The Lamp June 2021

SAFE STAFFING

AGED CARE

COVID-19

REGULARS

Queensland’s ratios save lives and money

Big handouts may bypass residents

Support grows for a “People’s Vaccine”

page 10

page 22

page 26

Your rights and entitlements at work p.32 Nursing research online p.41 Crossword p.43 Reviews p.45

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 78 NO. 3 JUNE/JULY 2021

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

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

VOLUME 78 NO. 3 JUNE/JULY 2021

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

8

Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au

COVER STORY

Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary O’Bray Smith, NSWNMA President Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Liz McCall, Byron Central Hospital Diane Lang, South East Regional Hospital, Bega Valley

“NSW Health thinks staffing is safe and there are no workload problems” Our ratios claim is backed by incontrovertible clinical evidence

Printed by Ovato Print Pty Ltd, 37–49 Browns Road, Clayton VIC 3168 Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Adrian Hayward, Coordinator.

T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General Disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Authorised by B.Holmes, General Secretary, NSW Nurses and Midwives’ Association, 50 O’Dea Avenue Waterloo NSW 2017 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 2021 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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Avg Net Distribution per Issue

The Lamp is independently audited under the AMAA's CAB Total Distribution Audit.

Audit Period: 01/04/2020 - 31/03/2021 (Yearly Audit)

20

AGED CARE

26

Reforms are welcome – but must go further The Morrison government’s aged care package is a step in the right direction, but falls well short of royal commission recommendations.

PROFESSIONAL ISSUES

28

Employers need guidance on psychosocial hazards, says minister Two Association members recently met with Kevin Anderson, the NSW Minister for Better Regulation and Innovation, to discuss the urgent need to combat nonphysical hazards in the workplace.

COVID-19

Support grows for a “People’s Vaccine” The US responds to calls for a WTO waiver on vaccine intellectual property rights as concerns mount over vaccine access and inoculation in low- and middleincome countries.

29

REGULARS

5 6 32 34 36 41

Editorial Your letters Ask Judith What’s on News in brief Nursing Research Online and Professional Issues 43 Crossword 45 Book Club 46 Your Health

SAFE STAFFING

AGED CARE

COVID-19

REGULARS

Queensland’s ratios save lives and money

Big handouts may bypass residents

Support grows for a “People’s Vaccine”

page 10

page 22

page 26

Your rights and entitlements at work p.32 Nursing research online p.41 Crossword p.43 Reviews p.45

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 78 NO. 3 JUNE/JULY 2021

INDIGENOUS ISSUES

New training resource for Indigenous end-of-life care Palliative Care Australia has released a new online video to support health professionals working with Aboriginal and Torres Strait Islander peoples.

TAKING A STAND ON RATIOS AND PAY Print Post Approved: PP100007890

COVER: Sharon Hickey

The Lamp is printed on PEFC certified paper. The paper is certified under the Programme for the Endorsement of Forest Certification (PEFC) which assures consumers that the utilised forestry products can be traced from a certified, sustainably managed forest through all stages of processing and production by a chain of custody process. The Lamp is wrapped in Ecopure film which is recyclable and biodegradable.

THE LAMP JUNE/JULY 2021 | 3

New South Wales Nurses and Midwives’ Association

T

Summary of Financial Information for the Year Ended 31 December 2020

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

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

SUMMARY STATEMENT OF PROFIT OR LOSS AND OTHER COMPREHENSIVE INCOME FOR THE YEAR ENDED 31 DECEMBER 2020 2020 ($) Membership revenue 44,654,489 NursePower fund subscriptions 922,663 Other income 2,659,577 Total income 48,236,729 Less total expenditure (45,300,812) Result for the year 2,935,917 Remeasurement of retirement benefit obligations (45,662) Total comprehensive income attributable to members 2,890,255 SUMMARY BALANCE SHEET AS AT 31 DECEMBER 2020 Total equity 48,596,464 Represented by: Current assets 19,714,935 Non-current assets 36,446,990 Total assets 56,161,925 Current liabilities 7,255,919 Non-current liabilities 309,542 Total liabilities 7,565,461 Net assets 48,596,464

INFORMATION TO BE PROVIDED TO MEMBERS OR REGISTRAR In accordance with the requirements of the Industrial Relations Act, 1991 [NSW] the attention of members is drawn to the provisions of Sub-Sections (1) and (2) of Section 512 which read as follows: (1) A member of an organisation, or the Industrial Registrar, may apply to the organisation for specified information prescribed by the regulations in relation to the organisation.

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

4 | THE LAMP JUNE/JULY 2021

2019 ($) 40,393,833 2,125,991 2,926,166 45,445,990 (45,744,373) (298,383) (53,330) (351,713)

45,706,209 21,864,135 30,734,698 52,598,833 6,600,552 292,072 6,892,624 45,706,209

REPORT OF THE INDEPENDENT AUDITOR ON THE SUMMARY FINANCIAL STATEMENTS TO THE MEMBERS OF THE NEW SOUTH WALES NURSES AND MIDWIVES’ ASSOCIATION

opinion

The summary financial statements which comprise the summary balance sheet as at 31 December 2020 and the summary statement of profit or loss and other comprehensive income for the year then ended are derived from the audited financial report of New South Wales Nurses and Midwives’ Association for the year ended 31 December 2020. In our opinion, the accompanying summary financial statements are a fair summary of the audited financial report.

Summary Financial StatementS

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

the audited Financial report and our report thereon

We expressed an unmodified audit opinion on the audited financial report in our report dated 13 April 2021. Our Independent Auditor’s Report to the members on the Financial Report did not contain any particulars of any deficiency, failure or shortcoming as referred to in the Industrial Relations Act, 1991 [NSW], as applied by section 282(3) of the Industrial Relations Act, 1996.

committee oF management’S reSponSibility For the Summary Financial StatementS

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

auditor’S reSponSibility

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

Daley Audit

Stephen Milgate

Partner

13 April 2021, Wollongong Liability limited by a Scheme approved under Professional Standards Legislation

A copy of the Financial Report, including the Independent Audit Report, is available to members on the Member Central portal accessed via www.nswnma.asn.au.

Members can obtain a hard copy by emailing the General Secretary, NSWNMA at gensec@nswnma.asn.au or calling 1300 367 962.

EDITORIAL

BRETT

Holmes GENERAL SECRETARY

Listen to the science on ratios An evaluation of Queensland’s ratios has swept away the last tenuous excuses for not implementing them in NSW. The evaluation, conducted by researchers from the United States and from Queensland, was a requirement built into the law that established ratios in 2016.

It found that ratios pay for themselves. In fact, the savings in Queensland were twice the cost of additional nurse staffing. The study also found the system delivered a “flexible design” (see pp 10-11).

The research found that more staff were attracted to work at hospitals where nurse-to-patient ratios were implemented. There were significant improvements in patient mortality, length of stay and re-admissions.

There were substantial cost savings.

To paraphrase our Prime Minister’s favourite saying: How good are ratios?

The study, published in the prestigious medical journal The Lancet, builds on decades of previous research.

But it goes further and demolishes the last remaining arguments used to block their implementation. It provides unequivocal evidence that government intervention will yield better staffing and those extra staff will lead to better patient outcomes.

WE NEED TO MAKE THE GOVERNMENT ACT The evidence is now well and truly in and our immediate challenge is to get the NSW government to listen to the science and act.

Premier asking her to work with us to implement shift-by-shift ratios and to meet with a group of nurses and midwives to hear the challenges they face at the frontline. To date, she hasn’t even paid the courtesy of replying.

This isn’t good enough. The government has benefitted greatly from the hard work and sacrifices made by nurses and midwives during the pandemic.

NSWNMA members throughout the state have been taking our message to their communities throughout May. We intend escalating those actions.

We are buoyed by the knowledge that the community is on our side and appreciate the sterling efforts of nurses during the pandemic.

We will continue to reach out to the community to join us in putting pressure on the government to meet their responsibilities and adequately resource the public health system with safe staffing.

ONLY BOLD LEADERSHIP WILL SAVE OUR WITHERED AGED CARE SECTOR Scott Morrison promised us a “once in a generation” reform of aged care in the federal budget but after raising such expectations the outcome was a damp squib.

At a time when bold leadership has been needed the prime minister has been found wanting.

myriad problems.

The royal commission concluded that inadequate staffing levels, skills mix and training were the principal causes of substandard care.

While there are positives in the budget but there is a sense of tinkering around the edges when it is so clear that fundamental change is required.

The time-honoured reflex of throwing taxpayers’ money from a helicopter at aged care providers has never worked and will never work when there is no accountability for delivering that money to the direct care of residents and consumers of home care.

Aged care needs to be reformed not only considering the royal commission’s findings but also in the broader context of lessons to be learned from the pandemic. The royal commission did not deliver on all of our claims, but the least Scott Morrison could do is implement those recommendations in full.

Expecting our public health system and our aged care sector to be able to provide safety and protection to our communities and our elderly when they are inadequately funded and where providers put profit before care will no longer wash.

Aged care has been left to wither over a long period of time and by governments of different stripes.

While we welcome the positives in the budget, the problems have not been sufficiently addressed and we will continue to campaign until they are. n

It needs to hear that the system is in crisis and that nurses are holding a precarious public health system together.

The Royal Commission into Aged Care had done much to shine a harsh light on the sector and to provide a framework for fixing its

Worryingly, we are receiving reports that many nurses and midwives can’t take it anymore and are walking away from the public health system.

‘ We are buoyed by the knowledge that the community is on our side and appreciate the sterling efforts of nurses during the pandemic.’

We simply cannot let this happen.

The Association wrote to the

THE LAMP JUNE/JULY 2021 | 5

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YOUR LETTERS

Have your

Say

Moral distress in aged care Well done, NSWNMA, for attaining the SafeWork NSW Award and for the interesting articles on nursing in COVID-19 times published in The Lamp.

The News in Brief article, “Nurses need psychological PPE during a pandemic”, was of particular interest to those of us who work in aged care, as it addressed the growing concern of nurses for their colleagues as this COVID-19 pandemic unfolds, in waves. Dr Anita My Goh and Professor Briony Dow wrote in their article (published in Pursuit) about the need to keep aged care staff safe, not just from “infection, but also safe from the psychological effects of caring for people in the midst of a highly communicable pandemic”.

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The aged care workforce is under a lot of pressure to perform and care well with the rollout of COVID-19 vaccine clinics in aged care facilities. They do their best to follow the Commonwealth Government guidelines for preparedness of these clinics, but it is understandable if, in particular, Registered Nurses have expressed their fear of the outcomes, and indeed their own involvement in what is a new and sometimes controversial service at this critical time. This may be due to lack of knowledge and experience in the field of vaccination programs in aged care, and could lead to signs and symptoms of “psychological distress: insomnia, alcohol and/or drug misuse and symptoms of post-traumatic stress disorder (PTSD) such as feelings of anxiety, depression, burnout and even anger” (source: University of Lausanne, BMC Public Health, Aug. 2020).

According to recent literature, there is another element of distress that can occur in this situation: that of moral distress. This may be correlated with burnout and the desire to change one’s professional circumstances, which are no longer in alignment with the workplace ethical climate. Aged care staff are often ill-prepared for situations beyond their scope of practice and training. COVID calls for clear communication and organisational agility. For example, no-one should be asked to carry out duties, assist with or accept the uptake of any vaccine, without providing individuallevel ethics education and information covering all areas of concern. Furthermore, institutional constraints can make it very difficult for aged care staff to pursue the right action, even when they know the correct thing to do.

People’s fears need to be listened to, addressed and ameliorated before they cause harm, as aged care workers become distressed at not being equipped to provide adequate care for those they support.

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.

Supporting staff with pre- or postshift briefings on how they are managing, how they are feeling, will place value on their ethical stance and help direct their moral compass.

Georgina Hoddle RN and Gabrielle Macaulay RN

It feels good to be part of this union I wished to say thank you to officers at the NSWNMA for your help with a situation I found myself in.

In short, after an allegation by my employer, I found myself well supported by the team at the Association. I felt that a good outcome was reached. The Association representative was well respected by the employer and that made the process a lot smoother for both sides.

Thank you all at NSWNMA for your help. In such a litigious world, it feels good to be part of this union. It really is true when they say: united we bargain, divided we beg.

Eddie Barry RN

Letter of the month 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.

The letter judged best each month will receive a $50 Coles Group and Myer gift card.

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

LETTER OF THE MONTH Punished for working in health I would like to voice my disappointment in the NSW Government for its continued lack of care and compassion shown to the healthcare workers in our state.

In the midst of a pandemic, which continues to this moment, it has continued to show a lack of leadership and advocacy in the fight for fair conditions and pay to those of us keeping the screening clinics and screening desks going and keeping our community safe.

