEMENTIA UNIT The Association met management to raise concerns that inadequate resident care and the heavy workload would be made even worse by the loss of an AiN position.

When management rejected a union request to delay cutting the position to allow for more consultation, staff contacted the commission.

They told the commission there was a high level of violence in the dementia unit, which was often staffed by a lone AiN, as well as an increase in resident falls and unnecessary hospital admissions.

Staff said that just two days after the AiN position was removed from the afternoon shift, it experienced a serious incident of resident violence.

The facility’s NSWNMA branch called on management to maintain residents’ safety as a

AGED CARE

‘ I’m hoping they will put more staff on,’ said one family member who complained that her brother sometimes went without a shower ‘for days and days’.

priority and establish an adequate casual staff pool to help replace any leave.

NSWNMA General Secretary Brett Holmes said the Pioneer House case shows why mandated ratios in aged care are needed urgently.

“Our members are reporting ongoing incidents of missed care and situations where they are working in unsafe conditions, such as in isolation,” Brett said.

“Residents with high-care needs and their families deserve to know whether or not they are receiving the high level of care they require.

“Unsafe workloads, a lack of support from management and fears around resident safety are a recipe for disaster in any aged care setting.”

IF YOU HAVE CONCERNS, SPEAK UP Brett said members at other nursing homes worried about poor standards should follow the example of Pioneer House staff by putting their concerns to management in writing and speaking to the Aged Care Quality and Safety Commission.

The Mudgee Guardian reported it received “numerous calls” from concerned family members and staff who “say they feel angry and frustrated with the lack of transparency” shown by Pioneer House management.

The newspaper said it spoke to several relatives of residents who asked to remain anonymous because they feared their family members being “singled out” for “retribution”.

“I’m hoping they will put more staff on,” said one family member who complained that her brother sometimes went without a shower “for days and days”.

The paper said: “Another resident asked for help going to the bathroom and was allegedly told that they’d need to get themselves to the bathroom because there were no staff on hand to assist. The resident was unable to and subsequently soiled themselves before help arrived.”

One woman told the paper she wanted “answers as to how we got into this position in the first place. That’s the starting point.

It’s all overwhelming, it was such a well-regarded establishment in the community and now not so much.” ■

THE LAMP JUNE 2019 | 19

CLIMATE CHANGE

The right to health A National Strategy on Climate and Health would not only deal with the threats to health from global warming, it would also be an opportunity to improve our health system.

A

ddressing both the causes and impacts of climate change can bring health improvements through policies that reduce air pollution, reduce heat stress and encourage physical activity, say health experts.

In the lead-up to the federal election an open letter from “an unprecedented coalition of health, welfare and environment groups” called on all parties to recognise climate change as a core public health threat and to commit to the strategy.

While there has been policy paralysis in Australia for many years over climate change – with little planning for health at the federal level – clinicians and other health experts have used that time to craft a framework strategy that could be a strong foundation for new government policy.

The Climate and Health Alliance – which includes the NSWNMA and the ANMF – has developed a comprehensive plan – The National Strategy on Climate, Health and Well-being for Australia – for what it calls “a health emergency”.

The strategy was put together after extensive consultation with health care professionals and policy stakeholders.

“We have already seen hundreds of thousands of deaths directly linked to the impacts of climate change. We must have urgent action to protect the people of Australia from further harm,” wrote CAHA Executive Director, Fiona Armstrong, 20 | THE LAMP JUNE 2019

‘Australia can make a contribution to the global effort of tackling global warming while reaping immediate and local benefits of its citizens in the near term.’

— Professor Peter Doherty, Nobel Laureate for Medicine in the letter to the political parties.

Terry Slevin, the CEO of the Public Health Association of Australia said: “Climate change threatens all of the ecological and social determinants of health and wellbeing.

“We have to ensure that policies at every level of government are in place to reverse our current trajectory on climate change. Our health and the health of future generations depend on it.”

WHAT NEEDS TO BE DONE The Framework for a National Strategy on Climate and Health comprehensively covers seven areas of policy action: • Health-promoting and emissionsreducing policies • Emergency preparedness

a nd

disaster-

• Supporting healthy and resilient communities • Education and capacity building • Leadership and governance • A sustainable and climate-resilient

health care sector • Research and data.

The Nobel Laureate for Medicine, Professor Peter Doherty, says CAHA’s framework strategy gives the Australian Government an opportunity to become a world leader in health and climate change policy.

“Au s t r a l i a can m a ke a contribution to the global effort of tack ling g loba l wa rming while reaping immediate and local benefits of its citizens in the near term,” he says.

THE OPPORTUNITY FOR A HEALTHIER NATION The fra mework strateg y outlines both the threats and the opportunities posed by climate change to health.

“The public health risks posed by climate change represent a health emergency, which threatens to undermine the last 50 years of gains in development and global health,” it says.

But it also points out how “many

CLIMATE CHANGE

‘We have to ensure that policies at every level of government are in place to reverse our current trajectory on climate change.

Our health and the health of future generations depends on it.’

— Terry Slevin, the CEO of the Public Health Association of Australia

climate change mitigation and adaption policies are also win/win opportunities, which both reduce greenhouse gas emissions and the social and economic burden of ill-health”.

The framework strategy emphasises that there is a “growing recognition of the links between climate change and the human right to health”.

“Australia has ratified all international human rights law instruments in which the right to health is enshrined, and is therefore obliged to ensure that its domestic and foreign policies contribute towards the realisation of the right to health,” it says.

The seven areas of climate change policy action CAHA’s Framework for a National Strategy outlines key actions that must be taken at the federal, state/territory and local level to achieve the vision of “a fair and environmentally sustainable national policy framework”.

In its letter to political parties prior to the election, CAHA was blunt in its assessment of political action to date on climate and health: “The response from successive governments to date has been woefully inadequate, and people’s health and lives are at risk.

“These risks cannot be managed through the existing health system. The Australian health sector is ill-prepared to manage the impacts of climate change on vulnerable communities and the healthcare system.” ■

Find out more Download the National Strategy on Climate, Health and Well-being for Australia at: https://www.caha.org. au/national-strategy-climatehealth-wellbeing THE LAMP JUNE 2019 | 21

CLIMATE CHANGE

Be a climate change champion in your workplace Two nurses who attended the recent NSWNMA seminar – “Sydney Climate Health Champions Workshop” – spoke to The Lamp about the importance of increasing awareness among healthcare workers of the consequences of climate change.

Health professionals need to know more about climate change Sarah Ellyard says health professionals need to know more about the impact of climate change on the health system.

She says nurses and midwives are more aware than before “but we still have some way to go”.

“I think that lack of awareness stems from a lack of focus in education starting at university, but also in continuing education. I don’t see hospitals running in-services about it. We have to increase awareness among health professionals about climate change and its impacts.

She says the negative health impacts are not something that will occur in the future – they are in the here and now.

“We are already seeing an increase in presentations from climate change impacts. Heatwaves are one of the biggest killers in Australia compared to other extreme weather events. They are already having an impact on people who have chronic illnesses.”

“The increase in emergency presentations during heatwaves flows into increased admissions to other nonemergency wards. Chronic illness from climate change impacts on the mental health system. It impacts on nurses working out in the community as well. It’s a huge thing.

There will need to be an increase in the number of staff.

“There is also the social impact of climate change like displacement and the increase in conflict that will come and that is already happening. Climate change is seen as one of the biggest health threats by the World Health Organization.”

Sarah says the health system has plenty to do to reduce its own contributions to global warming.

Become a climate change champion in your workplace For more information contact alice.eggleston@caha.org.au 22 | THE LAMP JUNE 2019

“I think the health system needs to do a lot more to reduce its own impact, to reduce its own emissions.

That’s a huge thing to start with. There needs to be more funding and resources go into preparing the system.”

Of course, she says, there needs to be responses to climate change beyond the health system if people’s health is to be protected.

“We need to get our political leaders to do everything they can to transition to renewables – to invest in renewables and to make renewables more affordable for people. We need strong legislation to phase out fossil

CLIMATE CHANGE

Let’s get a conversation going in our workplaces Mark Quealy says his interest in climate change “just sort of crept up. It happened over many years”.

He says it is important to him “because it directly relates to a person’s health”.

This eventually led to him participating in a recent NSWNMA workshop for “climate health champions”.

‘We need to be doing more than we are now.’ fuels. We need to prevent any new fossil fuel projects.

“We need to be doing more than we are now.”

Sarah says: “I had a long-standing interest in the environment before I became a nurse. I’ve always had a strong connection to nature and the environment. My dad is involved in environmental activism and conservation. I’ve always been a passionate bush walker.

“There has always been something there. It gradually evolved with global warming and how important it was to our future and the health impacts.

“Now I want to focus on the health impacts and work with other health professionals who are already doing work in this area – to have more conversations about climate change and health.

He says the workshop of concerned health professionals – including nurses and doctors – was valuable “as there needs to be more discussion among health professionals about how climate change will impact on patients and the health system’s ability to deliver care”.

“There needs to be more awareness – more meetings and updates with staff about the issue. More examples of how it is affecting people. Staff need to know more about that.”

Mark says he heard some interesting examples of how climate change was impacting on other Australians at the workshop.

“One of the doctors talked about Torres Strait Islanders and how climate change has affected their agriculture and what they can grow now.

“They’ve had to import more food and they are losing agricultural land through rising sea waters.

That’s pretty in-the-face for those communities. That is not so obvious to me when I live in a temperate climate.

“It’s also clearly having an impact in Western Sydney according to one of the participants at the seminar.

She is seeing more deaths related

‘I think there needs to be more emphasis on the science around climate change.’ to higher temperatures.”

Mark says the lack of action and the disinformation around climate change is frustrating.

“I think there needs to be more emphasis on the science around climate change. There hasn’t been enough publicity about how it is actually impacting on us. The media is not taking up the examples of how it is directly affecting people now.

“I certainly want to get the conversation going in my workplace amongst my colleagues and get some awareness about what’s happening and they might make some personal decisions about how they react to that.

“I don’t think a lot of my colleagues are terribly interested. I’d like to bring them around. I’ll keep working on it.”

THE LAMP JUNE 2019 | 23

CLIMATE CHANGE

Climate change action starts in our workplaces Two Sydney nurses are leading recycling initiatives in their hospitals, collecting waste materials such as surgical wraps, IV bags and oxygen masks so they can be repurposed into garden hoses, safety mats and plastic parts for toys.

Sustainability begins with waste reduction Veronica Mills, a gynaeoncology clinical nurse specialist at the Chris O’Brien Lifehouse in Camperdown, started a program to reduce and recycle hospital waste after seeing the “vast amount of single-use items being used on a day-to-day basis” in theatres.

In a presentation at the NSWNMA Hea lt h Env ironment For um, Veronica explained that she has now implemented a bin system to recycle Kimguard surgical wrap and plastic hollow-ware containers.

“We’ve also begun to re-use our sterile pack plastic coverings from surgical packs to bag patient belongings in our day surgery unit,” she said.

Veronica said she was inspired to establish an Environmental Sustainability Committee at the Chris O’Brien Lifehouse after attending an earlier health forum at the Association in 2017.

“I gathered up a group of about 15 colleagues, and we created a strategy document including a value 24 | THE LAMP JUNE 2019

‘ We created a strategy document including a value statement and a brief outline of the short-, midand long-term goals.’ — Veronica Mills statement and a brief outline of the short-, mid- and long-term goals.”

After researching sustainability projects at other hospitals “it was clear that we needed to start small and only focus on a couple of target areas,” she said.

“We chose waste as a starting point as this seemed the most tangible area of sustainability that most members of the committee were keen to address.”

Involving staff at all levels of seniority and across departments is a key factor in the program’s success, Veronica said. She has managed to “get a representative from each area of theatres, including our day surgery unit, anaesthetics and recovery department, scrub/scout, our sterilising department as well as an anaesthetist and some surgeons.”

“Having

interest

from

all

areas of the department is really important if you want to see ongoing commitment and support through the introduction and trialling of improvement practices.”

One of the challenges Veronica has faced is finding out exactly what happens to recycled items – there is no formal tracking system, for example. Through her own investigations, Veronica has found that hospital waste is turned into palletised plastic, which is then supplied to plastic manufacturers for products such as electronic plastic casing, toy parts and plastic household furniture and appliances.

Another challenge has been gathering “meaningful, quantifiable data that you can take to upper management that’s going to reflect a cost saving and environmentally beneficial waste management plan”.

CLIMATE CHANGE

CHELSEA MCGUINN SPEAKING AT THE NSWNMA HEALTH ENVIRONMENT FORUM.

For more information See how other hospitals have introduced successful environmental programs. https://www. greenhospitals.net/

Save the environment, save money Recycling PVC items such as IV bags, oxygen tubing and oxygen masks not only saves the environment, it is saving Canterbury Hospital money, according to Chelsea McGuinn, a nurse in the hospital’s emergency department.

Chelsea recently introduced a recycling program at the hospital to repurpose PVC items into other usable items such as garden hoses and safety mats. She says PVC recycling costs are “roughly $10 for a 240-litre bin, [which is] miniscule compared to how much general waste costs”.

Recycling is also an incredibly effective use of resources, she added.

“It takes roughly a quarter of the energy to repurpose an item from already used PVC than to make new materials from scratch.”

Chelsea faced early challenges in setting up recycling systems in her hospital, she told the NSWNMA Environmental Health Forum.

“It was a really long back and forth for about four months between management and Baxter (the waste

‘ Because there is a constant rotation of staff, doctors and nurses in ED, education is always ongoing.’ — Chelsea McGuinn consultant) just to organise the bins. The cleaning staff were a bit perplexed to see new bins around the department. A few of them tried to clean them, but word soon spread to leave them as they are to be recycled separately.”

Like Veronica she also found gaining the support of all levels of her department, both “managers and colleagues”, was critical to success.

“I’ve now got a little squad of ‘greenies’ in my department who are also very conscious of the environment and very supportive of the change.”

Because there is a constant rotation of staff, doctors and nurses in ED, “education is always ongoing”, she says.

Chelsea has installed extra signage so that staff use the correct bins, and she has sent out reminder emails to her ward about “what to

do and not to do, and tips and tricks about making recycling easier”.

“Cross-contamination was and still is a major issue,” she says.

Chelsea still needs to “bin dive” to separate IV sets from “Maccas bags”.

Overall though, she says the initiative has had a “great response,” which makes it easier to roll out the trial in the ED ward “across the hospital”.

Since introducing her recycling program, Chelsea has seen staff becoming more environmentally conscious in other areas, with more staff “bringing reusable water bottles and keep cups”.

The department is also switching from plastic single-use cutlery to metal or wooden options, and other areas in the hospital are “brainstorming ideas”.

THE LAMP JUNE 2019 | 25

ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH

Doing the right thing The Lamp spoke to Melanie Robinson, the new CEO of CATSINaM (Congress of Aboriginal and Torres Strait Islander Nurses and Midwives), about the issues faced by her members and her priorities as the leader of the peak body for Indigenous nurses, midwives and students.

Q. Can you tell us about your background as a nurse and journey to lead CATSINaM? A. I practised clinically for

18 years in adult and paediatric nursing, specialising in oncology and haematology.

I worked at one of the big teaching hospitals in Perth called Princess Margaret Hospital. And I also worked in Derby Hospital in the Kimberley, an area where access to health care is a real challenge. Some of the health services you find in urban areas aren’t available there, and there are a lot of social issues and a lot of poverty and violence related to alcohol and drug issues which doesn’t lead to very good health outcomes. Prior to coming to CATSINaM I was a director of Aboriginal health strategy at the Perth Children’s Hospital (formerly Princess Margaret Hospital). Recently I undertook an Aboriginal Leadership and Excellence Development Program run by the WA Department of Health, and that gave me the confidence to apply for the CATSINaM role.

Q. What do you see as the big issues for your members in training?

A. I think getting through university and training is a challenge for any first-year

26 | THE LAMP JUNE 2019

nursing student, but it can be particularly challenging for Indigenous students. The transition from having a job and an income to becoming a student is really difficult.

Then there are challenges within the university system, where racism is manifested in the classroom when students are talking about Aboriginal health in the Aboriginal culture and history unit. One of the other students will bring up a stereotype like “All Aboriginal people are useless’, and often our members are the ones who feel they will have to say, ‘That is not true, that is just a stereotype’. Later on, the tutor or lecturer will say ‘I’m glad you said that’, but we want them to initiate that discussion, and call it out and say, ‘This is not appropriate”. You see big dropouts from first year to third year: as a peak body we can help to address that sense of isolation Indigenous students feel, and we can also support the academics to build their skills to be able to address issues like racism.

Q. Do Indigenous students face particular issues during placement?

A. One of our students was in her second-year placement when she overheard two clinicians talking about

ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH

‘We are focused on building relationships with universities and hospitals to ensure the best practice in culturally safe learning and service delivery.’

NAIDOC Week in the tearoom.

One of the clinicians said: “I don’t know why we need these special things for Aboriginal people, why can’t they just integrate”.

The other clinician looked really uncomfortable but still didn’t say anything. Senior staff need to call out these kinds of interactions.

CATSINaM supports members by giving them some practical ways to deal with these kinds of situations without offending their colleagues.

We also offer affiliate memberships to non-Indigenous health workers, and we run a Leaders In Nursing and Midwifery Education Network (LINMEN), a peer support network for nursing and midwifery educators and education providers to develop and share best practice in cultural safety training and education in Aboriginal and Torres Strait Islander health, history and culture.

Q. What practical measures can help retention rates for Indigenous nursing students?

A. I bring my personal experience

to this goal. Not long ago I completed a masters degree where I interviewed nine Aboriginal women who enrolled in nursing studies. After hearing their stories I created a series of recommendations that can be used by universities to help with their retention. They include students becoming members of CATSINaM and universities having

a go-to person for advice on issues related to being an Indigenous student. Universities also need to have a Reconciliation Action Plan and provide opportunities to do cultural activities on campus – building that sense of pride in your identity. Access to financial support and knowing what scholarships are available is also really important. We are also working to get the government interested in investing again in the Indigenous cadetship scheme, where students work 30 days a semester in a hospital or a clinic setting. The students then receive a salary and allowance, which provides an income … they don’t have to worry about money, and they can focus on their studies.