As a NUM in the end-of-life space, I could say that “our leaders” have very little idea about the current issues we are dealing with – and continue to deal with – on a daily basis. These include visitor restrictions, verbal abuse, code blacks because visitors won’t abide by the rules and restrictions, and the lack of auxiliary services to support 24-hour care and those working in healthcare facilities.

My role as a NUM is to ensure my staff are safe and have everything they need to do their job well. But in COVID times, this has become more difficult. Now we’re expected to hold daily meetings with families to explain the importance of restricted visiting, on top of continuing to provide nursing care, and keeping staff and community safe.

My staff and I are fatigued.

Despite this, the NSW Government continues to offer nursing staff pay increases well below those previously budgeted. Where is the fair go and equity?

Yes, I am glad I became a nurse and I never thought we would go through a pandemic. I am glad to have continued to work through this pandemic. It was my choice 28 years ago to become a nurse, but that doesn’t mean I don’t deserve a fair pay rise. I feel that we are being punished for working in health – but isn’t the community lucky that we have a health system like we do?

Trish Dalgliesh RN

Advertise in The Lamp and reach more than 70,000 nurses and midwives.

To advertise contact Danielle Nicholson 02 8595 2139 / 0429 269 750 dnicholson@nswnma.asn.au THE LAMP JUNE/JULY 2021 | 7

COVER STORY

“NSW Health thinks staffing is safe and there are no workload problems” Our ratios claim is backed by incontrovertible clinical evidence. In Queensland, ratios are paying for themselves and more. A host of economists, including the head of the Reserve Bank, is calling for significant pay rises to boost the Australian economy. Yet, the NSW government wilfully refuses to listen. Least of all, to the voices of nurses and midwives who have given their all at the frontline.

“

Enough is enough”. That’s the message NSW nurses and midwives are taking to their communities in the face of intransigence from the state government in response to our pay and conditions claim.

NSW Health has rejected all our 2021 Ratios and Conditions Claim.

On 15 April it offered a 1.04 per cent pay rise. This is well below the 4.7 per cent increase claimed by the Association to make up for the 0.3 per cent wage freeze imposed on nurses and midwives last year.

NSWNMA General Secretary, Brett Holmes, said the government and NSW Health think nothing needs to change.

“They think your staffing is safe, there are no workload problems and that nurses and midwives’ registration is safe,” he said.

“They need to hear that the system is in crisis and it is nurses and midwives holding the precarious health system together.”

Brett says the Association wrote

8 | THE LAMP JUNE/JULY 2021

to the premier asking the government to work with us to implement shiftby-shift ratios and to seek a meeting with a group of nurses and midwives.

“To date, the premier has ignored nurses and midwives,” he said.

NSWNMA members have not taken the government’s insulting response lying down.

During May, nurses and midwives turned out in large numbers in rallies held throughout the state, including the combined branches in the Lower Hunter, Shellharbour Hospital, Prince of Wales Hospital with the Royal Hospital for Women, Prince of Wales Mental Health and Sydney Children’s Hospital.

Westmead; Cumberland and Westmead Kids Hospitals; Mount Druitt, Auburn, Blacktown Hospital, Canterbury; Maitland, John Hunter Hospital and Belmont Hospital; Balmain Hospital and South East Regional Hospital, Bega, have also held lunchtime rallies.

As The Lamp goes to press, members are conducting extra-

ordinary branch meetings to vote on whether to accept the state government’s paltry offer of a 1.04 per cent pay rise and no improvements to staffing.

LISTEN TO THE SCIENCE ON RATIOS Our campaign for shift-byshift ratios has been boosted by a g roundbrea k ing study of Queensland’s ratios by an international team of researchers (see pp 10–11).

Experts from the University of Pennsylvania, in collaboration with the Queensland University of Technology’s School of Nursing, say Queensland’s experience with ratios “offers insights for the jurisdictions that are debating minimum nurseto-patient ratio policies”.

The Queensland study adds to decades of research showing that improved nurse staffing levels lead to better patient outcomes.

But the Queensland evaluation goes further. It also debunks

COVER STORY

Our campaign takes to TV The NSWNMA has launched a TV ad to alert the public to the critical state of our public hospital system, under even more pressure as the result of the pandemic: Watch the ad at www. ratioslifeordeath.org.au

criticisms of ratios that have been levelled after their implementation in Victoria and California.

“Opponents argued that little information existed about the return on investment from the additional nurses required as a result of a ratios mandate. Our findings fill these gaps,” it said.

The evaluation found that savings due to fewer readmissions and shorter length of stay were more than twice the cost of the additional nurse staffing.

Another criticism was that ratios were “inflexible”.

“Queensland mandated a minimum average staffing level at the ward level – an individual could have more or fewer as long as the average number of patients per nurse didn’t exceed ratio limits,” the researchers said.

“This offered more flexibility in patient assignments. Our analysis suggests that Queensland’s flexible design is feasible and yields good outcomes.”

“The results … suggest that minimum nurse-to-patient ratio policies are a feasible policy instrument to improve nurse staffing, produce better patient outcomes, and yield a good return on investment.”

DECENT PAY RISES ARE GOOD FOR THE ECONOMY The pay component of our claim is also consistent with what prominent economists say is necessary for the Australian economy to bounce back from the pandemic.

The Governor of the Reserve Bank of Australia has made it clear that wage growth in Australia needs to be at least three per cent per year for the country to prosper.

This is in line with analyses by the International Monetary Fund and the International Labour Organization.

In other Australian states, governments have rewarded their nurses and midwives with pay increases well in excess of NSW. n

COD considers all options At our latest Committee of Delegates meeting, a resolution passed that expressed “frustration and anger at the recent rejection of members’ ratios and safe staffing claims, along with the meagre pay offer by the Ministry of Health”.

“The Ministry has failed to recognise and address the current staffing crisis in NSW Health. The evidence is clearly demonstrated in Queensland and Victoria, showing that shift-by-shift ratios is the solution to this staffing crisis,” it said.

“We see no other option but to … consider all options to convince the government of the need for a fair pay increase and mandated shiftby-shift ratios in NSW, to ensure safe patient care.”

THE LAMP JUNE/JULY 2021 | 9

COVER STORY

Queensland’s ratios save lives and money New research published in The Lancet shows the Queensland public health system has benefited greatly – clinically and economically – from nurse-to-patient ratios.

T

he resea rch fou nd significantly better patient outcomes in Queensland hospita ls that had implemented ratios, with a reduction in re-admissions, shortened hospital stays and reduced costs.

The study also looked at the cost implications of implementing ratios and found that the money saved from fewer re-admissions and shorter length of stay was more than twice the cost of the additional nurse staffing – while also yielding lower mortality.

Queensland passed a law in 2016 establishing minimum nurse-topatient ratios in medical–surgical wards in 27 public hospitals, which care for 83 per cent of patients hospitalised across the state. It was just the fourth jurisdiction in the world to implement ratios.

‘ Our study takes the additional step of informing whether direct state intervention yields better staffing, and whether those staffing improvements result in better patient outcomes.

The answer to both questions was yes.’ legislation. The research published in The Lancet is the result of that analysis.

The evaluation consisted of a real-time assessment of the scheme by experts from the University of Pennsylvania in collaboration with researchers from Queensland University of Technology’s (QUT) School of Nursing.

The study ran from the ratios’ introduction in 2016 to 2018, with the researchers collecting extensive data from about 17,000 nurses and more than 400,000 patients.

The data was compared with a similar number of hospitals that did not implement ratios.

The researchers estimated that in each hospital with ratios, there

The legislation requires that average nurse-to-patient ratios on morning and afternoon shifts be no lower than 1:4 and on night shifts no lower than 1:7.

It was a massive win for the Queensland Nurses and Midwives’ Union, after a long and tenacious campaign.

Queensland is notewor thy because an independent evaluation was included as part of the 10 | THE LAMP JUNE/JULY 2021

QUEENSLAND NURSES IN PARLIAMENT CELEBRATE THE PASSING OF THE LAW INTRODUCING SHIFT-BY-SHIFT RATIOS INTO THE STATE'S PUBLIC HEALTH SYSTEM IN 2016.

COVER STORY

Key findings > Significant improvements in staffing at hospitals where nurse-to patient ratios were implemented.

QNMU SECRETARY BETH MOHLE WITH PREMIER ANNASTACIA PALASZCZUK AFTER THE QUEENSLAND PARLIAMENT PASSED THE LAW MANDATING SHIFT-BY-SHIFT RATIOS.

were 145 fewer deaths, 255 fewer re-admissions, and 29,222 fewer hospital days than if they had not implemented the policy.

QU T Facult y of Hea lt h executive dean Professor Patsy Yates told the Sydney Morning Herald that in addition to improved patient outcomes, the measures also had direct cost benefits to the state’s public health system of about $70 million dollars over the study period.

“In fact, we saved twice as much as it cost for the extra staff, so this shows a clear economic benefit for early intervention and good nursing care.”

The researchers said their results were consistent with previous studies on the impact of better nurse staffing, in particular a landmark study published in The Lancet in 2014, which surveyed nearly half a million patients in nine European countries. They say the Queensland evaluation goes even further.

“Our study takes the additional step of informing whether direct state intervention yields better staffing, and whether those staffing improvements result in better patient outcomes. The answer to both questions was yes,”

they said. “ Q u e e n s l a n d ’s policy implementation is a viable model, offering lessons for other countries.”

L e a d aut hor P rofe s s or Matthew McHugh, from the University of Pennsylvania, said the study findings were even more important in light of the pandemic and its effect on frontline health staff.

> Significant improvements in mortality, length of stay and re-admissions. > Significant cost savings

“These results are all the more relevant in the context of COVID19, which has pushed an already strained and burnt-out hospital nurse workforce to the brink,” he said.

“Minimum safeguards to ensure that there are enough nurses to provide high-quality care to every patient is a simple but effective public safety measure.”

NSWNMA General Secretary, Brett Holmes, called on the NSW government to act on the findings.

“This research is further proof of why we desperately need shift-by-shift ratios in NSW. Enough is enough. The NSW government must stop relying on nurses’ goodwill to stay at the bedside. They deserve to be valued with shift-by-shift ratios and fair pay.” n

Read the report ‘Effects of nurse-topatient ratio legislation on nurse staffing and patient mortality, re-admissions, and length of stay: a prospective study in a panel of hospitals’ https://www.thelancet.com/ journals/lancet/article/ PIIS0140-6736(21)00768-6/ fulltext

THE LAMP JUNE/JULY 2021 | 11

COVER STORY

Nurses are leaving.

Who can blame them?

This article by Kaitlin Arvidson, NSWNMA Branch Secretary, Belmont Hospital, explaining our campaign for better pay and ratios, was published in the Newcastle Herald.

Ilove nursing, but it is hard. You come on shift and get handover information about all the people on your ward. Each one is an individual, complicated person.

They are sick, in pain, stressed and tired. They have families who want to know what’s going on. They have medications due, IV fluids, they need help mobilising, showering, toileting; sometimes they need help to eat or even to understand where they are and why they need to stay in hospital.

‘ How much I can get done depends on how many staff are on the floor. How many patients I have to look after dictates the kind of care I can provide.’ — Kaitlin Arvidson

The phone is ringing; I really should go to my break soon, but there are discharges and admissions, transport is coming. There are junior staff who need support, someone’s going to X-ray, an IV pump is beeping, there are wound dressings to change, buzzers are going off, someone spilled their drink and asked ‘Can I make them a coffee?’

CARE REFLECTS STAFF NUMBERS

Vital signs need to be checked, antibiotics need to be made up and given, someone needs pain relief, there are blood sugars to check 12 | THE LAMP JUNE/JULY 2021

– how is it lunchtime already? It’s a whirlwind. And of course, we’re documenting everything as we go.

I can list all of the tasks, but it is viscerally different to be there at the bedside. At different times there’s crying, vomiting, anger or rage, confusion, blood and grief. That’s the environment in which you have to have excellent time management and judgement.

How much I can get done depends on how many staff are on the floor.

How many patients I have to

look after dictates the kind of care I can provide. I feel bad when I have to rush someone’s shower or cut off their story. When I don’t have time to give someone a shave or stay and hold their hand because I have so many other things that I have to be doing.

Legislated nurse-to-patient ratios save lives, save money and increase nurses’ job satisfaction. We know this because nurses in Victoria and Queensland have ratios. Studies found that during the first three years ratios were introduced in Queensland, they prevented 145 deaths, 255 readmissions, 29,200

COVER STORY

‘ We don’t go into nursing to become millionaires, but we do hope to be able to raise a family and keep up with the cost of living’ — Kaitlin Arvidson

hospital days and saved $81 million.