The cadetship scheme also gives the students clinical experience, which helps when they apply for Transition to Practice Programs.

The scheme is coming to an end, but it should continue because it really does work.

Q. What are your goals as CEO of CATSINaM? A. I’ve got to mention the

CATSINaM Strategic Plan 2018– 2023. There are four priorities, and one is about recruitment and retention of Indigenous nursing students, which I’ve just talked about. Another priority is to inform Indigenous health and education policy. Part of the advocacy we do involves going to different forums

and workshops and identifying different ways that we can help. It also means being involved in that national workforce development at state and federal level. Another priority is providing a cultural hub for resilience and leadership development. This year we are looking at establishing mentor workshops to teach people who are interested in mentoring. We are also focused on building relationships with universities and hospitals and helping to ensure the best practice in culturally safe learning and service delivery.

We have a range of people who run workshops for university and hospital staff. We have just got some funding to do an online program on cultural safety.

Q. How can the NSWNMA support Aboriginal and Torres Strait Islander nurses and midwives?

A. Let people know that we are

here and that we can be another source of advice and guidance.

It is free for Indigenous people.

Australia is a big country with a lot of complexity, so the more allies and partners we can establish the better. Sometimes you just do things because it is the right thing.

THE LAMP JUNE 2019 | 27

AGED CARE

Art as remembrance The drawings of a dementia patient inspired an aged care RN to transform his work into something more lasting.

W

hen she worked nightshifts in a nursing home, registered nurse Rebecca St apledon came across a man suffering from severe dementia who would regularly stay awake at night in an agitated state.

“He had come to Australia as a young man from Italy, and he had reverted to his first language, a language no one in the nursing home staff spoke or understood,” Rebecca told The Lamp.

Rebecca noticed that other residents would often have trouble sleeping too. They would “pace the corridors with nothing to occupy them, except disturbing other residents”.

Rebecca, who is also a trained artist, began experimenting with activities to occupy residents during the night. She soon discovered the Italian-speaking resident, now in his 80s and no longer able to read or write, loved to draw.

“I gave him a paper and a biro,” Rebecca says. “First his marks were tentative and he seemed to be trying to write letters. Then he became

‘ The sense of exuberance and joy in the work was reflected in the man’s behaviour.’ more engrossed and more fluid in his mark making.

“I just thought ‘Wow, that is amazing that this man is enjoying the process’. His drawings were tight to begin with, and then he started using the whole page.

I would just give him more and more pages and he would be really expressing himself.”

Rebecca says the sense of “exuberance” and “joy” in the work was reflected in the man’s behaviour.

“He seemed to find a lot of relief and be more confident the more he did it. It was really nice to see because he was really agitated a lot of the time.”

Rebecca has now made her own artworks responding to the resident’s drawings.

“I kept some of his drawings …

I didn’t copy them directly, but I responded to them. People at the

nursing home were throwing them in the bin because they were not seeing them as art pieces, but I kept hold of them”.

Rebecca, sees her own drawings as “a type of remembrance. I wanted to give what he had produced some weight and importance.”

Rebecca says she has adopted some of the resident’s visual language, transforming his markings into more resolved pieces.

“Some pieces use geometric forms to create a structure to frame and suggest strength in his selfexpression and creativity. Other works are more a soothing and nurturing reaction [to his art] with the use of watercolour and a neutral, pale palette to signify the compassion, love and tenderness that is evident amongst the staff in a care home environment.

See the exhibition See Rebecca’s exhibition, Dear Felice: A Response to Alzheimer’s, at: Gaffa Gallery, 281 Clarence St Sydney, 6-17 June 28 | THE LAMP JUNE 2019

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THE LAMP JUNE 2019 | 29

COVER STORY ANNUAL

CONFERENCE ICC, SYDNEY | 3-5 JULY 2019

tainability s u S e& r a C Promoting Self NSW Nurses & Midwives’ Professional Day

WEDNESDAY 3 JULY 9AM – 5.20PM ICC SYDNEY, PYRMONT THEATRE 9 – 9.20 Introduction from MC

SOPHIE SCOTT, ABC National Medical Reporter

1.45 – 2.45 Digital resilience: thriving in a digitally transforming world

KAMAL SARMA, Rezilium Director & Chair Conversations ThinkTank at R U OK?

Welcome to Country 9.20 – 10 Psychosocial hazards at work: WHS frameworks

DR CARLO CAPONECCHIA, Senior Lecturer, University of New South Wales & President, International Association on Workplace Bullying and Harassment (IAWBH)

2.45 – 3.45 Building sustainable campaigns

ISAAC ASTILL, 2013 Young Environmentalist of the Year & Co-Founder, Tipping Point

3.45 – 4.15 Afternoon tea 4.15 – 5.15 Healthcare waste

CRAIG REUCASSEL, Writer & Comedian, The War on Waste and The Chaser

10 – 10.45 Morning tea 10.45 – 11.15 Violence in nursing and midwifery DR JACQUI PICH, Lecturer & Researcher, University of Technology Sydney

11.15 – 11.45 Ageing successfully

PROF SUSAN KURRLE, Director, Cognitive Decline Partnership Centre & Curran Chair in Health Care of Older People, University of Sydney

11.45 – 12.15 Why are Australian women drinking more and what can we do about it?

DR SALLY HUNT, Clinical Psychologist & Senior Lecturer, University of Newcastle

12.15 – 12.30 Chief Nursing and Midwifery Officer address

JACQUI CROSS, Chief Nursing & Midwifery Officer, NSW Health

12.30 – 1.45 Lunch 30 | THE LAMP JUNE 2019

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Keynote speakers COVER STORY

MC

Craig Reucassel is an Australian writer and comedian who is best known for his work with The Chaser and for going through your bins on The War on Waste. He co-founded The Chaser newspaper, which led to a number of ABC TV Chaser programs including The Election Chaser, CNNNN and The Chaser’s War on Everything.

Craig was born in South Africa but moved to Australia at a young age. He graduated with honours in Bachelor of Economics (Social Science) and Laws from University of Sydney.

KAMAL SARMA

Kamal has developed deep insight into organisations and people cultivated by his own unique background. Living in a monastery he trained as monk for six years before excelling in senior corporate positions.

Currently, Kamal is the director of a strategic leadership firm, Rezilium and co-founder of the Institute for Mental Resilience, which works to provide solutions to counter the high rate of youth suicide. He is also Chair of Conversations Think Tank – R U OK?

SOPHIE SCOTT

DR CARLO CAPONECCHIA

PROF SUSAN KURRLE

JACQUI CROSS

CRAIG REUCASSEL

Dr Caponecchia is a Senior Lecturer at the University of New South Wales. He has a background in psychology and has taught safety risk management for over 12 years. His research interests are in Human Factors and Safety, with a range of projects across industrial domains on psychosocial hazards at work, risk perception and management, and human error. Carlo is the President of the International Association on Workplace Bullying and Harassment (IAWBH).

DR JACQUI PICH

Dr Jacqui Pich is currently employed as a lecturer at UTS. Her PhD was a national study on the experiences of emergency nurses with patient-related violence and she has presented these findings at domestic and international conferences. More recently Jacqui worked on a survey of NSW nurses and midwives’ experiences of violence at work. She is part of an international Cochrane review on the education and training for preventing and minimising workplace aggression directed toward healthcare workers.

Susan Kurrle practises geriatric medicine at Hornsby Ku-ring-gai Hospital and Batemans Bay Hospital. She holds the Curran Chair in Health Care of Older People at the University of Sydney leading the NHMRC Cognitive Decline Partnership Centre, which focuses on care aspects of dementia.

DR SALLY HUNT

Dr Sally Hunt is a Clinical Psychologist and senior lecturer at the University of Newcastle. She has worked both clinically and in a research capacity in the field of mental health for over 15 years. Sally’s research examines the relationship between substance use and mental health disorders, with a focus on developing and disseminating eHealth interventions for these problems.

Currently, Sally is leading research into the increased use of alcohol by Australian women and the development of an online intervention to support women’s health and well-being.

Sophie Scott is an award-winning journalist and the ABC’s National Medical Reporter.

Sophie’s stories appear on the ABC’s flagship news bulletin at 7pm, Lateline, Stateline and 7.30 Report and throughout the Asia-Pacific Region via ABC’s Australia TV network. She is also on ABC radio, presenting The Health Quarter on ABC News 24.

Sophie was an executive of the Australian Medical Writers Association and is on the board of the Australian Medical Association Charitable Foundation NSW.

Jacqui Cross commenced in the role of the Chief Nursing and Midwifery Officer for NSW Health in July 2016. A registered nurse, Jacqui has held a variety of nursing roles within NSW Health including clinical nursing roles, as a RN, NUM and Nurse Manager. Jacqui has experience in senior nursing management positions as the DON at the Children’s Hospital at Westmead from 2012–2015, with her most recent role being a member of the senior executive team as Director of Nursing and Midwifery at South Western Sydney LHD.

ISAAC ASTILL

Isaac Astill has been active in the climate movement since age seventeen. He is an enthusiast for distributed organising and organising at scale, non-violent but disruptive tactics, and corporate campaigning. Isaac works on the #StopAdani campaign that has seen the seeding of hundreds of local groups and is already shifting Australia’s biggest companies and politicians. Isaac has been awarded Bob Brown’s Young Environmentalist of the Year for his work.