This is what the NSW Government is saying no to right now, by refusing to introduce shift-by-shift ratios in NSW. That normal workday? That was before COVID, by the way.

Everything now takes longer: gloving and gowning, extra cleaning of surfaces and equipment. It’s hot and sweaty in those plastic gowns, the mask makes your glasses fog up and it’s harder to communicate, especially with elderly patients.

In 2020, we were really worried about bringing COVID home to our families, especially those of us with vulnerable loved ones. But we rose to the challenge, we worked hard, and we kept ourselves and our community safe. Premier Gladys Berejiklian said, “We are deeply grateful for their hard work, skill, care and the sacrifices they have made to keep us all safe.” She showed that gratitude with a 0.3 per cent pay rise. In her government’s eyes, we were not even worth a pay

rise that kept up with the cost of living, let alone one that reflected the value of the lives we saved or the economic shutdown we helped avoid. I know many of us have partners who lost work in the pandemic as well; just how far did that 60 cents a day go?

STAGNANT WAGES HARM ECONOMY Now in 2021, we as nurses and midwives have asked for safe staffing ratios and a respectful pay rise. We don’t go into nursing to become millionaires, but we do hope to be able to raise a family and keep up with the cost of living. We expect to be adequately compensated for the weekends, the midnights, the Christmas mornings that we spend looking after other people’s families and missing out on our own. For the stress, the heartbreak, the risk, the exhaustion that is all part of being in a frontline caring profession. We see nurses leaving and who can blame them?

Does the government think wage freezes and understaffing are going to retain valuable, experienced nurses? Or attract the next generation? Stagnant wages aren’t just bad for nurses and midwives, they’re bad for the economy and the local businesses that depend on our custom.

If the NSW Government thinks we’re going to tolerate these unreasonable, unsafe workloads for disrespectful wages, they are wrong. If they think we’re going to continue to put our backs, our mental health and our professional registrations on the line because they won’t legislate safe ratios, they’re wrong.

We are not making unreasonable requests here. We want to be able to provide care that is safe and that we can be proud of. We deserve to be paid a wage that reflects how hard we work and how valuable we are to society. That is what the state government is saying no to. NSW deserves better. n THE LAMP JUNE/JULY 2021 | 13

COVER STORY

Public are onside over ratios “We are determined to get staffing ratios. This is not going to go away.

We are over people having to work short, burning out and leaving.”

That’s how Prince of Wales Hospital Branch President Jan Ogden sums up the mood of her fellow nurses following the Berejiklian government’s refusal to consider staffing ratios.

Combined with its measly pay offer, the government’s response has left nurses feeling “slighted and insulted” Jan says.

“In the International Year of the Nurse and Midwife, in the middle of a COVID pandemic, it was insulting to be offered a 1.04 per cent pay increase for 2021–22, following a piddling 0.3 per cent last year.”

Jan, who is the NSWNMA branch president and delegate at POW Hospital, attended a lunchtime protest rally of about 50–60 nurses outside the hospital.

“There is a very deep feeling of anger that we haven’t been given ratios despite having propped up the system through a long period of staff shortages and people working ridiculous amounts of overtime,” she says.

“We’ve got lots of young parents who are nurses. They can’t maintain these levels of overtime with no recognition from the government. It’s just too hard and too disheartening.

“People are leaving the profession in frightening numbers. They are burnt out, they don’t feel their registration is safe and, most importantly, don’t feel their patients are safe.

“We know there are a lot of new grads who can’t get positions, yet we don’t have enough nurses in the hospital. That’s totally inappropriate.

“There has been no proper acknowledgement of the risks we’ve faced, including COVID, and what 14 | THE LAMP JUNE/JULY 2021

‘ The public is deeply grateful and respectful of what we’ve done – especially during the pandemic.’

— Jan Ogden

we’ve given up. The government shouldn’t continue to get up in public and say ‘nurses are heroes; we respect you’, because it doesn’t.

“The federal and state governments are splashing money around everywhere, yet in NSW there is a virtual pay freeze on people who are doing the hard yards.”

Jan says the NSWNMA should continue to campaign for a better deal, drawing on community goodwill towards nurses.

“I think most of the public hold us

in high regard,” she says. “They are deeply grateful and respectful of what we’ve done – especially during the pandemic. They do respect nurses’ opinions.

“It’s really important that nurses realise what a great influence they can have on the public.” n

COVER STORY

Public awareness is key to ratios battle Shellharbour Hospital branch member Debbi Simpson joined fellow nurses and midwives at a rally outside the hospital as part of their fight for fair pay and safe nurse-topatient ratios.

“I’m really angry about the government’s pathetic pay offer and its refusal to talk about staffing ratios,” said Debbi, a registered nurse in the emergency department.

She said Shellharbour ED staffing levels were inadequate to cope with a big increase in presentations experienced over recent months.

As a Class C1 hospital, Shellharbour ED is not entitled to the 1:3 staffing ratio that applies to the ED at nearby Wollongong Hospital, which is Class A1.

“We have been seeing approximately half as many ED presentations as Wollongong lately. However, we don’t have any support services such as specialist care, and Wollongong ED is nearly three times bigger,” Debbi said.

“With fewer staff than Wollongong we haven’t always been able to give our patients the time and care they deserve.

“We’re getting slammed, and everyone is overworked.

“I worry that something drastic will happen because the pressure on staff is unsustainable.”

Debbi said Shellharbour Hospital wards only qualify for five nursing hours per patient per day, compared to six hours at Wollongong Hospital.

“That means if you are admitted to Shellharbour, you can expect less care because we are not staffed for it.

“Why should Shellharbour patients get less nursing care than people in Wollongong? Why should your

‘ We need to spread the message that staffing levels are no longer safe at their public hospital.’ — Debbi Simpson postcode dictate the care someone receives?”

“Our wait times are getting longer.

Nurses in triage are copping a backlash from some members of the public who are angry about having to wait so long.

“The situation won’t improve until we get mandated staffing ratios.

“I’m happy to support further union action because the situation is just not right.

“I think we as a union should be doing more to make the community aware that nurses and the public

are getting a bad deal. We need to spread the message that staffing levels are no longer safe at their public hospital.

“We’re all saying, we don’t want to be called a ‘healthcare hero’ and not be given a fair pay increase.

“Other states have given their nurses reasonable pay rises during the pandemic. Why can’t NSW afford it?

“Public health is a basic human right and I don’t think the government values us or the community we serve.” n

THE LAMP JUNE/JULY 2021 | 15

COVER STORY

Wyong nurses prevent cuts to shifts Management has dropped a plan to cut nursing hours – but the NSWNMA Wyong branch warns the fight is not over.

N

urses at Wyong Hospital have blocked an attempt to cut nursing hours, despite already working excessive hours and carrying dangerous workloads.

Management has dropped the proposal, but given no guarantee they won’t try to cut hours again.

The hospital’s NSWNMA branch warns the fight is not over.

Wyong is a Group B hospital and has been running at 6.0 NHPPD (nursing hours per patient day) since 2016.

To cut costs, management of Central Coast Local Health District said they intended to permanently reduce all Wyong NHPPD wards to 5.5 NHPPD, which is the award minimum.

Affected wards included M1, M3, R1 and GRU. NSWNMA delegate at Wyong,

Kelly Falconer, said cutting half an hour’s nursing per patient could potentially eliminate two nursing shifts per day on a 32-bed ward.

“Staff are already struggling to handle the workload with 6.0 NHPPD,” said Kelly, who is an ED nurse. “To suffer that proposed cut would have been devastating and extremely dangerous to our patients.”

She said the proposed cut would have denied patients the care they need.

“Nurses are already working as hard as they can, often missing meal breaks and having to stay behind after their shifts.

“Patients mostly get great care, but it shouldn’t be at the cost of nurses having to do a 10-hour night shift without getting any breaks.”

To fight the cuts, the branch identified member leaders on each

‘ We talked from the heart and let it rip. We said “This is disgusting, you can’t do this’ — Kelly Falconer

affected ward, started a WhatsApp communication group for members, and met with Wyong MP David Harris, the Labor Party spokesperson for the Central Coast.

NSWNMA General Secretary, Brett Holmes, said cutting nursing hours could lead to a breach of Clause 53 (iii) (f) of the Award, which prov ides t hat nurses and midwives “will not be allocated an unreasonable or excessive nursing workload”. n

MEMBERS OF THE NSWNMA WYONG BRANCH CELEBRATE THEIR WIN. 16 | THE LAMP JUNE/JULY 2021

COVER STORY

Nurse numbers cut at Gosford

In a letter to the hospital’s Director of Nursing (DON), Nadine Bridgett, Brett said the proposed cuts were at odds with the consensus view of t he ho spit a l’s Re a s on a ble Workloads Committee, made up of both NSWNMA members and nursing management.

Branch officials and member representatives from each ward attended a “grievance meeting” with management reps, including hospital General Manager, Chris Bone, and DON, Nadine Bridgett.

Kelly sa id nurses gave sp eci f ic ex a mple s of t he unreasonable work loads, which contributed to nurses being assaulted and missed patient cares.

“We talked from the heart and let it rip,” she said. “We said ‘This is disgusting, you can’t do this’.”

“A couple of nurses told of not having time to take geriatric patients to the toilet because nurses were look ing a f ter extremely confused patients who were wandering and at risk of falling.

“They have to tell them to ‘Go into your nappy and we’ll clean you as soon as we can’.”

Follow ing t he grieva nce meeting, management confirmed in writing that the status quo of 6.0 NHPPD would remain, but gave no commitment to NHPPD once the hospital redevelopment is finished.

Nurses are due to move into the redeveloped facility in July. n

Central Coast Local Health District managers have enforced cuts to nurse numbers at Gosford Hospital, the area’s major health facility.

A medical ward has lost a key clinical support position and weekend nursing shifts have been cut in the cardiology ward.

The hospital has also lost dedicated staffing for four maternity beds, reducing the midwives on shift to equal an average of 24 beds, despite 30 or more beds being in use on a daily basis.

A midwifery shift has been removed in the morning and the team leader now has a patient load. A mothercraft position has also been deleted.

Gosford Hospital is the only facility providing birthing and maternity care for the entire Central Coast, following the indefinite closure of the maternity ward at Wyong Hospital.

In the cardiology ward, J8, nursing shifts have been removed permanently to reduce the district’s budget, despite an increase in patient acuity and occasions of care.

The union is trying to get the cardiology cuts reversed through the hospital’s reasonable workloads committee.

Members of the NSWNMA’s Gosford Hospital branch told NBN TV that management is cutting staff simply to make budget savings.

Branch President, Meg Pendrick, said members are fed up with being expected to do so much more for less, especially in light of the Berejiklian Government’s wage freeze.

“We are routinely being asked to go above and beyond and take on extra shifts to meet the increased demand,” she said.

“Our conditions are exhausting and when you’re not compensated with fair pay, then it does make you wonder why. And our concern is, what is going to happen in coming years? Who will be attracted to this profession?”

NSWNMA branch steward and RN Candice McCartney said the situation was the worst she had seen in 20 years.

“We have nurses crying on shifts because it’s just so hard. The patients just aren’t getting the care. We can’t give showers; we can’t do personal hygiene.” n

‘ We are routinely being asked to go above and beyond and take on extra shifts to meet the increased demand.’

— Meg Pendrick

THE LAMP JUNE/JULY 2021 | 17

COVER STORY

More staff for Lismore ED Lismore Hospital’s NSWNMA branch is leading a campaign to get more nurses rostered in the hard-pressed emergency department.

L

ismore Base Hospita l’s emergency department is getting more nurses thanks to a strong campaign by the hospital’s NSWNMA branch.

The campaign has secured the employment of an additional RN as an ED resource nurse on every shift.

Staff are also seeking the employment of another RN on night shift. The proposal is being discussed by the hospital’s reasonable workloads committee (RWC).

Meanwhile, the hospital is recruiting to provide additional nurse practitioner staffing (equivalent to 1.4 full-time employees) as a result of changes to the model of care.

The call for more staff was unanimously supported by wellattended meetings of the NSWNMA branch and endorsed by 285 staff members, who signed an open letter to management.

NSWNMA member and ED clinical nurse educator Rebecca Austin said the campaign had raised the profile of the branch among nurses and “reinforced to everyone the power of numbers”.

to the RWC, which supported staff increases for the ED. Management responded by asking for more data and the NSWNM A branch passed a resolution suppor ting t he RWC recommendation.

Northern NSW Local Health District management said it would increase nurse practitioner staffing but rejected other requests for more nurses.