THE LAMP JUNE 2019 | 31

NEWS IN BRIEF

AUSTRALIA

Free flu vaccines available for the most vulnerable NSW Health’s 2019 Winter Flu campaign aims to combat complacency among the public about flu vaccinations and respiratory hygiene.

WORLD

Measles up 300 per cent worldwide Measles has resurfaced in some countries due to falls in vaccine coverage and weak health care systems.

Measles cases are up 300 per cent globally in the first three months of this year compared with the same period last year, says UNICEF, with 110,000 confirmed reports.

In the first six months of last year Europe had 41,000 cases of measles, double the total of the previous year. In 2017, 110,000 people died from measles worldwide.

Nearly 170 million children in the world under the age of 10 – including half a million in the UK and 2.5 million in the US – are unprotected from measles, Unicef warns.

“The measles virus will always find unvaccinated children. If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child, in rich and poor countries alike,” said Henrietta Fore, Unicef executive director.

Unicef says the situation is critical in low- and middleincome countries. In 2017, Nigeria had the highest number of children under the age of one who missed out on the vaccine, at nearly 4 million. It was followed by India (2.9 million), Pakistan and Indonesia (1.2 million each), and Ethiopia (1.1 million).

Australia was declared free of measles in 2014. Yet, this summer there have been nine cases of measles in NSW and others in other states.

Australia has an all-time high vaccine coverage with 94.5 per cent of five-year-old children fully immunised at the end of 2017.

‘ The measles virus will always find unvaccinated children.’

32 | THE LAMP JUNE 2019

The campaign began on 1 May and will continue till 31 August 2019.

The campaign encourages flu immunisation for people who are at greatest risk of complications and hospitalisation from flu. They can access free flu vaccines via the National Immunisation Program (NIP) or government programs.

The groups who are eligible for these programs are: • All Aboriginal people from six months of age • Culturally and linguistically diverse children six months to less than five years • Other children six months to less than five years • People aged 65 years and older.

The flu vaccination will also be available free of charge to all pregnant women residing in NSW. NSW Health says there are other people at increased risk of severe flu because of medical conditions including those with: • Diabetes • Chronic respiratory illnesses, such as COPD and severe asthma • Cancer • Immune disorders • Kidney disease • Liver disease • Heart disease Each year up to one in five people in NSW will get seasonal flu, which can cause severe illness and life-threatening complications such as pneumonia and bronchitis, often requiring hospitalisation.

In 2017 there were over 650 deaths in NSW from flu-related illness.

In 2018 there were significantly less, with 39 deaths reported in NSW.

‘ The flu vaccination will be available free of charge to all pregnant women residing in NSW.’

NEWS IN BRIEF

AUSTRALIA

Antibiotic shortages put Aboriginal kids at risk The most effective antibiotic to treat school sores is in short supply, and this is putting Aboriginal kids at risk of lifethreatening infections.

UNITED STATES

Americans pay more for drugs despite cheap alternatives US drug companies’ anti-competitive practices are pushing the price of prescription drugs through the roof.

Spending by American Medicare beneficiaries for brand name drugs rose by 62 per cent between 2011 and 2015 despite the availability of cheaper generic substitutes.

According to the online news website Project Syndicate there is no mystery why.

“Pharmaceutical companies pay players throughout the healthcare system to favour their more expensive drugs over lower-priced alternatives,” wrote Robin Feldman, the author of a recent book – Drugs, money and secret handshakes: the unstoppable growth of prescription drug prices.

According to Feldman, the pharmaceutical industry has “perverse incentive structures” that favour higher priced drugs and block cheaper alternatives.

These incentives are chiefly aimed at “pharmacy benefit managers” (PBMs), who represent health-insurance plans in drug-price negotiations with pharmaceutical companies.

“Drug companies can also pay doctors, clinics, hospitals, patientassistance programs, and patient-advocacy groups to favour their more expensive drugs,” Feldman says.

There is, she says, “a tempting flow of money for many players who should be acting as watchdogs for patients”.

Feldman says disrupting such a lucrative, well-entrenched system will require a combination of changes.

“These must include curtailing payments by drug companies, full transparency (so that competition can flourish), and cutting back on the many government-granted competition rights that reinforce pharmaceutical firms’ power across a range of drugs,” she said.

The withdrawal of the antibiotic Bactrim syrup from the market and the exhausted supply of the alternative Septrin has affected a large number of Aboriginal children with school sores, reports The Conversation.

School sores (or Impetigo) are common in Aboriginal children living in remote areas due to the association with scabies, tinea and head lice, which are also very common.

School sores are caused by the bacteria Staphylococcus aureus and Group A Streptococcus.

These bacteria are highly contagious and spread easily from child to child.

At any time, almost one in two Aboriginal children living in remote areas will have a school sore. That means there are an estimated 15,000 children who need treatment.

Asha Bowen, head of skin health at the Telethon Kids Institute, says that drug shortages are a huge problem in health care.

“Old, cheap antibiotics are no longer on patent and not generally profitable for the manufacturers. These antibiotics are usually prescribed for short courses of three to five days, and so are rarely prioritised in comparison to the long-term medications,” she says.

“In a developed country with world-class health care, it’s unacceptable if an antibiotic needed to treat an infection is not available because we don’t have a national system for coordinating and maintaining antibiotic supply,” she said.

‘ At any time, almost one in two Aboriginal children living in remote areas will have a school sore.’

‘ There is a tempting flow of money for many players who should be acting as watchdogs for patients.’

THE LAMP JUNE 2019 | 33

NEWS IN BRIEF

WORLD

Tobacco use among teens continues to fall New research finds anti-smoking trend continues despite the rise of vaping.

A study led by Cardiff University researchers suggests the number of teenagers who said they had tried smoking or thought it was acceptable to smoke has continued to fall despite the rise in e-cigarette use.

The study, published in the journal Tobacco Control, examined data from England, Wales and Scotland, and found that from 1998 to 2015 the percentage of children aged between 13 and 15 who had smoked decreased from 60 per cent to 19 per cent, while regular smokers in the same age group fell from 19 per cent to 5 per cent.

It also reported that the percentage of young people who reported that trying a cigarette was “OK” declined from 70 per cent in 1999 to 27 per cent in 2015.

The report also points out that in the same period there was a fall in cannabis and alcohol use.

Experts say the study demonstrates the success of public health efforts in reducing smoking among young people in the last 20 years and that e-cigarettes have had no impact on this.

The tobacco control campaign group Ash says e-cigarettes have a crucial role to play in reducing smoking.

“We welcome the results of the study and hope this will strengthen the case for e-cigarettes to be considered a highly effective smoking cessation tool and a far safer alternative to smoking tobacco,” said Ash CEO, Suzanne Cass.

‘ From 1998 to 2015 the percentage of children aged between 13 and 15 who had smoked decreased from 60 per cent to 19 per cent.’

AUSTRALIA

Breastfeeding reduces child obesity: WHO study Breastfeeding can cut the chances of a child becoming obese by up to 25 per cent, according to a major study involving 16 countries.

World Health Organization (WHO) experts are calling for more help and encouragement for women to breastfeed, as well as curbs on the marketing of formula milk.

“We need to see more measures to encourage breastfeeding, like properly paid maternity leave. We need less inappropriate marketing of formula milk, which may lead some mothers to believe it is as good for babies as breast milk,” Dr João Breda told The Guardian.

The data came from nearly 30,000 children monitored as part of the WHO Childhood Obesity Surveillance Initiative (Cosi).

The study found that 16.8 per cent of children who were never breastfed were obese, compared with 13.2 per cent who had been breastfed at some time and 9.3 per cent of children breastfed for six months or more.

Kate Brintworth, head of maternity transformation at the Royal College of Midwives, said the study reinforced the need to put more resources into supporting women to breastfeed.

“We need both more specialist breastfeeding support for women after the birth and more time for midwives to offer the support women are telling us they need,” she said.

‘ We need to see more measures to encourage breastfeeding, like properly paid maternity leave.’

— Dr João Breda, World Health Organization 34 | THE LAMP JUNE 2019

NEWS IN BRIEF

AUSTRALIA

Call the plumber … when you need to rip up the floor, change the pipes and deploy a hydrogen peroxidespraying robot to kill a disease-resistant superbug.

WORLD

Big oil paralyses climate change action The economic self-interest and political power of oil companies is sabotaging action on climate change.

ExxonMobil, one of the world’s biggest oil companies, plans to pump an astonishing 25 per cent more oil and gas in 2025 than it did in 2017, despite increasingly urgent warnings from the UN’s Intergovernmental Panel on Climate Change for immediate and radical reductions in carbon emissions.

The company’s plans even drew the ire of The Economist, which said: “If the rest of the industry pursues even modest growth, the consequence for the climate could be disastrous. The market cannot solve climate change by itself.”

A recent New York Times article has highlighted the extreme steps sometimes needed to stop the spread of drug-resistant superbugs.

The article chronicled the rise of an antifungal-resistant yeast called Candida auris in hospitals around the world.

Nearly half of people who fall sick to it die within 90 days.