The branch decided to hold a lunchtime community rally outside the hospital. However, it was called off after hospital chief executive, Wayne Jones, offered to employ an additional resource nurse on each shift seven days a week.

Rebecca said the resource nurse

works as the second nurse in the resuscitation room when it has two or more patients. At other times the nurse assists other areas of the department.

“We felt we achieved something important by getting the resource nurse,” she said. “Our request for an additional RN on night duty is back with the RWC for the time being.”

Rebecca said it was encouraging to see large numbers of NSWNMA members attend branch meetings during the campaign.

“We also welcomed non-members to the meetings as observers. They couldn’t speak or vote, but they could see how the branch was working to improve the safety and conditions of both patients and staff.” n

‘ The highest-risk area was the drastically understaffed and over-utilised resuscitation room.’ — Rebecca Austin

She said presentations and acuit y at Lismore ED have risen over the past three years, with ATS1 (resuscitation) cases up by 23 per cent and ATS2 (emergency) cases up by 41 per cent. However, staff numbers did not increase.

“The highest risk area was the drastically understaffed and over-utilised resuscitation room,” Rebecca said.

“Also, we were maintaining the same acuity and same utilisation throughout the night, when we had one less nurse on shift.”

ED nurses took their concerns 18 | THE LAMP JUNE/JULY 2021

STAFF FROM LISMORE ED. REBECCA AUSTIN IS AT THE REAR ON THE RIGHT.

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Scholarships for the academic year 2022 Applications for the Edith Cavell Trust Scholarships are being accepted from 1 May 2021, closing 31 July 2021, for studies being undertaken in the academic year 2022.

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 or midwifery education programs at graduate, post-graduate and continuing education professional development level; in accordance with a number of categories.

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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 THE LAMP JUNE/JULY 2021 | 19

AGED CARE

Reforms are welcome – but must go further The Morrison government’s aged care package is a step in the right direction, but falls well short of royal commission recommendations.

T

he federal government has made a positive start to fixing the broken aged care system. But it has failed to deliver the “once in a generation” reform promised by Prime Minister Scott Morrison.

The Aged Care Royal Commission’s recommendations were aimed at repairing a system it described as “inadequate and inhumane”.

In its May Budget, the government responded by injecting an extra $17.7 billion into aged care over five years.

The Australian Nursing and Midwifery Federation (ANMF), which represents state-based nursing unions including the NSWNMA, said the government’s package included some “very positive” measures.

However, the ANMF said the package ignored too many of the commission’s recommendations.

“It simply won’t go far enough to guarantee safe, quality care for all older Australians,” said ANMF Federal Secretary, Annie Butler.

On the vital issue of staffing, the government committed to a mandatory minimum care time for aged care residents.

From October 2023, nursing 20 | THE LAMP JUNE/JULY 2021

‘ Elderly residents will continue to be denied roundthe-clock nursing care.’

— Annie Butler

homes will be required to provide at least 200 minutes of care per day to each resident, including 40 minutes of care delivered by a registered nurse.

October 2023 is more than a year later than the start time – July 2022 – recommended by the commission.

Also, the budget measures do not include any subsequent increase in minimum staff time as recommended by the commission.

The commission called for at least 215 minutes per resident per day from July 2024, with at least 44 minutes provided by an RN. Most critically, the reforms don’t include any requirement for a registered nurse to be on site 24/7, as the commission also recommended.

The government will only require an RN to be on duty for 16 hours per day.

Annie Butler said this means care is likely to remain at an “adequate

3-star level” rather than reaching a level of high-quality care across the sector.

“Elderly residents will continue to be denied round-the-clock nursing care,” she said.

“The effect of this could be that residents may be forced to go without pain relief or be transported to hospital for a minor incident, because the care workers on duty don’t have the support of a nurse’s clinical expertise.”

Annie said the government has done little to bridge the pay gap for aged care RNs, which is as much as 15 per cent below hospital pay.

I n stead, t he gover n ment promised a retention bonus for RNs who stay with their employer for at least a year.

The bonus is $3700 for full-time RNs, or $2700 for part-time RNs. Annie said money should go to lifting wages throughout the sector,

AGED CARE

Staffing, workforce reforms at a glance

improving conditions and putting proper career structures in place.

“What RNs need to come into the aged care workforce is safe staffing and safe workloads.

“In particular, young, newly graduated nurses need to feel supported.

What the Royal Commission recommended

What the Morrison government has committed to

RN on site 24/7

RN on site 16 hours per day

Minimum care hours – 200 minutes per resident per day in 2022, 215 minutes by 2023, case-mix adjusted

200 care minutes per resident per day, including 40 minutes with nurse, case-mix adjusted, from October 2023

Increase award wages for care workers

No mention

Registration of all care workers

New voluntary register and code of conduct

Minimum Certificate 3 training of care workers, including mandatory dementia training

Not mandated, but 33,800 training places will be subsidised for workers to get Certificate 3

“That’s why having nurses 24 hours a day is critical.”

T he roy a l c om m i s sion concluded that inadequate staffing levels, skills mix and training were the principal causes of substandard care.

“The royal commission made it absolutely clear that until you get the staffing right, none of the other stuff really matters,” Annie said.

“You can tinker around the edges, but quality care won’t be delivered until you get the staffing right. That means enough care time with the right mix of skills.

“This budget will not guarantee high-quality and safe aged care.

It’s particularly disappointing because this package is the government’s full response to the royal commission, which is simply not enough.” n

We won’t forget you, Albanese tells staff Labor leader Anthony Albanese called on PM Morrison to explain why he rejected many of the royal commission’s most important recommendations – including a nurse on duty at all times.

In his reply to the Budget, Mr Albanese also criticised the government’s failure to support increases in “the appallingly low wages of hard-working aged care staff.”

He pledged a Labor government “will not forget the dedicated, mostly female staff who care for our elderly, [and are] almost uniformly understaffed and underpaid.”

Labor would ensure that “every dollar spent in aged care goes to employing a guaranteed minimum level of nurses, assistants and carers, and to daily needs like decent food – rather than into the pockets of the more unscrupulous providers.”

“We also support the Fair Work Commission moving quickly to meaningfully lift the wages of aged care workers,” he said. n

THE LAMP JUNE/JULY 2021 | 21

AGED CARE

Big handouts may bypass residents The Morrison government is giving aged care providers a $3.2 billion handout, with no obligation to spend it on residents.

T

unscrupulous providers will continue to put profits before care.

he federal Budget gave aged care operators a $10 daily supplement for every resident. How will that money – $3.2 billion over four years – be spent?

Will it go to residents, perhaps in the form of better food and adequate staff to prepare meals? Or will it go to executive perks, flash offices and company profits?

The royal commission recommended a $10 increase to the basic daily fee ($52.71) as the minimum necessary to keep the sector afloat.

The commission said bad food was among the top three complaints from residents.

Annie Butler, Federal Secretary of the Australian Nursing and Midwifery Federation (ANMF) says the $10 increase comes with no strings attached – despite evidence of some providers misusing funds.

“We don’t know whether that money will go to better food and/or more staff, because the government hasn’t adequately addressed the need for more transparency and accountability,” she said.

“We will continue to see neglect, negligence and abuse in age care homes,” she warns.

‘ You have to tie how providers spend the money.’

— Sarah Russell

aged care.

From 1 July 2022, providers will be required to publish care-staffing minutes for each facility on the My Aged Care website.

Providers will also be required to report to residents and their families on care delivered. The Budget gave no details on what happens if they don’t report and publish.

At the same time, a star-rating system on the My Aged Care website will be introduced for residential aged care.

“Some providers will choose to do the right thing and invest in care.

Many may not.”

However, the ANMF says the measures do not go far enough. Many independent experts agree.

The government has taken steps to improve governance and accountability in residential

Dr Sarah Russell, spokesperson for the group Aged Care Reform Now, says that without financial transparency,

22 | THE LAMP JUNE/JULY 2021

Dr Russell said at the top of residents’ minds are staff who have time to spend with them and food they like. In some aged care homes, they get neither.

"You have to tie how providers spend the money,” she told the Sydney Morning Herald.

“If you have no control, in so many cases the money won’t go to the people it is intended to go to. This is just pouring more money into a dysfunctional system.”

The government has failed to implement a royal commission recommendation t hat homes guarantee appropriate nutrition for residents and show how much they spend on residents’ basic needs, “especially their nutritional needs”.

The government says that the $10-a-day supplement will only be paid to homes once they have agreed to repor t their food expenditure quarterly.

AGED CARE

‘ Clear transparency measures will be needed to ensure the additional billions don’t end up boosting providers’ profits.’

— The Gratton Institute

Lack of transparency risks reforms A leading public policy think tank, the Grattan Institute, says the government has “fallen short” on governance and transparency, which it calls “the biggest risk to achieving real structural change” in aged care.

Writing in The Conversation, the Institute’s Stephen Duckett and Anika Stobart note the government has failed to support the establishment of an independent aged care commission.

“Most disappointingly, it is pumping $260 million into the Aged Care Quality and Safety Commission, which the royal commission found had demonstrably failed,” they say.

“While some transparency will be provided through public reporting of staffing hours and star ratings to compare provider performance, clear transparency measures will be needed to ensure the additional billions don’t end up boosting providers’ profits.”

Stephen Duckett is the Institute’s health program director and a former secretary of the federal health department.

He says he is concerned the government’s aged care spending increase of $17.7 billion over five years is about half what is needed to address the royal commission’s recommendations.

Duckett told The Guardian newspaper the government’s promise to clear the roughly 100,000-strong waiting list for home care packages cannot be achieved with the $6.5 billion over five years allocated in the Budget.

More nurses needed to prevent hospital transfers – AMA Nursing homes with poorer staff-to-resident ratios have higher rates of transfer to hospital, compared with those that have RNs more readily available, a study by the Australian Medical Association (AMA) has found.

Savings of $21.2 billion are available through potentially avoidable admissions, presentations to and stays in hospitals from the aged care sector and could be achieved through better provision of primary care in aged care settings, the study finds.

An AMA research paper, Putting Health Care Back Into Aged Care (https://ama.com.au/ articles/report-putting-health-care-back-agedcare) says that as a result of lack of timely and adequate care, older people end up in hospitals more frequently and stay longer.

It says experienced nurses can provide appropriate and skilled care within the nursing home, which in conjunction with GP oversight, can prevent transfers to hospitals.

AMA President, Dr Omar Khorshid, said many nursing homes have insufficient numbers of RNs, leading to older people’s health deteriorating so badly, they end up in hospital.

THE LAMP JUNE/JULY 2021 | 23

AGED CARE

Real change for aged care …

It’s not too much to ask The Morrison government has only adopted some of the recommendations of the aged care royal commission.

Achieving real reform remains a work in progress.

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he Australian Nursing and Midwifery Federation (ANMF) wants nurses and their supporters to help push the government to finish the job of aged care reform.

40 minutes with a nurse, from October 2023.

The ANMF is campaigning under the slogan “Real change for aged care … It’s not too much to ask.”

The ANMF is pushing for laws that require guaranteed minimum staff ratios and skill mix in every facility, on every shift – day, afternoon and night.

It has set up a website – https:// www.itsnottoomuch.com/ – which allows the public to show its support for staff ratios.

“Austra lia, our aged care residents need your assistance,” the website says.

“They don't ask for much, just the basic dignities we all deserve in life.

“But a lack of staff ratio laws means many are suffering. It only takes a minute or two to help change that.”

Supporters can select to “donate” their time to the campaign: two minutes to share the campaign message on social media (Twitter, Facebook or email), five minutes to send a message to politicians, or seven minutes to do both.

The government committed to mandating 200 care minutes (3.3 hours) per resident per day, including 24 | THE LAMP JUNE/JULY 2021

But it has failed to adopt a key recommendation of the commission: that a registered nurse be on site 24/7.

It wants RNs to be on site, at every facility, for every shift – as the royal commission recommended.

The ANMF wants to ensure, through legislation, that residents receive an average of 4.3 hours of care, including at least 54 minutes of RN care per day.

It argues for a mandated minimum skill mix of 30 per cent RNs, 20 per cent enrolled nurses and 50 per cent personal care workers.

The “Real change for aged care” campaign advocates other measures, including legislated transparency and accountability measures.

They include f unding linked to quality-of-care outcomes and proof that government funding for wage costs has been used for that purpose.

Better wages for aged care workers in line with public sector wages is another focus of the campaign.

The government ’s Budget response to the royal commission report failed to address its recommendations for lifting aged care pay rates.

A little of your time can make a real difference.

Visit the website. https://www. itsnottoomuch.com/

AGED CARE

A LITTLE MEALTIME ASSISTANCE...