C. auris can survive for weeks outside a patient, on sinks and mattresses, door knobs and bedside tables.

The Times says to eradicate it after one patient died, a hospital in Brooklyn even “had to rip out some of the ceiling and floor tiles” in his room.

The online magazine Slate (April, 2019) also detailed the extreme measures needed to deal with an outbreak of the superbug KPC after standard cleaning failed to stop its spread.

“The hospital staff tore apart the plumbing in some rooms to remove sink drains where they found the bacteria lurking. They also used a robot to spray hydrogen peroxide in those emptied-out rooms after patients were moved to a separate ICU. These cleaning and isolation methods eventually worked, but of the 18 patients infected by KPC that year, six died from it,” it said.

It would seem more knowledge is power over the superbug.

“As experts have become more familiar with C. auris, they feel more confident about how to eradicate it from an environment. A simple bleach cleaning would likely do the trick,” said Slate.

The Intergovernmental Panel on Climate Change says if we wish to prevent global temperatures rising by more than 1.5C above preindustrial levels – beyond which climate disasters multiply – then oil and gas production has to fall by 20 per cent by 2030, and 55 per cent by 2050.

Last year, the fossil fuel industry spent an incredible $124,837,199 on lobbying politicians in the US. During the 2016 elections, the industry spent over $100 million on campaign contributions. The top donors included ExxonMobil, the Koch brothers and Chevron – all corporate giants in the oil and fossil fuel sectors.

That investment has proved productive. Research published in Science Direct in 2017 found that fossil fuel subsidies amounted to 6.5 per cent of global GDP in 2015 or $5.3 trillion.

‘ Last year, the fossil fuel industry spent an incredible $124,837,199 on lobbying politicians in the US.’

READ MORE How Do Hospitals Stop the Spread of Drug-Resistant Superbugs Like C. Auris? https://slate.com/ technology/2019/04/candidaauris-hospitals-superbugspread-prevention.html THE LAMP JUNE 2019 | 35

NEWS IN BRIEF

REVIEWS

MEM RO

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An Ebola epidemic is ravaging the Democratic Republic of Congo (DRC) and could become as serious as the outbreak that devastated three countries in west Africa between 2013 and 2016, experts have warned.

MO

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MEM AL

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Ebola out of control in Congo

RUR

WORLD

AY

GIV E

IE

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If you would like to be a movie reviewer, email lamp@nswnma.asn.au

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GIV E

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Aid agencies say they are struggling to enact a public health response in areas that have suffered decades of neglect and conflict, with incredibly fragile health systems and regular outbreaks of deadly violence involving armed groups.

“I’m very concerned – as concerned as one can be,” Jeremy Farrar, the head of the Wellcome Trust told The Guardian.

John Wick: Chapter 3 – Parabellum

“This is massive in comparison with any other outbreak in the history of Ebola and it is still expanding. It’s remarkable it hasn’t spread more geographically but the numbers are frightening and the fact that they are going up is terrifying.”

More than 1,600 people have been infected with

In this third virus installment the adrenaline-fueled actionand the Ebola in theofNorth Kivu region of DRC more than 1,000 have died far –(Keanu the great majority franchise, super-assassin JohnsoWick Reeves) womenwith andachildren. fatality ratehead is higher returns $14 millionThe price tag on his and anthan in previous outbreaks,killers at about 67trail. per After cent.killing a army of bounty-hunting on his The World Health Organization director general, member of the shadowy international assassin’s guild, the Dr Tedros Ghebreyesus said the number ofthe cases High Table, John Wick is excommunicado, but world’s was increasing of violent that set us most ruthless hit “because men and women awaitacts his every turn. back each time”.

In Cinemas – 16 May 2019 “The tragedy is that we have the technical means to Twitter: @studiocanalaus stop Ebola, but until all parties halt attacks on the

response, it will be very difficult to end this outbreak,” he said.

‘ The numbers are frightening and the fact that they are going up is terrifying.’

36 | THE LAMP JUNE 2019

The Bletchley Circle – San Francisco, Complete Series Set during the thrilling social change of the mid-1950s, these new episodes capture the lives of four remarkable women with extraordinary intelligence, breath-taking capacity for pattern recognition and ingenuity for decryption.

The series follows two of the original lead characters, Millie (Rachael Stirling, Churchill’s Secret) and Jean (Julie Graham, Shetland), as they travel to America and join forces with US code breakers Iris (Crystal Balint, The Good Doctor, Prison Break) and Hailey (Chanelle Peloso, Zapped, Incredible Crew) to tackle a string of new murder cases. Using their unique skills and intellectual abilities, the four women solve complex mysteries that baffle local law enforcement.

Email The Lamp by the end of June to be in the draw to win one of 10 copies of The Bletchley Circle – San Francisco, Complete Series thanks to Acorn Media. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

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| 37

PROFESSIONAL EDUCATION

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Waterloo

The Resourceful Nurse / Midwife – NEW Tuesday 13 August, $95 / $190, 6 CPD Hours,

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Know where you stand with Law, Ethics and Professional Standards in nursing and midwifery Thursday 20 June, $95 / $190, 6 CPD Hours

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Wound Care: Leg Ulcers and Compression Dressing 2-Day Course, Fridays 12 and 26 July, $190 / $380, 12 CPD Hours Palliative Care Workshop – NEW Wednesday 31 July, $95 / $190, 6 CPD Hours Midwifery Seminar Friday 9 August, $60 / $120, 6 CPD Hours, Midwives

Medications: How we do it better Tuesday 13 August, $95 / $190, 6 CPD Hours Clinical Communication and Documentation Wednesday 14 August, $95 / $190, 6 CPD Hours

Maitland

Alcohol and Other Drugs: The Current Situation An update for all nurses and midwives Saturday 31 August, $95 / $190, 6 CPD Hours

Know where you stand with Law, Ethics and Professional Standards in nursing and midwifery Thursday 22 August, $95 / $190, 6 CPD Hours The Influential Thought Leader at Work Thursday 29 August, $95 / $190, 6 CPD Hours

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Alcohol and Other Drugs: The Current Situation An update for all nurses and midwives.

Friday 7 June, $95 / $190, 6 CPD Hours Standard Mental Health First Aid 2-Day Course, Wednesdays, 24 July and 7 August, $190 / $380, 12 CPD Hours Wound Care: Negative Pressure Wound Therapy Thursday 15 August, $95 / $190, 6 CPD Hours

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Dementia Management Training Tuesday 18 June, $95 / $190, 7 CPD Hours

Increasing Resilience in Stressful and Changing Times Tuesday 16 July, $95 / $190, 6 CPD Hours Ageing and Disability: New Challenges in Service Delivery Wednesday 26 June, $95 / $190, 6 CPD Hours

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38 | THE LAMP JUNE 2019

YOUR RIGHTS

Ask

Judith Breaking News Making governments accountable Now that election season is over for the next three to four years, the focus at least in part shifts to ensuring that elected governments are held accountable for the commitments they have made. Commitments given to the electorate, especially those to nurses and midwives working in public hospitals, must now be translated to actual action and implementation.

In NSW, that test starts on Tuesday, 18 June when the State Budget is handed down. Much was promised. We hope that the Budget will set out a blueprint for the rollout of the 5000 additional nurses and midwives promised for this four-year term. And this rollout, despite what many of us fear will be inadequate to sufficiently meet growing demand, let alone provide for safe staffing levels, is needed now.

NSW Wages Policy impacts on health workforce One policy that the NSW Government is enthusiastically clinging to is its Wages Policy. This caps any wage increase to 2.5 per cent per annum … unless you ‘trade away’ current entitlements to fund any increase beyond that. This was demonstrated in spades when even this modest amount was partially discounted a few years ago to help defray the increase of superannuation to 9.5 per cent. This policy does little to attract and retain skilled nurses and midwives in an already stretched system. It does not assist in targeting wanted nursing or midwifery resources to areas of need.

Simply put, this policy will continue to make a hard job even harder.

Single days of annual leave I work at a hospital run by Healthe Care. Can I take annual leave in single days?

Clause 27(xiv), Annual Leave and Public Holidays, of the Healthe Care Pty Ltd (New South Wales Hospitals) and the NSWNMA/ANMF NSW Branch Enterprise Agreement 2017 sets out that an employee may elect, with the consent of their employer,

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

to access annual leave in single day lots up to a maximum of ten per calendar year.

Qualifications for a CNC job I am considering applying for a job in a public hospital advertised as a Clinical Nurse Consultant Grade 2. Whilst I have postgraduate qualifications and meet the expected criteria, the job ad asks for a further qualification.

Is this right?

Clause 3, Definitions, of the Public Health System Nurses’ and Midwives’ (State) Award sets out that the hospital “… may also require a higher qualification in the specialist nursing field where such a qualification is considered essential for the performance of the individual position”. The key word is “may” and that it must be “essential” to undertake the role, and not just nice to have.

Nurse Educator role I am employed as a Clinical Nurse Educator in a hospital operated

by Healthscope. Should I routinely be involved in providing clinical care to patients in this role?

Clause 5, Definitions, of the Healthscope – NSWNMA/ANMF – NSW Nurses and Midwives’ – Enterprise Agreement 2015–2019 makes plain that the “… provision of direct clinical care by Clinical Nurse Educator/Clinical Midwife Educator should be for the purpose of providing clinical education to other employees.