IS THAT TOO MUCH TO ASK? UP TO 68% OF RESIDENTS IN AGED CARE FACILITIES ARE AT RISK OF MALNUTRITION, MANY OF WHOM NEED ASSISTANCE TO EAT

PAIN RELIEF WHEN I NEED IT...

IS THAT TOO MUCH TO ASK?

STOP PRESS ANMF seeks 25 per cent pay increase in aged care

The Morrison Government must act now to fix chronic and widespread understaffing by mandating staff ratio laws

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ITSNOTTOOMUCH.COM

itsnottoomuch.com

Authorised by Australian Nursing and Midwifery Federation Tasmanian Branch Secretary Emily Shepherd, April 2021

Authorised by A. Butler for the Australian Nursing and Midwifery Federation, Melbourne

As The Lamp goes to press the ANMF has applied to the Fair Work Commission for a 25 per cent wage increase for Registered and Enrolled Nurses and Personal Care Workers in the aged care sector in Australia.

The ANMF made the work value application “on the basis that the work of staff delivering aged care has long been recognised as undervalued”.

The Royal Commission into Aged Care recommended that proceedings be begun at the Fair Work Commission to rectify the problem of low wages in the aged care sector.

What the media said about Morrison’s aged care package

“

The billions of extra dollars going into aged care has to improve the system, but it is not the ‘generational change’ the prime minister is touting.

“When the royal commissioners into Aged Care Quality and Safety, Tony Pagone QC and Lynelle Briggs, wrapped up their $90 million, two-anda-half-year inquiry into aged care, they had one wish: a ‘landmark Australian social policy reform’ that would ensure well-trained, well-paid staff overseen by an independent auditor and with complete transparency for the billions of dollars in taxpayer funds given to the industry each year.

“Best calculation to achieve that: an extra $10 billion a year.

“What Australia received is almost $18 billion over five years, no guarantee of mandatory minimum training of workers, a refusal to lift wages, a bolstering of an inept regulator, and continuing freedom for providers to spend money as they see fit.

”

— Anne Connolly, ABC Investigations Unit

“

In a broadside directed at Canberra, the royal commission pointed the finger at Australian governments that ‘have brought a level of ambivalence, timidity and detachment to their approach to aged care ... The absence of leadership at a system level is at the heart of many ... systemic problems.’ No amount of money is going to fix this.

“In December, Health Minister Greg Hunt was given the extra responsibility of Aged Care, elevating the portfolio into Cabinet. In future, there will be no excuse for the responsible minister not to have a seat at the highest level of government.

It took more than two years for the aged care royal commission to reveal the full extent of the deep-seated problems in the sector, and provide a comprehensive to-do list. With the budget announcements and broader response to the commission, the Morrison government has got off to a good start. But that is exactly what it is: a start.

”

— Sydney Morning Herald Editorial

THE LAMP JUNE/JULY 2021 | 25

PROFESSIONAL ISSUES

Employers need guidance on psychosocial hazards, says minister Two Association members recently met with Kevin Anderson, the NSW Minister for Better Regulation and Innovation, to discuss the urgent need to combat non-physical hazards in the workplace.

N

ick Howson, an RN and br a nch pre sident at Cumberla nd Hospit a l, and Skye Romer, secretary of the Prince of Wales Mental Health Branch, spoke to the minister about their harrowing experiences of psychosocial hazards at their workplaces.

Nick and Skye, accompanied

by NSWNMA professional officer Veronica Black, met with Kevin Anderson at his Martin Place office, ahead of a meeting of all Australian ministers responsible for workplace health and safety laws.

The ministers will be voting on the 34 changes recommended by Marie Boland, a former executive director of SafeWork SA, who recently conducted an independent review of Australia’s model workplace health and safety legislation. In her review, Boland found that workplace health and safety laws lacked regulations and specific guidance for managing psychosocial risks.

“In submissions to Boland’s review process, the NSWNMA argued that occupational violence and other psychosocial hazards were not being effectively addressed and prevented under the existing system,” said NSWNMA Assistant General Secretary, Judith Kiejda.

26 | THE LAMP JUNE/JULY 2021

“A lot of psychosocial injuries in the workplace occur when there are feelings that there is no organisational justice, leaving workers feeling unsupported,” Judith said.

“When Marie Boland’s recommendations came out, she was really clear that employers don’t have any guidance to help them understand what their obligations are in managing hazards such as workloads, bullying and sexual harassment. SafeWork inspectors can’t write notices for things that aren’t in the law, so we argued that psychosocial injuries must be clearly identified and be notifiable injuries.”

Currently, the onus is on workers in the healthcare system to follow up if they need mental health support. Nick told The Lamp, “If big organisations like health aren’t able to psychologically protect workers, what chance do other organisations have?”

Skye spoke to the minister about the lack of workplace support she received after an attack by a consumer that resulted in surgeries and an ongoing recovery process.

“I’ve had firsthand experience of what it is like to be injured in the workplace. It has been absolutely horrendous. Coming into work

‘ I’ve had firsthand experience of what it is like to be injured in the workplace. It has been absolutely horrendous.’

— Skye Romer after you’ve already been injured, your body is in a flight-or-fight response. At the same time, you are

PROFESSIONAL ISSUES

‘ We strongly support a code of practice. It is a good document, and while it doesn’t do everything, it goes a long way to filling the gap.’

— Judith Kiedja, Assistant General Secretary, NSWNMA

investigated by the insurers in a way that is verging on stalking.”

A LACK OF SUPPORT Sk ye has had to attend multiple medical appointments and undergo numerous treatments.

Sk ye also suffered a “massive drop in pay” and had to move out of her home when the workers’ compensation system did not take into account her history of overtime.

“In my mind, I was paying for being assaulted at work.”

Nick said they asked the minister to support all 34 of Boland’s recommendations, as well as implement the proposed code of practice.

“When we spoke to the minister, he conceded that there is clearly a problem, and that bosses need guidance,” Nick said.

In a separate process to the Boland recommendations, the NSW government has released a draft code to cover psychological risks.

<9%

of NSW workplaces have a systematic approach to managing psychological health issues.

“The code gives an outline for everyone to work to, so they don’t have to make it up,” Nick said.

“I was pleasantly surprised by the minister’s willingness to listen. He even went as far to say that he thought the input of unions was of vital importance, because they see how it affects workers.”

STOP PRESS As The Lamp goes to press the WHS ministers have agreed to regulate psychosocial hazards.

The ACTU said the decision “was a major step towards the prevention of mental illness”.

“Years of campaigning from working people and their unions have gone into winning this regulation. It will make Australian workplaces safer for future generations of workers,” said ACTU assistant secretary Liam O’Brien.

>70%

increase in claims for psychological injury by nurses working for NSW Health between 2014 and 2019.

Beefing up the law In 2011, Australian states and territories began to harmonise the different acts and regulations covering workplace health and safety so that there was consistency between the rules and regulations in each jurisdiction.

In 2019, after a long-delayed independent review of the model act, Marie Boland made 34 recommendations for changes.

Ministers from all jurisdictions will soon meet to vote on whether to update the act with each of Boland’s recommendations.

Each recommendation needs a two-thirds majority vote to change the act.

In a separate process, the NSW government has released a draft code of practice for managing workplace risks to psychological health. The code – developed by a working group that included Safe Work Australia and SafeWork NSW, unions, employers and academic experts – provides detailed information on how to manage risks to psychological health in the workplace.

New South Wales will be the first Australian state to develop a code of this kind.

“We strongly support a code of practice,” NSWNMA Assistant General Secretary, Judith Kiejda, said. “It is a good document, and while it doesn’t do everything, it goes a long way to filling the gap.”

THE LAMP JUNE/JULY 2021 | 27

COVID-19

Support grows for a “People’s Vaccine” The US responds to calls for a WTO waiver on vaccine intellectual property rights as concerns mount over vaccine access and inoculation in low- and middle-income countries.

T

he United States has agreed to support a waiver on vaccine patents for the duration of the COVID pandemic. The World Health Organization says this is a major step towards global equity in the distribution of the vaccines.

More than 170 former political leaders and Nobel laureates had previously put their names to a joint letter calling on the US to support the waiver.

The signatories to the letter said they were “gravely concerned by the slow progress in scaling up global COVID-19 vaccine access and inoculation in low- and middleincome countries”.

“A WTO waiver is a vital and necessary step to bringing an end to this pandemic. It must be combined with ensuring that vaccine know-how and technology is shared openly. This will save lives and advance us toward global herd immunity,” the letter said.

“These actions would expand global manufacturing capacity, unhindered by industry mono-

‘ The market cannot adequately meet these challenges, and neither can narrow nationalism.’ polies that are driving the dire supply shortages and blocking vaccine access.”

The leaders called for “robust international health architecture”.

“If the past year has taught us anything, it is that threats to public health are global, and that strategic government investment, action, cooperation, and solidarity are vital.

The market cannot adequately meet these challenges, and neither can narrow nationalism.”

The slow rollout to low-income countries has been worsened by the COVID crisis in India. India produces 70 per cent of the world’s vaccines.

The Serum Institute of India was given the rights to the AstraZeneca vaccine for 64 low-income countries as part of the World Health O r g a n i z a t i o n ’s Covax program.

Exports of the vaccine to these count ries has been postponed or called off as India sinks under the catastrophe of its second wave. n

28 | THE LAMP JUNE/JULY 2021

… but again, Australia aligns with the pariahs Despite growing momentum for a WTO waiver, it could be sabotaged by a small number of countries – including Australia.

Australia, the UK, the European Union, Switzerland, Japan, Brazil and Norway continue to withhold support for the campaign.

The ACTU, health unions and public health organisations have called on the Australian Government to support the waiver at the WTO. “The Morrison government is brazenly putting the profit of multinational pharmaceutical companies ahead of the safety of millions of people who need medicines and vaccines,” said ACTU President, Michele O’Neil.

“This government has not only presided over a botched rollout of the COVID vaccine in Australia, but is now preventing the widespread access to the COVID vaccine in developing countries by not supporting this waiver.”

The Public Health Association of Australia (PHAA), Médecins Sans Frontiers (MSF), Public Services International (PSI), the ANMF and the NSWNMA also support the campaign.

INDIGENOUS ISSUES

New training resource for Indigenous end-of-life care Palliative Care Australia has released a new online video to support health professionals working with Aboriginal and Torres Strait Islander peoples.

F

ilmed on Groote Eylandt in the Northern Territory, the video, Discussing Choices – Indigenous Advance Care Plans, is a practical case study for professional health, Aboriginal and community workers (see box).

“For Aboriginal people, when it comes to end-of-life care, culture, kinship and Country are probably our most important things,” says Palliative Care Northern Territory (PCNT) President, Jonathan DodsonJauncey, who guides viewers through the video.

On Groote Eylandt, local health centre professionals have been working with the local Anindilyakwa people to complete an individual Advance Care Plan (ACP) called a ‘jura’.

Com munit y members a re empowered when health workers com mun icate clea rly a nd respect f ully, use t ra nslators whenever needed, involve the right family members, and are very specific about alternatives and options in different scenarios that may occur, as well as a person’s right to change their jura at any point.

Conversations between health professionals and clients around end of life are challenging. The same is true for many Aboriginal and Torres Strait Islander peoples: talking about death and dying can be uncomfortable. As Dodson-Jauncey explains, discussing the end of life can be viewed as “tempting fate”.

NOT A TABOO SUBJECT Dodson-Jauncey says t he success health workers on Groote Eylandt have had working with the Anindilyakwa community is due to the support of the community and the elders, who have said that “this is not a taboo subject; I can talk about it”.

“We have to go from the community up to the clinic, as opposed to from the clinic down to the community.”

Dodson-Jauncey says preparing an ACP is also an opportunity to share culture and stories. It becomes a time of “actually getting time to spend with family, and time to share those stories. There might be things that we’ve never actually told, or expressed, to our family”.

He adds that an ACP document can include health and medical choices, and it can also include financial information. Being able to have your wishes written down in terms of returning to Country is really important, he says.

“It may be important for a person’s individual beliefs on the afterlife. For some Aboriginal people, we need to be back on Country to ensure the next part of our journey can continue. There are obviously some important things about being on Country, such as having access to our traditional bush foods, having access to our traditional healers.” n

Where to find the video Health trainers and health professionals are invited to incorporate the video into their suite of existing training resources: https://palliativecare.org.au/ discussing-choices-indigenousadvance-care-planning/ Warning: Aboriginal and Torres Strait Islander people may find content in this film upsetting.

THE LAMP JUNE/JULY 2021 | 29

NSWNMA

RS A N I B E W E LIV We also arrange other additional one-off webinars facilitated by external presenters on interesting and topical subjects. Keep an eye on the education page and our education emails for updates and additions.

The NSWNMA has released a series of free webinars on a range of subjects relevant to nursing and midwifery practice. We have a suite of regular topics, such as Medications, Communication and Documentation, Professional Obligations and many more.

Go to the Education page of our website to search our face-toface and webinar CPD education options.

PROFESSIONAL EDUCATION

bit.ly/educationNSWNMA

Lead WITH Confidence

A webinar series for Nurse & Midwife Managers

PROFESSIONAL EDUCATION The NSWNMA has released an additional series of leadership webinars aimed specifically at senior nurses and midwives.

How to Prepare and Develop a Business Case Thu 10 June, 7pm

How to Get Through the Pitfalls of Rostering

Building a Ward Budget Thu 12 August, 7pm

Wed 28 July, 7pm

REGISTER NOW bit.ly/educationNSWNMA

Professional Obligations of Supervision, Delegation and Allocation in Management Thu 16 September, 7pm

Separate registration into each session is required. These webinars will be recorded and will be available following each event to members of the NSWNMA. The recording will be published in Member Central.

30 | THE LAMP JUNE/JULY 2021

PROFESSIONAL EDUCATION

free webinars

Quality Aged Care

Professional Practice Webinar Series PRESENTED BY:

PRESENTED BY:

Educator Consultant, Aged Care

Aged Care Consultant/Director, Aged Care Consulting

Helen Samphier Each webinar commences at 4.30pm and will run between 60-75 minutes.

Elder Abuse, Mon 28 June LGBTIQ Awareness in Aged Care, Mon 26 July Cultural Safety, Mon 23 August Dementia Management, Mon 27 September This series of webinars is targeted to nurses, managers and staff in residential and community aged care.

Separate registration is required into each session.

Can’t attend on these days?

Recordings of the sessions will be available in the Professional Education section of Member Central for 7 days following the event (please allow 2-3 working days following for events to be published).

REGISTER NOW

Kathryne Turek

Each webinar commences at 1.30pm and will run for 90 minutes.

Serious Incident Reporting Scheme (SIRS), Wed 9 June High Impact High Prevalence Risk Management, Wed 14 July Minimising and documenting Restrictive Practices, Wed 11 August Risk Assessments and Risk Management in Aged Care, Wed 8 September Consumer Consultation in Assessments, Care Planning and Care Conferencing, Wed 13 October Diabetes in Residential Aged Care and Community Care, Wed 10 November Effective Management of the Deteriorating Consumer, Wed 8 December 2021 Minimising the use of Psychotropic Medication and Correct Documentation, Wed 9 February (2022) Managing Complex Complaints, Wed 9 March (2022)

bit.ly/educationNSWNMA

THE LAMP JUNE/JULY 2021 | 31

YOUR RIGHTS

Ask

Judith Mid-year and at the crossroads ...

Nearly six months into 2021, and we are well and truly at the crossroads.

Or perhaps another all-too-familiar dead end. The Aged Care Royal Commission recommendations heralded a defining generational moment, but sadly and predictably, the response is falling well short.

Not ignoring but not really breaking through, either. Our aged and those who care for their clinical needs are left wanting. In the minds of many of our leaders, it would seem to be far better to build another road or tunnel or bridge than repair the social fabric and soul of our nation.

Public hospitals cough and splutter along, understaffed, overstretched, at times plainly broken. The response is, largely, more of the same. No concession on staffing. No admission of responsibility. No recognition of the real worth of nurses and midwives.

So, what happens? Nurses and midwives just leave the profession completely, or go interstate, or leave full-time work behind, or revert to survival mode, or, worse still, become broken.

There are plenty of similar stories in other workplace settings and industries. For example, some of our ex-FACS nurses who were privatised and forced to work in the NGO sector are now starting to be shown the door in larger numbers.

Just as we predicted: budgets and balance sheets prevail over the needs of residents and clients.

It would seem that until the actual health and wellbeing of our society, in all its forms, becomes the defining measure of the success of those who govern us, beyond mere economic terms, little prospect for change exists.

But change we must ...

32 | THE LAMP JUNE/JULY 2021

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

Registration renewal time What does it mean when I’m asked if my right to practise has been withdrawn or restricted at renewal?

In an April 2021 Fact Sheet, the Nursing and Midwifery Board of Australia clarified the intent of this question. It only applies to a small number of nurses and midwives who are given ‘rights’ to work at hospitals or other facilities, such as privately practising nurse practitioners or midwives who have admitting rights. Nurses and midwives in independent private practice whose right to practise has been withdrawn or restricted, based on their conduct, professional performance or health, need to declare this information in response to this question. To be clear, beyond the above scenarios, this question does not require you to declare if your employment has been terminated, suspended or you are being performance managed.

Shift penalty at Southern Cross Care I work at a facility run by Southern Cross Care. I worked a shift the other day that started at noon.

What penalty is applied?

Under Clause 19(a) of the Southern Cross Care (NSW & ACT) Enterprise Agreement 2017–2020, it would be a 10 per cent penalty. However, please note if you are part time, this penalty would only be payable if your shift finished beyond 6 pm. If not, then no penalty would be applicable.

Annual leave I work under the Nurses Award 2010. I recently had some annual leave knocked back due to operational needs. Can they do that?

The Nurses Award 2010 is somewhat silent on the issue of application and agreement to proceed onto leave or notification periods. The Fair Work Act 2009 sets out the minimum standards for proceeding onto annual leave in the following way: “The employer must not unreasonably refuse to agree to a

request by the employee to take paid annual leave” [Section 88(2)]. On that basis, it will then depend on the individual circumstances.

Influenza vaccination I am a registered nurse who recently started in a public hospital. I am a bit concerned about the requirement to have an influenza vaccination as I have previously had a recorded adverse medical reaction. What can I do?

It is really more about what the LHD can do to help you. Under PD2020_017 (Occupational Assessment, Screening and Vaccination Against Specified Infectious Diseases), the influenza season extends from 1 June to 30 September inclusive, unless another period is determined by the Chief Health Officer. If you have a medical contraindication to receiving the influenza vaccination and are in a Category A High-Risk position, the LHD should look at redeployment options for you during the flu season to a non-highrisk area.

Vaccinations in work time If I work in the public hospital system and I book to have my COVID shot at the vaccination centre at Olympic Park Homebush, is that counted as work time?

Only if the LHD books and sends you there for your vaccination. If you book yourself in (as opposed to having the vaccination at a location they direct you to), it will not be considered work time.

Minimum start at Christadelphian I work in a home run by Christadelphian Aged Care.

What is the minimum shift for a part timer?

Clause 19.5 of the Christadelphian Aged Care (NSW) Enterprise Agreement 2019 sets out that with the exception of mandatory training scheduled by the employer outside ordinary hours of work, a part-time employee will be engaged for (and paid) a minimum of four hours for each start.

There are some things you shouldn’t handle alone.

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

Call us on 8595 1234 (metro) or 1300 367 962 (non-metro) Email gensec@nswnma.asn.au www.nswnma.asn.au

THE LAMP JUNE/JULY 2021 | 33

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ANNUALCONFERENCE

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ICC, SYDNEY

21–23 JULY 2021

s e rou novative be Intuitiv tiv e gene c be In e A b g e n i b be Accomplished ing be Nurturin be kind be Knowbe us pir Mov geo be Ins g e a b r u A B K L IC E be RE be OP be Confdent be Co le REMAR ng TIMIST be SP rab ivati ressive be u E o t n ial CTE o be Happy be Ho rog D be spec be M be P Y be LEGENDAR roud eP be Powerful b

led Up Pos geabl st itiv e e

OUR

Moment MAKE IT HAPPEN

COUNT TOWARDS CPD HOURS

Wednesday 21 July

9am – 5.20pm ICC Sydney, Pyrmont Theatre & online 9am

Welcome to Country

9.10am

Introduction from MC

9.20am

NSW NURSES & MIDWIVES’ PROFESSIONAL DAY 1.40pm

Towards social justice and equity in health care

PROFESSOR DEBRA JACKSON

2.40pm 3.30pm

JULIE McCROSSIN

4pm

“There is a crack, a crack in everything, That’s how the light gets in”: making the most of disruption

5pm

Morning tea

COST

In conversation

SHANE FITZSIMMONS

Afternoon tea Keynote speaker

GEORGIE CARROLL

Wrap-up and close

PROFESSOR JILL WHITE

10am

Early-Bird Rate

(closing Friday 11/6)

Full Rate

(12/6 – 11/7)

10.30am Reflections on the Royal Commission into Aged Care Quality & Safety

Members

$110

$160

PROFESSOR KATHY EAGAR

Non-members

$160

$240

11.10am

Aged care staffing & skills mix report

Retired associate members and student members

$75

$100

Branch Officials

Free

Free

Online conference registration

Member $60 Non-member $90

ROB BONNER

11.40am COVID-19 & aged care: a pandemic of virtue, vicissitude & vanity PROFESSOR JOSEPH IBRAHIM

12.20pm Lunch 34 | THE LAMP JUNE/JULY 2021

(closing Monday 19/7)

KEYNOTE SPEAKERS Shane Fitzsimmons AFSM Shane Fitzsimmons was appointed as the inaugural Commissioner for Resilience NSW and Deputy Secretary, Emergency Management with the Department of Premier and Cabinet from 1 May 2020. He is the chair of the State Emergency Management Committee (SEMC), the State Recovery Committee (SRC), Board of Commissioners (BOC) and the National Emergency Medal Committee (NEMC).

This appointment followed a distinguished career with the NSW Rural Fire Service of over 35 years, serving as both a volunteer and salaried member.

Commissioner Fitzsimmons has been awarded the Rural Fire Service Long-Service Medal for more than 30 years, the National Medal in recognition of more than 35 years, and the Australian Fire Service Medal (AFSM). He has most recently been announced as the 2021 NSW Australian of the Year.

Georgie Carroll

Australia’s funniest nurse Georgie will bring the lols to the NSW Nurses and Midwives Association’s Professional Day. Author of Off the Charts and creator of the viral stand up clip 3 Stages of Nursing is happy to show you her funniest bits in this session. You won’t be learning, you will be in stitches, the good kind.

MC Julie McCrossin AM Julie is renowned across Australia for her warmth, humour, intelligence, professionalism and commitment to justice and diversity.

For over 20 years she worked with ABC Radio National, ABC TV and Network Ten before becoming a freelance journalist, podcaster and voice-over broadcaster.

Following treatment for stage four throat cancer in 2013, Julie became an Ambassador for Beyond Five, Targeting Cancer and TROG Cancer Research. In 2019, Julie was awarded a Member of the Order of Australia for significant service to the community, particularly through LGBTIQ advocacy roles and to the broadcast media.

SPEAKERS Professor Joseph Ibrahim

Head of the Health Law & Ageing Research Unit, Monash University Professor Ibrahim is the lead author of Recommendations for prevention of injury-related deaths in residential aged care services. His work has informed approaches for protecting residents from abuse and poor practices and ensuring proper clinical and medical care standards are maintained and practiced.

He was one of the Sydney Morning Herald Good Weekend’s “People Who Mattered 2019: Health”.

Professor Debra Jackson

AO, RN, PhD, SFHEA, FACN, University of Sydney Professor Jackson is a distinguished nurse scientist and scholar. Her career has spanned clinical practice, academic work, research and scholarship. In 2020 she was named as Australia’s leading nurse researcher by The Australian newspaper’s top 250 researchers.

Professor Jill White

Professor Emerita, Susan Wakel School of Nursing and Midwifery, University of Sydney and the Faculty of Health, University of Technology Professor White was the 2010-2013 inaugural Chair of the Australian Nursing and Midwifery Accreditation Council, having had an active leadership role in regulation since 2002. She is now an independent consultant in the areas of health education, regulation and policy.

Professor Kathy Eagar

Professor of Health Services Research and Director of the Australian Health Services Research Institute (AHSRI), University of Wollongong Professor Eagar led the design of the new Australian National Aged Care

Classification (AN-ACC) and funding model for residential aged care and undertook research commissioned by the Aged Care Royal Commission into the adequacy of residential aged care staffing. Based on that research, the Aged Care Royal Commission recommended mandated staffing ratios and a 5 star public reporting system for aged care.

Rob Bonner

Director Operations & Strategy, ANMF (SA) Rob established the ANMF (SA) registered training organisation, ANMEC. He has led the national research exploring aged care staffing arrangements for the ANMF (2016 report). Rob is the Deputy Chair of the national aged services industry reference committee, working to revise training and education related to the aged care sector.