Direct clinical care shall be limited to emergency circumstances only.”

Like-for-like replacement I currently work at a hospital operated by St John of God. What is the like-for-like replacement policy when absences occur?

Clause A8(c) of the St John of God Health Care Hawkesbury District Health Service and New South Wales Nurses and Midwives’ Association/ ANMF NSW Branch Nursing and Midwifery Enterprise Agreement 2017 sets out that when a nurse or

midwife is absent and a replacement needed, the level of skill required will be determined by the NUM or ward management based on operational requirements. If ‘like-for-like’ is found necessary (e.g. registered nurse for a registered nurse), the hospital will need to undertake all reasonable avenues to fill this requirement.

Roster pattern for 12-hour shifts We work in a public hospital and have been approached to introduce a 12-hour shift system.

However, the hours don’t add up on the draft proposal for full-time employees. What is the roster pattern to be worked?

Clause 5(v)(b) of the Public Health System Nurses’ and Midwives’ (State) Award sets out the choices and approach to specific roster systems to be utilised, dependent on the roster period. For example, 12 x 12-hour shifts and 1 x 8-hour shift would be worked to average full-time hours over a four-week roster period. If balanced over a six-week roster period, it will be 19 x 12-hour shifts.

Increasing contracted hours

I have worked part time at a nursing home operated by RSL LifeCare for about two years. I am always doing extra shifts. Can this be recognised in some way?

Clause 11.3(d) of the RSL LifeCare, NSWNMA and HSU NSW Enterprise Agreement 2017–2020 permits a review of part-time hours at the request of an employee. This can be done annually and looks at whether an employee is regularly working more than their guaranteed minimum hours. If so, these can be adjusted to reflect this, recorded in writing. However, additional hours won’t be counted if due to another employee being absent on leave or a temporary increase owing to a specific resident need.

THE LAMP JUNE 2019 | 39

Count towards CPD Hours

Ready

Venue & time: NSWNMA 50 O’Dea Avenue Waterloo 8.30am-3.30pm

r 2019 e b o t 19 O c

Wellness, resilience and building the skills needed for future workplace success Start your day with

Be inspired

Yoga & meditation

Be healthy

Cost: $40 members & students $60 non-members

Breakfast & lunch included

Be mindful

Be Financially Fit

Learn smart investment strategies to budget, manage debt and plan for retirement.

Kurt Fearnley

Kathryn Hawkins

Paralympian & Disability Rights Advocate

Dietitian, Nutritionist & Presenter

Lucinda aka The Mindful Nurse RN, Life Coach, mindfulness & meditation teacher

Register now! bit.ly/futurereadyconf

SOCIAL MEDIA

Do you have a story to tell? An opinion to share?

Nurse Uncut is a blog written by everyday nurses and midwives.

We welcome your ideas at nurseuncut@nswnma.asn.au

New on our Support Nurses YouTube channel

The permanent casual – is there such a thing?

NSWNMA: MAY DAY 2019 HIGHLIGHTS Nurses and midwives marched this May Day to change the rules in aged care. http://bit.ly/ NSWNMAMayDay19

Q&A: BILL SHORTEN ON AGED CARE Libby (daughter of an Aged Care nurse) asks Bill Shorten (ALP) how the Labor Party will support and fund the recommendations of the Royal Commission into Aged Care. http://bit.ly/agedcareqanda Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association www.facebook.com/nswnma Ratios put patient safety first www.facebook.com/ safepatientcare Aged Care Nurses www.facebook.com/ agedcarenurses Look for your local branch on our Facebook page www.facebook.com/nswnma

Are you employed as a casual but don’t know how it compares? Or maybe you’d like to be permanent? Ben from the NSW Nurses and Midwives’ Association (NSWNMA) breaks down a lot of what it means to be casual and how that could soon change. https://www. nurseuncut.com.au/the-permanentcasual-is-there-such-a-thing/

Fact check: are you better off under Labor’s or the Coalition’s tax cuts?

In this year’s pre-election budgets, both Labor and the Coalition announced income tax cuts as part of their pitches to the electorate. Nurse Uncut Fact Check assesses whether you’ll be better off under Labor or with the Coalition’s plan. https://www.nurseuncut.com. au/fact-check-are-you-better-offunder-labor-or-coalition-tax-cuts/

Follow us on Twitter @nswnma / @nurseuncut Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma!

Nurses and midwives: know your penalty rates With a number of public holidays in April,

nurses and midwives asked us to clarify what they’re entitled to. David from the NSW Nurses and Midwives’ Association has kindly collated this information to make sure you don’t miss out. https:// www.nurseuncut.com.au/nursesand-midwives-know-your-penaltyrates/

Confused by your CPD requirements? Read this article As a nurse or midwife, making sure you’re across your CPD hours can seem daunting, but it shouldn’t be. Laura from the Professional Services team at the NSW Nurses and Midwives’ Association clears up all you need to know. https://www.nurseuncut.com. au/confused-by-your-cpdrequirements-read-this-article/ bullying-and-harassment-of-healthworkers-endangers-patient-safety/

Listen to our podcast Work, Health & Safety in the Workplace – Veronica Black http:// bit.ly/NSWNMAWHS THE LAMP JUNE 2019 | 41

e n st th tio Ju d to ca ! u de Ed ram ad 19 rog 20 p

Palliative Care Workshops Wednesday 31 July, Waterloo NSWNMA 50 O’Dea Avenue Thursday 12 September, Newcastle Wests New Lambton Bowls Club, 1a Tauranga Road Wednesday 6 November, Gymea “Tradies” Sutherland District Trade Union Club, 57 Manchester Road

COURSE STRUCTURE:

CPD

6

REGISTER ONLINE

• • • • • •

Introduction and overview of Palliative Care; Advance Care Directives; Symptom Management; Care Delivery; Cultural Diversity / Inclusive Palliative Care; Summary of the Day.

bit.ly/educationNSWNMA

A on c ppl l 31 os ica JU e 5 tion LY PM s 20 19

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

$

Members $95 Non-members $190 9.00am – 4.30pm Lunch and refreshments are provided Numbers in each course are strictly limited.

For full details of the workshops content and to register, go online to bit.ly/ educationNSWNMA.

PROFESSIONAL EDUCATION 2019

Scholarships for the academic year 2020 Applications for the Edith Cavell Trust Scholarships are now being accepted for the academic year 2020.

Members or Associate Members of the NSW Nurses and Midwives’ Association or the Australian Nursing and Midwifery Federation (NSW Branch) are invited to apply.

All grants, awards or loans shall be made to financially assist nurses, midwives, assistants in nursing, assistants in midwifery (including students of those disciplines), and accredited nursing or midwifery organisations, schools and faculties in the furtherance of: (i) accredited nursing or midwifery studies; (ii) such academic research programs as are approved by the Trustees in the theory or practice of nursing or midwifery work; or (iii) clinical nursing education programs at graduate, post-graduate and continuing education professional development level; in accordance with a number of categories.

www.nswnma.asn.au CLICK ON ‘EDUCATION’

Full details of the scholarship categories, how to apply and to obtain the official application form is available from the NSWNMA website. Prior to applying, please ensure you have read the Edith Cavell Trust Scholarship Rules.

FOR FURTHER INFORMATION CONTACT: SCHOLARSHIP COORDINATOR, THE EDITH CAVELL TRUST 50 O’Dea Avenue, Waterloo NSW 2017 T 1300 367 962 E edithcavell@nswnma.asn.au

42 | THE LAMP JUNE 2019

SOCIAL MEDIA

your

Say

Abuse from many sides Five healthcare workers shared what it’s like to be abused daily and here’s what you said.

I feel more abused by the ‘Health Hierarchy’ who expect us to miss out on meal breaks and cope with being run ragged for 95 per cent of our shifts due to ridiculous staff ratios that don’t take into account patients’ needs at all.

Abuse by patients has never affected the nurses I know in the way that abuse by our employer does.

Let’s talk about the violence that comes from the people who should be supporting staff. Management with a culture of blame expecting nurses to do more with less.

More and more paperwork/ tick boxes that takes you away from the client.

Nurses pushed beyond what are reasonable workloads.

If nurses are burnt out how do patients/clients feel?

Daily occurrence and if you complain you’re told that ‘it’s part of your job’.

All health care workers endure abuse. As a then young Registered Nurse, I can recall a past manager saying that workplace abuse is part of your job, “you signed up for it, shut up and put up with it”. I never recalled abuse at

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

work formed part of my employment contract.

When I first started nursing patients were so respectful, polite and grateful. Now people just feel entitled and want things immediately as if a nurse is a google search.

The behaviour, rudeness and violence should shock.

Violence against women and violence against nurses ... we just continue to confine it at every level it seems.

the gallery

overtime and extra shifts due to short staffing and sick leave caused by burnout.

Why is the hardest and most dangerous shift the longest shift? Maybe look at changing shift times.

/1

There should be a sleep allowance and it should be big money.

I always find it funny that doctors have a zone for fatigue but we as nurses are never asked what our fatigue level is. After years of giving up my 10-hour break for a fast turnaround of the 8 hr break I can’t do it anymore and looking after myself and going back to a 10-hour break.