Register now! nswnma.info/profday21 REGISTRATION CLOSES Sunday 11 July

PROFESSIONAL DAY IS GOING ONLINE! Registration closes Monday 19 July

THE LAMP JUNE/JULY 2021 | 35 Arrangements for Julie McCrossin’s appearance were made through Celebrity Speakers – www.celebrityspeakers.com.au

NEWS IN BRIEF

INDIA

“The situation in India is beyond heartbreaking” The World Health Organization (WHO) says India’s deadly COVID-19 second wave was caused by a “perfect storm” of mass gatherings, low vaccination rates and more contagious variants.

In mid-April in Haridwar, an Indian temple town that hosts the Kumbh Mela, a Hindu festival that is the world’s biggest religious gathering, between one and three million people came together to take a ritual dip in the Ganges.

At the same time, many Muslims were celebrating Ramadan with their friends and families. Indian Prime Minister Narendra Modi was also encouraging massive election rallies after declaring the pandemic had reached its “endgame” in March.

WHO says this “complacent behaviour”, allowing mass gatherings after a relatively successful management of the COVID first wave, had played a major role in the devastating second wave.

India has been hit by a highly infectious variant of COVID-19, the so-called “double mutation” or B1617 variant, and it also has weak health infrastructure.

WHO Director-General, Tedros Adhanom Ghebreyesus, said: “The situation in India is beyond heartbreaking.”

India’s catastrophe has had dire consequences for other poor countries. The world’s biggest producer of vaccines, the Serum Institute of India was supposed to supply doses to developing nations, especially in Africa.

But the export of doses dropped precipitously in April when it shipped 1.2 million doses abroad compared with 64 million in the previous three months.

‘ The incidence is almost vertical. This can happen in any country if we let our guard down. We are in a fragile situation.’ — Dr Maria Van Kerkhove, Technical lead, WHO Emergency Program

WORLD

Science dazzles but not enough benefit One year on, the scientific advances to combat the pandemic have been breathtaking, but the rollout to vulnerable countries is not nearly fast enough.

A year ago, the collective understanding of COVID-19 was limited; there were no rapid tests, no vaccines, and little was known about effective treatments.

April saw the first anniversary of the World Health Organization-led ACT-Accelerator – a scheme to develop and deliver the tests, treatments and vaccines the world needs to fight COVID-19.

Today, rapid diagnostic tests, repurposed treatments and vaccines exist. This scientific progress has been rapid and unprecedented in scale and levels of collaboration.

However, the scheme remains grossly underfunded.

“World leaders face a choice: invest in saving lives by treating the cause of the pandemic everywhere, now, or continue to spend trillions on the consequences with no end in sight,” said WHO DirectorGeneral Dr Tedros Adhanom Ghebreyesus.

The explosion of COVID in India has highlighted the weak spot in efforts to control the pandemic – the vulnerability of low- and middle-income countries – which puts the whole world at risk.

“COVID-19 knows no borders,” said WHO Special Envoy, Carl Bildt.

“A new variant from anywhere could unravel progress everywhere, even in a country that has achieved 100 per cent vaccination. The pandemic is still on the rise.

“Only a reinforced global effort to deliver tests, treatments and vaccines to all people everywhere, based on need rather than ability to pay, will bring an end to this pandemic.”

‘ A new variant from anywhere could unravel progress everywhere.’

— Carl Bildt, WHO Special Envoy 36 | THE LAMP JUNE/JULY 2021

NEWS IN BRIEF

UNITED STATES

Biden puts $400 billion into home-based care The US President’s $2 trillion stimulus package for US jobs and infrastructure includes $400 billion over eight years for home-based, long-term healthcare services.

Economic commentators point out that Biden deliberately included the investment in care as part of the economic agenda, arguing that it would create better, higher-paying jobs and unleash untapped potential for growth.

“This is an absolutely critical piece of the package. We think of it as core to our nation’s infrastructure,” said Heather Boushey, a member of the White House Council of Economic Advisers.

If implemented in full, it would represent the single largest investment in home- and community-based services for disabled and older people in American history.

The plan, however, is expected to face fierce opposition from the Republican Party.

The plan outlines how caregivers would receive “a long-overdue raise, stronger benefits and an opportunity to organise or join a union”.

The inclusion of the home-care funding – close to twice current expenditures – came after intense lobbying by the SEIU, the union that represents more than one million caretakers.

‘ Caregivers would receive a long-overdue raise, stronger benefits and an opportunity to organise or join a union.’

CROSSWORD SOLUTION

According to the SEIU, the median salary for a homecare worker is approximately $17,200 a year. More than half of home-care workers are on some form of public assistance such as food stamps. They are overwhelmingly female and far more likely to be people of colour than the general population.

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

Call the NSWNMA on 1300 367 962

and find out how you can access this great service

Offices in Sydney and Newcastle with visiting offices in regional areas (by appointment) THE LAMP JUNE/JULY 2021 | 37

NEWS IN BRIEF

UNITED KINGDOM

British nurse fined £10,000 for 1 per cent pay protest Sixty-one-year-old nurse Karen Reissmann is hammered with a £10,000 fine, despite taking all precautions to ensure her protest was COVID-safe.

Karen and 40 colleagues were protesting in St Peter’s Square, Manchester, against the government’s one per cent pay rise for NHS workers.

AUSTRALIA

Aged care vaccine rollout “an absolute debacle” By the end of April, barely 10 per cent of Australia’s 330,000 aged care workers had been vaccinated, though they are classified in the 1a group for the highest priority frontline staff.

Fewer than one-third of aged care facilities had administered both doses of the COVID19 vaccine to their residents eight weeks into the program, as logistics companies fail to deliver the vaccines, health providers fail to show up and the vast majority of workers have no clear access to vaccinations, the Sydney Morning Herald (SMH) reported.

One major aged care provider told the SMH that the rollout was “an absolute debacle”.

Aged care providers told the SMH that their workers did not have access to the NSW Health-operated hubs that vaccinate the highest priority groups, such as frontline medical workers and hotel quarantine staff, because aged care falls under the federal government.

NSW Health confirmed this.

The Morrison government said its initial strategy of inoculating staff at their workplace was “under review”.

The federal government had planned to send dedicated teams to aged care facilities to vaccinate staff and to establish offsite “pop-up” vaccination hubs.

The ACTU said the government walked away from these commitments.

“These workers were told they would be treated with the same urgency and attention as other frontline health staff, but many will end up waiting six months to be vaccinated,” said ACTU Assistant Secretary Liam O’Brien.

‘ Aged care workers did not have access to the NSW Health-operated hubs because aged care falls under the federal government. ’ 38 | THE LAMP JUNE/JULY 2021

She has worked as a frontline nurse throughout the pandemic, and was handed the fine in March despite offering a risk assessment of her protest to Greater Manchester Police (GMP) and ensuring it was COVID-safe. She had limited the number of protesters to guarantee social distancing.

GMP assistant chief constable, Nick Bailey, said the force’s lawyers had reviewed the £10,000 (A$18,000) fine and were “satisfied that the issue was proportionate, legal, accountable and necessary in the circumstances”.

Karen, who has been a nurse for 39 years, told The Guardian: “Somebody calculated that if I used my one per cent pay rise, it would take me 56 years to pay off the fine.”

Karen said she believed the force’s desire to prosecute was meant to intimidate other nurses from organising protests.

“It’s so punitive; clearly designed to stop others. I know people who stepped back from protesting because they were afraid of the £10,000 fine,” she said.

‘It’s so punitive, clearly designed to stop others.’

NEWS IN BRIEF

AUSTRALIA

Climate change to drive a third of doctors out of the Northern Territory New research published in The Lancet Planetary Health found 34 per cent of doctors have already or are likely to consider leaving the NT because of climate change.

The authors, from the Australian National University, say: “This would leave a large gap in the territory’s healthcare system, which already suffers from a fast turnover of staff. These doctors would leave behind communities already suffering from the effects of climate change.”

Twenty-five per cent of doctors working in the NT responded to the survey.

The study showed NT doctors believe climate change is a serious public health issue. A total of 85 per cent indicated climate change has already or is likely to negatively impact their patients’ health; 74 per cent believed climate change is already causing or is likely to cause parts of the NT to become uninhabitable. And for 34 per cent, climate change has already, or is likely to, make them consider leaving the NT. The two summers of 2018–20 were the hottest ever recorded in the NT. From December 2019 to January 2020, temperatures were about 4°C above the long-term average. In late 2019, it was so hot, remote kidney dialysis centres struggled to say cool enough for their life-saving dialysis machines.

Some of the hottest conditions in 2019 were in the Katherine region, which shattered previous records. In 2019 there were 54 days of 40°C or above in Katherine.

‘ This would leave a large gap in the territory’s healthcare system.’

COLUMBIA

ACTU condemns Colombian government violence The Colombian government has responded with brutal repression to widespread civil unrest that started with a national strike organised by the Colombian union movement.

As The Lamp went to press, police and military units had killed more than 40 protestors.

According to reports from human rights organisations, by 10 May there had been more than 1089 cases of violence, 726 arbitrary detentions, 234 wounded, five demonstrators had disappeared and six women raped

by ESMAD soldiers (Escuadrón Móvil Antidisturbios – the Mobile AntiDisturbances Squadron).

Working people, led by an alliance of trade unions and social groups, have taken to the streets daily since the national strike on 28 April to oppose a tax reform bill, which would have increased inequality by disproportionately impacting workers and the poor, who were already struggling with the economic impacts of COVID-19.

More than 80,000 people have died from COVID in Colombia.

In a letter to the Colombian President, Ivan Duque, the ACTU said: “The Australian union movement stands in solidarity with the workers in Colombia who have taken the brave decision to continue with peaceful demonstrations in line with the decisions of the Comité Nacional del Paro (National Strike Committee).

“Colombia is already the most dangerous place in the world to be a trade unionist, with more than 3000 trade unionists murdered since 1989. Most of these crimes remain unresolved, as your government has failed to address the culture of impunity.”

‘ Colombia is already the most dangerous place in the world to be a trade unionist, with more than 3000 trade unionists murdered since 1989.’ — ACTU THE LAMP JUNE/JULY 2021 | 39

NEW MEMBER BENEFIT

Access to online Professional Education ers!

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

FEATURING Access to over 20 hours of FREE CPD* 61 topics including those modules that are deemed mandatory annual competencies by large health organisations and nursing agencies* Free professional development portfolio to provide evidence to the Nursing and Midwifery Board of Australia (NMBA) of participation in CPD annually Access free webinars on a range of topics

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

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

bit.ly/NSWNMAMemberCentral * Nurses and midwives have various obligations in relation to CPD, which you can read more about on the NMBA website or here. The NMBA outlines that CPD must be relevant to your context of practice, and recommends nurses and midwives complete a range of CPD activities, e.g. – face-to-face, simulation, interactive e-learning, self-directed learning. The ANMF Education is developed for nurses and midwives working across Australia. For nurses and midwives practicing in NSW, it is important to ensure you follow relevant governance and legislative requirements.

40 | THE LAMP JUNE/JULY 2021

NURSING RESEARCH AND PROFESSIONAL ISSUES Telehealth has been ubiquitous during the pandemic. It promises so much, but it is not a panacea. When the NSWNMA consulted members from rural and regional NSW for the current Upper House inquiry, we heard how telehealth offers a mixed bag of costs and benefits for people who rely on it to access and deliver healthcare.

Opportunities and challenges for telehealth within, and beyond, a pandemic

Video and phone consultations only scratch the surface of what telehealth has to offer

Blandford, Wesson, Amalberti, AlHazme, Allwihan

Snoswell, Smith, Thomas, Haydon, Caffery

The Lancet, Global Health: August 2020

The Conversation: October 2020

The COVID-19 pandemic is unlike any previous pandemic. The ubiquity of international travel, the ease of transmission of the virus and symptom variability have resulted in an unprecedented rate of spread. The need for physical distancing has also led to the rapid adoption of telehealth solutions globally.

Telehealth is the provision and management of health care in which individuals (often working with family members) manage aspects of their care with remote support from healthcare professionals. Care is most commonly digitally mediated, but is also supported by direct communications. Individuals might be based in their homes or care facilities. The digital capture and selective sharing of data facilitates surveillance at regional, national and international levels. Telehealth also facilitates epidemiological research, which informs future healthcare delivery.

Telehealth has direct and indirect roles in reducing the spread of infections by enabling physical distancing, tracking symptoms and outbreaks, and supporting policy makers in anticipating needs, and deciding appropriate and timely interventions.

The pressures to adopt telehealth solutions to support self-management have been growing, largely because of the increasing number of patients with chronic diseases surviving to old age, thanks to the pace of medical innovation. https://www.thelancet.com/ journals/langlo/article/PIIS2214109X(20)30362-4/fulltext

The COVID-19 pandemic has resulted in rapid changes to the way Australians access health care.