/2

/3

Shift work and penalty rates Here are your thoughts on the impact of shift work and how important penalty rates are to you.

Thank you for fighting for our penalty rates. Can you also take on board the clock forward/clock back night duty pay? The decades old adage of the person who works the clock forward and still get paid the standard shift (10 or 12hrs) also then does the clock back and doesn’t get paid the extra hour worked, it’s utter BS. Rosters don’t work like that. People don’t get to choose when they do nights generally, and no one has ever rostered with that mindset in my 20+ years of nursing.

NSW is behind other states.

Night shift in WA is 30 per cent for RNs. It is exacerbated by all the

/4

The care show must go on Our patients don’t stop needing care just because it’s a public holiday.

And students doing it for free – bring on graduation!

And good health care assistants too.

Domestics, nurses, support workers, doctors, receptionists, students, midwives – the whole team working together.

Who came up with that name penalty rate – I don’t get it – employers are being penalised?

Change the term.

/5 1/ Rallying on the Central Coast as part of a National Day of Action to Change the Rules 2/ A ged Care nurses joined hundreds of union activists on the South Coast to declare that we need Ratios in Aged Care NOW 3/ A t the Sydney May Day March, Rema and Fred know that it’s time to Change the Rules in Aged Care 4/ N urses handing out at prepoll in the seat of Robertson!

5/ S tanding together with other union volunteers at Ashfield prepoll

THE LAMP JUNE 2019 | 43

Dreaming of Fiji?

Recruit a new member and go into the draw to win a 5-night holiday at the Sofitel Fiji Resort & Spa, Denarau THE 2018–2019 NSWNMA MEMBER RECRUITMENT SCHEME PRIZE The winner will experience a luxurious holiday at the Sofitel Fiji Resort & Spa, with the following inclusions (for two adults): • 5 nights’ accommodation in a Luxury Oceanside King Room • VIP Meet & Greet welcome at Nadi Airport along with return airport transfers provided by Rosie Holidays • Full buffet breakfast daily • 1 x Salt Sensations Beach Bure Dinner for two inclusive of arrival cocktail • 1 x 60-minute full body massage for 2 guests at SO Spa, including a glass of bubbles at the end of the treatment The NSWNMA will arrange return flights for two to Nadi International Airport Escape to the South Pacific and retreat to a Fiji beach resort, merging luxury hotel facilities with the destination’s natural beauty, vibrant culture and an elegant French touch.

Experience a holiday in paradise. Relax and unwind.

Every member you sign up over the year gives you an entry in the draw!

Recruiter’s 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. You will then be entered in to the NSWNMA Member Recruitment scheme draw.

PRIZE DRAWN 30 JUNE 2019

Conditions apply. Competition opens 1/7/18 and closes 30/6/19. Prize must be redeemed by 30 June 2020 and is subject to room availability. Block- out dates include all Australian and NZ school holidays and 44 | /THE JUNE Christmas New LAMP Year period.

The2019 prize will be drawn on 30 June 2019. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/19/04224

NURSING RESEARCH AND PROFESSIONAL ISSUES The Australian Journal of Advanced Nursing aims to provide a vehicle for nurses to publish original research and scholarly papers about all areas of nursing. Papers will develop, enhance, or critique nursing knowledge and provide practitioners, scholars and administrators with well-tested debate.

The Art of Clinical Supervision: strategies to assist with the delivery of student feedback

Fast-track rehabilitation and nursing care in postanaesthesia care unit on orthopedic patients

Quality Control Circle improves self-monitoring of blood glucose in Type 2 diabetic patients

Associate Professor Kylie Russell

Xiulan Zou, Ling Cong, Zhiping Yu, Junru Wang

Jun Wu, Aijuan Lin, Xiaoyou Su, Huiyan Wei, Hong Lian, Jibo Hu

Fast-track surgery (FTS), initiated in the early 1990s, aims to reduce the length of hospital stays and has been adapted in many hospitals (Esakov et al 2018; Kastelik et al 2018; Rao et al 2017).

The main goal of this concept is to reduce the postoperative length of hospital stay (LOS) and accelerate the recovery of patients.

To achieve this, a multidisciplinary team approach is implemented to maintain cardiovascular, pulmonary, gastrointestinal, neurological and humoral functions (Kehlet 2005) under the Consensus Guidelines for ERAS (Lassen et al 2009).

This approach combines new technologies and methods with traditional care to reduce the postoperative stress response, complication rate and mortality, and hospitalisation costs (Na et al 2014; Anderson et al 2003).

Patients undergoing orthopaedic surgery often have severe trauma and are slow to recover (LeBlanc et al 2014). It is therefore important to develop pathways that reduce surgical stress and enhance rehabilitation for them. PostAnaesthesia Care Unit (PACU) care has been proposed to provide continuous monitoring of patients following anaesthesia and surgery to reduce postoperative complications (Varadhan et al 2010; Jakobsen et al 2006).

Several studies have shown that FTS rehabilitation improves a patient’s recovery.

A quality circle or quality control circle (QCC) refers to a group of workers who do the same or similar work, or perform work complementary to each other.

QCC activities have played important roles in the management of major enterprises in the United States of America, Europe, Japan and other developed countries. In recent years, QCC activities have been applied to management in various fields.

The health care industry is of no exception. In daily hospital management, the QCC applies scientific analysis methods to find the crux of problems so as to develop corresponding implementation plans and goals and carry them out through different stages.

QCC activities have been practised in the management of medical quality (Wang et al 2013), wait time between continuous surgery (Zhang et al 2015), surgical site infection (Liu and Wang 2016) and hand hygiene compliance (Chen et al 2016) in Chinese hospitals.

A previous study evaluated the effect of QCC on 1103 type-1 diabetic patients receiving an intensive insulin treatment.

Their results showed significant decrease in levels of glycosylated haemoglobin, incidence rates of severe hypoglycaemia and ketoacidosis (Muller et al 1999).

In the context of entry to practice health professional education, clinical supervision is the relationship between a student, and the registered health professional responsible for their clinical practice. Health Workforce Australia defines a clinical supervisor as: “an appropriately qualified and recognised professional who guides learners’ education and training during clinical placements. The clinical supervisor’s role may encompass educational, support and organisational functions. The clinical supervisor is responsible for ensuring safe, appropriate and high quality patient client care” (2014, pp.22).

Other terms used to describe this relationship include preceptor, mentor, coach, buddy and facilitator (Dimitriadou et al 2015).

The clinical supervisor provides student opportunities for practice, incorporating a number of clinical teaching strategies, inclusive of feedback. Feedback provides closure to the student learning experience, which enables an understanding of competence, and supports targeted learning.

The Art of Clinical Supervision (ACS), a one-day seminar for nurses and health professionals, provides a safe learning environment for the sharing and reflecting of clinical supervision practice. This article focuses on one key aspect provided within the ACS, the delivery of feedback to health professional students.

http://www.ajan.com.au/ Vol36/Issue3/1Russell.pdf

http://www.ajan.com.au/ Vol36/Issue3/5Wang.pdf

http://www.ajan.com.au/ Vol36/Issue3/3Hu.pdf

THE LAMP JUNE 2019 | 45

INSURANCE BENEFITS

For NSWNMA Members

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

Journey Accident Insurance provides cover for members who are injured as a result of an accident while travelling between their home and their regular place of employment.

Professional Indemnity Insurance provides legal representation and protection for members when required.

Make sure your membership remains financial at all times in order to access the insurance and other benefits provided by the NSWNMA.

Unsure if you are financial?

It’s easy!

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

www.nswnma.asn.au 46 |

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

CROSSWORD

test your

Knowledge 1

2

4

3

5

7

6

8

9 11

10 12 13 15

14

16 18

17 19

20 21

23

22

24 26

25

27

28 29 30

30 32

31

33

34

ACROSS 3. Radiate (10) 9. Neck (6) 10. Amyotrophic lateral sclerosis (1.1.1) 11. A piece of paper or card used to make a vote (6) 12. Limit, restrict (8) 13. Bully (8) 15. A drill bit used to cut hard tissues (enamel, bone) (4) 16. Shoulder blade (7)

35

17. Pavement (8) 19. A disease caused by a deficiency of vitamin B1 (4.4) 21. An inflammatory disease of the skin (4) 22. A young child (3) 23. Remove a prescription or over-the-counter medication from the market (4.6) 25. Symbol for silicon (2)

26. An index of obesity (1.1.1) 28. A fracture in which the skin is broken (4.8) 29. Sinew (6) 32. Inactive (4) 33. Astonishing; astounding (12) 34. Any of the three muscles that form the buttocks (7) 35. Open comedo (9)

DOWN 1. Mental dullness; apathy (8) 2. Virtual user icon (6) 3. The bones constituting the head and trunk of a vertebrate body (5.8) 4. Aminotransferase (12) 5. nfections acquired by patients receiving homebased care (10) 6. A benign tumour that mostly occurs in the breast of young women (12) 7. Jaundice associated with high fever and delirium (9.8) 8. One of two major muscle proteins (5) 14. Open Link Interface (1.1.1) 18. Any sugar that contains a ketone group (6) 19. Nocturnal enuresis (3.7) 20. A component of a mixture or compound (10) 24. Tongue (6) 26. Arms (7) 27. A cold local application to limit or reduce swelling (3.4) 30. The coloured diaphragm of the eye (4) 31. Grow older (4) THE LAMP JUNE 2019 | 47

OBITUARY

VA L E

Harold George Mansfield 1937–2019

H

arry grew up in Gilgandra, initially working in a bakery, then with an undertaker prior to commencing his nursing career in July 1957 at Gladesville Hospital. He transferred to Bloomfield at Orange in 1958, where he met his first wife, also a trainee nurse. He completed his final year at Gladesville Hospital. In 1960 he began a 37-year career at Cumberland hospital, for many years working in the transportation of patients between facilities and later in the admissions and recreation departments.

Harry undertook ‘mental nursing’ (psychiatric nursing) at a time when trainee nurses were referred to as ‘attendants’. Part of his role in that time included moving furniture, scrubbing rooms, painting, cleaning windows, and stoking fires on night shifts to keep the water heated (even in the snow). At a time when pharmaceutical treatments were unavailable, a part of Harry’s training involved ECT, straightjackets (camisoles) and patient restraint.

There were four hours a week to attend lectures.

Otherwise training was on the job, including attending post-mortems, which Harry referred to as better than any textbook for learning – at a time when textbooks were often too expensive to purchase. At the end of each year attendants attended oral exams with a doctor, and if they passed they moved on to the next year.

When Harry trained, psychiatric nursing services were unsophisticated with up to 120 patients accommodated in a ward and bed availability often stretched. Diagnoses were complex, with patients often admitted for psychiatric manifestations of physical illnesses. Occupational health and safety was always a serious issue and Harry did witness a patient fatally stabbing a nurse.

48 | THE LAMP JUNE 2019

Harry trained in a time when the sexes were segregated, both staff and patients, and female wage disparities were recognised (female nurses earning 75 per cent of a male wage). After these experiences Harry was a strong supporter of improved safety and equity in wages and conditions in the industry.

During Harry’s nursing career he witnessed the evolution of better medical and nursing care for patients. Harry was an advocate for more modern, enlightened care for the mentally ill.

To qualify as a registered nurse Harry attended the two-day process of written exams on one day, then on the second day, a hands-on exam with bandages, bed-making, and urine testing (using a Bunsen burner). These experiences resulted in his support for tertiary qualifications in nursing.

Harry joined the NSW Nurses’ Association in 1960 and became an active member, filling the roles of delegate and secretary until the 1990s, representing Cumberland Hospital branch at delegates meetings and annual conferences. He recruited many new members among the student nurses who went as escort nurses on country transfers and, being well known around the state, facilitated communications between hospital branches.

After retiring from Cumberland Hospital in 1997 Harry was delighted by the award of life membership of the Association. Moving to Cowra on his retirement he continued to work as a casual nurse at Bloomfield Hospital and also worked with his wife as a counsellor in the Lachlan Valley Counselling service, visiting patients and running a successful and popular men’s group.

Harry was a strong supporter of nursing and was proud that two of his daughters became registered nurses, and his grandson who is currently employed as an AiN with hopes of furthering his career.

REVIEWS All books can be ordered through the publisher or your local bookshop. Call 8595 1234 or 1300 367 962, or email gensec@nswnma.asn.au for assistance with loans or research. Some books are reviewed using information supplied and have not been independently reviewed.

C

T

ES

S PE

Donald Pfanz Westholme Publishing www.pen-and-sword.co.uk RRP $37.24. ISBN 9781594163104

INTE IAL

ST RE

Clara Barton’s Civil War

SPE C

book club

All the latest Book Club reviews from The Lamp can be read online at www.nswnma.asn.au/ library-services/book-reviews.

Essentials of Nursing Practice – Second Edition Catherine Delves-Yates

Sage Publishing: https://www.sagepub.com RRP $106.09 ISBN 9781526447159

Drawing together the best of text, video and interactive material for the complete introduction to modern nursing. This groundbreaking textbook has been brought together by eight editors, 37 contributors, 18 patients, 13 practitioners and 15 student nurses providing a comprehensive overview of holistic, person-centered nursing practice.

The Brink of Being: Talking About Miscarriage Julia Bueno Hachette Australia: www. dymocks.com.au RRP $32.99.

ISBN 9780349010762

It estimated that one in four pregnancies end in miscarriage and yet it persists as taboo.

In The Brink of Being, a groundbreaking and essential

book, psychotherapist Julia Bueno encourages us to talk about, think more, and reflect upon this often misunderstood, and little discussed event.

The Anxiety Toolkit: Strategies for managing your anxiety so you can get on with your life Dr Alice Boyes

Hachette Australia: https://www.amazon.com. au RRP $23.45 ISBN 9780349409818

Do you overthink before taking action? Are you prone to making negative predictions? Do you worry about the worst that could happen? Do you take negative feedback very hard? Are you self-critical? Does anything less than perfect performance feel like failure?

In The Anxiety Toolkit, Dr Alice Boyes translates powerful, evidence-based tools used in therapy clinics into tips and tricks you can employ in everyday life. Whether you have an anxiety disorder, or are just

R

IA Clara Barton was the most famous woman to emerge from the American L IN T E Civil War. In an age when few women worked in hospitals, much less at the front, Barton served in at least four Union armies, providing food and assistance to wounded soldiers on battlefields stretching from Maryland to South Carolina. Thousands of soldiers benefited from her actions, and she is unquestionably an American heroine.

In Clara Barton’s Civil War: Between Bullet and Hospital, distinguished historian Donald Pfanz provides the first balanced and accurate account of her wartime service.

anxiety-prone by nature, you’ll discover how anxiety works, strategies to help you cope with common anxiety ‘stuck’ points and a confidence that – anxious or not – you have all the tools you need to succeed in life and work.

Potter & Perry’s Fundamentals of Nursing – Australian Version: 5th Edition Jackie Crisp, Clint Douglas, Geraldine Rebeiro and Donna Waters

Elsevier Health Sciences: https://www.sagepub.com RRP $ 67.75 ISBN 9780729542364

Potter and Perry’s Fundamentals of Nursing, 5th Edition continues to set the standard as the leading fundamentals text for Australian and New Zealand nursing students. The 5th edition has been carefully revised and restructured, focusing on the very important basics – the fundamentals of care that are the building blocks on which professional nursing practice is built.

THE LAMP JUNE 2019 | 49

DIARY DATES

make a date

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

EVENTS: INTERSTATE Lowitja Institute Indigenous Health and Wellbeing Conference 17–20 June 2019, Darwin, NT http://www.nirakn.edu.au/ event/2019-lowitja-instituteinternational-indigenous-healthand-wellbeing-conference/ 20th Victorian Collaborative Mental Health Nursing Conference 15–16 August 2019 Melbourne, Victoria https://healthsciences.unimelb.edu. au/departments/nursing/about-us/ centre-for-psychiatric-nursing/engage/ victorian-collaborative-mental-healthnursing-conference Workplace Mental Health Symposium 2019 2–3 September 2019 Brisbane, Queensland https://nswmentalhealthcommission. com.au/events/ workplace-mental-health-symposium-2019 INTERNATIONAL 7th World Congress on Nursing and Healthcare Recent Innovations for Better Healthcare and The Facets of Nursing 17–18 June 2019, London, UK https://www.scientificfederation.com/ wcnh-2019/

50 | THE LAMP JUNE 2019

Please send event details in the format used here: event name, date and location, contact details – by the 5th of each preceding month.

Send your event details to: lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space.

Priority is given to non-profit professional events.

International Council of Nurses 2019 Congress 27 June–1 July 2019 Marina Bay Sands Expo and Convention Centre, Singapore http://www.icn.ch/events/ ICN-Congress-Singapore-June-2019/ International Council of Nurses (ICN) 21st International Conference on Nursing 25–26 September 2019 London United Kingdom www.icn.ch/ 2019 World Mental Health Congress 5–8 November 2019 Buenos Aires, Argentina https://wfmh.global/world-congress-2019/ EVENTS: REUNIONS St George Hospital June 1979 PTS Reunion 15 June 2019 Anne O’Callaghan 0422 068 045 St Vincent’s Hospital Lismore Past Nurses Annual Reunion Saturday 31 August 2019 Contact: Lesley Briggs 0419 487763 or Maria Miller marialouise1954@hotmail.com 50-year Anniversary Sydney Hospital Graduate Nurses 1969–1972 Reunion Lunch 29 September 2019 Contact Kathleen Wall (Allen 0420 305906 pkwall33@tpg.com.au Susan Crawford 0400 723020 denis.p1@bigpond.com

CROSSWORD SOLUTION

Welcome to

Improved communication channels and engagement

MEMBER CENTRAL

Seamless access to membership details Functionality at your fingertips

THE NEW ONLINE SYSTEM FOR NSWNMA MEMBERS

Unique NSWNMA member login with email

Create your new member login account & you could win a trip to Bali!

Log on to online.nswnma.asn.au and create your login to be automatically entered in the draw to win a 5 night holiday to

THE TRANS RESORT BALI, SEMINYAK

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

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

online.nswnma.asn.au

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

Prize drawn 1 Feb 2020

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

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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-05/19

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