We’re now using telehealth more than ever.

The federal budget confirmed a six-month extension of Medicare subsidies for telehealth consultations, worth A$2.4 billion.

It also included A$18.6 million for the preparation of permanent telehealth infrastructure beyond 31 March next year.

This goes some way to recognising telehealth is not only an important tool in our pandemic response – it’s much needed in our health system.

To fully realise the potential of telehealth, we need to recognise it’s more than just appointments via phone or videoconference. https://theconversation.com/ video-and-phone-consultationsonly-scratch-the-surface-of-whattelehealth-has-to-offer-146580

Navigating telehealth: the patients' perspective Hallam, Joyner, Nance Health Consumers NSW: April 2021 The rapid uptake of telehealth in Australia during the pandemic has been life-changing for many patients. There has been less pain, anxiety and exhaustion from joining a consultation from the comfort of home.

Being spared the time and cost of travelling to an appointment – often sitting for long periods in a waiting room – has reduced the impact on work and income. And importantly, people who would have delayed or avoided seeking medical treatment due to the obstacles they faced, have gained much-needed care.

This is just some of the positive feedback collated by Health

Consumers NSW (HCNSW) into telehealth changes since COVID-19.

This report highlights how critically important the consumer voice is in the design and implementation of the telehealth system moving forward. www.hcnsw.org.au/navigatingtelehealth/

Telehealth Palliative Care Needs Rounds During a Pandemic Samara, Liu, Kroon, Harvie, Hingeley, Johnston The Journal for Nurse Practitioners: Jan 2021 Older people living in care homes deserve access to specialist palliative care in their last months of life. They often live with high levels of disability due to multimorbid conditions and frailty, and care needs are high. End-of-life care in care homes needs urgent improvement and is one focus of the Royal Commission into Aged Care Quality and Safety in Australia.

Palliative Care Needs Rounds (Needs Rounds) were rigorously tested in the Australian Capital Territory (ACT) in a pilot study.

The Needs Rounds model has three components: Needs Rounds meetings, multidisciplinary case conferences, and clinical work.

Participation in the ACT study saved an equivalent of A$1,700,000 per year in reduced hospitalisation.

Needs Rounds identify risk factors for end of life and increase anticipatory planning, including advance care planning (ACP).

Needs Rounds facilitated by nurse practitioners (NPs) have been proven to reduce avoidable transfers to the hospital – with associated cost savings – improve the quality of death and dying of older people in care homes, normalise dying, improve planning for end of life, increase staff capacity to care for residents at end of life, and increase the likelihood of dying in the preferred place of death. https://www.npjournal.org/article/ S1555-4155(20)30651-6/fulltext THE LAMP JUNE/JULY 2021 | 41

The Edith Cavell Trust is now able to receive non-tax deductable donations/bequests.

The Trust – named in honour of Edith Cavell – assists in the advancement of NSW nurses, midwives and assistants in nursing/midwifery through further studies and research, made available through scholarship. The knowledge and expertise gained by nurses, midwives and assistants in nursing/ midwifery, supported by the Edith Cavell Scholarships, is an asset to the care of their patients and clients. Bequests to the Trust continue to support this important work.

Edith, a British nurse serving in Belgium in WW1, is a hero to most nurses and midwives. She helped some 200 Allied soldiers escape from German-occupied Belgium. Her actions saw her arrested, accused of treason, found guilty by a court-martial and sentenced to death. Despite international pressure for mercy, she was shot by a German firing squad.

NAME ADDRESS

EMAIL

Cavell Edith

TRUST BEQUESTS

PHONE

BEQUEST/ DONATION AMOUNT

$

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

Visa

$

Name on Card

Card no

Expiry Date

/

Signature of Cardholder

Scholarship

Activism • Campaign • Advocacy Roz Norman was an outstanding activist, branch official and Councillor of the NSWNMA and ANMF. In honour of her outstanding contributions, the Roz Norman Scholarship was created to further humanitarian, social or community causes.

The scholarship covers fees for an approved course promoting activism and the development of campaigning skills or public advocacy, including ongoing financial support for reasonable costs associated with campaigning for a period of one year, up to a maximum of $5,000.

NSWNMA Branch Officials or highly active members who can demonstrate leadership qualities are encouraged to apply.

Successful recipients are required to report back to Committee of Delegates (COD) at the end of the scholarship period.

Applications open 1 July, closing 30 September 2021

To apply go to bit.ly/RozNormanScholarship 42 | THE LAMP JUNE/JULY 2021

further enquiries: email gensec@nswnma.asn.au METRO: (02) 8595 1234 • RURAL: 1300 367 962

CROSSWORD

test your

Knowledge 1

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4

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10

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14 15

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ACROSS 1. Chronic excretion of very large amounts of urine, causing dehydration and extreme thirst (8.9) 10. Relating to the nose and forehead, or to the nasal cavity and frontal sinuses (11) 13. A baglike organ or structure (3) 14. Perform again (7) 15. The process of becoming light or less dense (11) 18. Burned residue (3) 19. Epidemic neuromyasthenia: ... disease (7) 20. Observer (7) 21. A strongly addictive narcotic drug (5) 22. Change (5)

23. A filovirus that causes disease in humans and nonhuman primates (5) 24. Relating to eye or vision (5) 26. Not firm or solid; weak or flimsy (13) 29. A notice of someone's death (4) 30. A curved line or segment of a circle (3) 32. A benign wart (9) 34. Developing in a stealthy or gradual manner (9) 36. Inactivity; inability to move spontaneously (7) 37. A drug that shrinks the swollen membranes in the nose, making it easier to breathe (5.12)

DOWN 1. A type of fertility procedure (5.12) 2. Processes which ultrathin layers of one substance forms on the surface of another substances (11) 3. Extracellular fluid (1.1.1) 4. Self (3) 5. Essential (9) 6. ` Selenosis (8.9) 7. A drug widely used to relieve pain and reduce fever (11) 8. Deflect (8) 9. A cataract occurring in the retained lens or capsule after a cataract extraction (9.8) 11 Ribonuclease (5) 12. Acoustoelectrical Oscillator (1.1.1) 16. Sheet of fibrous tissue that envelops body beneath the skin (5) 17. A pigment-containing cell (13) 25. Pill (6) 27. Having two feet (7) 28. Nothing (3) 31. Sacs or vesicles in the body (5) 33. Spaces (5) 35. Small bowel obstruction (1.1.1)

THE LAMP JUNE/JULY 2021 | 43

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 44 |

IMPORTANT NOTE From 1 December 2018 the insurance benefits have changed as follows: • Journey Accident Insurance: the waiting period for benefits is now 14 days • Professional Indemnity Insurance: the limit per claim is now $5 million THE LAMP JUNE/JULY 2021

REVIEWS

book club

Stories full of infectious, hospital-grade humour and loads of heart, from Australia’s favourite nurse.

Showering in gumboots. Bomb threats.

Tables of turds. Welcome to the life of a nurse.

This is a laugh-out-loud funny celebration of the big-hearted nurses who, sooner or later, play a huge role in all our lives.

Dear Mum

Edited by Samuel Johnson OAM Hachette Australia: RRP: $22.99 ISBN 9780733645938

From the team who gave you the bestselling Heroes Next Door comes an honest, moving, emotionally memorable collection of letters written by some of Australia’s most notable notables to their mothers.

If you could tell your mum anything, what would it be?

A wholehearted, warm and emotional assembly of letters celebrating motherhood.

Remember

T ES

CI

AL

R

S PE

Georgie Carroll MacMillan Australia RRP $34.99: ISBN 9781760982447

INTE IAL

ST RE

Off the Charts

SPE C

All books can be ordered through the publisher or your local bookshop. Call 8595 1234 or 1300 367 962, or email library@nswnma.asn.au for assistance with loans or research.

Books are not independently reviewed or reviewed using information supplied by the publishers.

IN T E

We have four copies of Off the Charts to give away thanks to Pan Macmillan Australia.

Email your name and membership number to lamp@nswnma.asn.au by 31 July to be in the draw to win.

Burnout – A Guide to Identifying Burnout and Pathways to Recovery

Gordon Parker, Gabriela Tavella and Kerrie Eyers Lisa Genova Simon & Schuster RRP $32.99: ISBN 9781761101205

A fascinating exploration of the intricacies of how we remember, why we forget, and what we can do to protect our memories, from the Harvard-trained neuroscientist and bestselling author of Still Alice.

Allen & Unwin RRP $32.99: ISBN 9781760878061

The first complete guide to Burnout, based on groundbreaking new research. It shows how you can tell whether you really have burnout, and helps you shape a strategy for recovery that will work for you.

Are you always exhausted?

Unable to feel for others or enjoy life’s pleasures? Find it hard to concentrate and take in what you read? You may have burnout.

THE LAMP JUNE/JULY 2021 | 45

YOUR HEALTH

fitness+wellbeing Karl from Vitruvian Health has created a 5-minute, 5-exercise workout that can be done anywhere, with no equipment needed.

This circuit consists of four workout exercises, including their variations, and the fifth exercise is for recovery. Your recovery depends on how long you can do the last exercise.

Therefore, this circuit can take a little longer or shorter – but based on our experience, the average is five minutes. This means that completing three sets will take 15 minutes and get your legs, abdominals and back working, contributing to postural improvements.

1. Squat • Start with your feet slightly more than hip-width apart • Turn your toes out by 15 degrees • Put your arms straight out in front of you • Squat down while pushing your knees out • Stand back up If you experience any restrictions while squatting, elevating your heels might help as it will allow you to go deeper.

If you find this too easy, increase time of a tension at the bottom of the movement by performing a quarter pulse: • Go all the way down • Rise up one quarter • Hold • Squat back down • Stand all the way up Aim to perform 20 reps or hold the squat for 60 seconds before moving to the second exercise.

2. Lunges • Step back with your left leg • Bend your knees and deepen the lunge • Focus on staying straight by engaging your core • Stand back up • Bring left leg forward in line with right leg • Repeat on the other side

46 | THE LAMP JUNE/JULY 2021

We start with the reverse option – lunging back and going straight up – providing a little more control.

As with the squat, a modification of this exercise is to pulse at the bottom.

On the other hand, if you find lunging too challenging, simply step back, slightly bend the knee and step back. You can modify the range and difficulty of each exercise, so you feel comfortable and safe performing them and aim for small improvements every time.

5. Side Hover Hold

3. Plank Moving to the ground, we have several variations here. The base movement is holding the plank, keeping your abdominals engaged.

• Lie down on your stomach • Place your palms on the floor aligned with shoulders • Extend your feet so your legs are straight • Ground your toes into the floor • The closer together your feet are, the more challenging the plank • Push up your hips

• Make sure your back is straight If you find this too easy, a modification would be to reach up with alternating hands, which will also work your upper back and shoulders, helping your posture.

If this is too challenging, you can come onto your knees and see how it feels, or place your hands on a table for elevation.

Aim to perform 10 reps (each side) before moving to the last workout exercise.

4. Aeroplanes • Lie on your stomach • Stretch out arms in a T-shape • With your left arm, reach as high as you can while looking at the rising hand, to help you work the upper back • Repeat on the other side Modified, easier option is to bend elbows and perform the same movement.

For beginners: • Lie down on one side • Rest on your elbow, directly underneath your shoulder • Bend your top leg and put it in front of the bottom leg to provide additional support • Lift your hips Alternatively, a progression from this stage is to straighten your bent leg and place it on top of the bottom leg.

A more advanced variation of this exercise is to lift your top leg and arm.

Stay as long as you can on one side (we recommend you start on your weaker side).

Once you can’t hold the position anymore, turn to the other side and repeat for the same amount of time. Remember, this is your recovery time so the longer you can hold it, the longer your ‘break’ is.

Afterwards, you can start again with the squats.

Ideally, complete four to five sets.

Scan the QR Code below to watch the whole circuit on YouTube!

If you find this too easy, lift your chest off the ground and twist from side to side, following the raising arm while not letting the arm close to the floor to drop.

After completing these four workout exercises, it’s time for your recovery exercise.

5-minutes, 5-exercises THE LAMP JUNE/JULY 2021 | 47

Winter

ESSENTIALS Keep warm in NSWNMA favourites which are not only stylish and comfortable, but also affordable and sold at cost to members.

Red or Navy Hoodies $50.

Active Soft Shell Navy Jacket $55.

Poly/spandex, micro polar fleece lining, breathable fabric.

80% cotton/20% poly brushed fleece, kangaroo pocket with full lining hood.

Snowy Puffer Jacket $55.

380T nylon outer, poly fill padding.

Two zippered pockets and elasticated cuffs.

ORDER VIA

MEMBER CENTRAL

LOGIN @ WWW.NSWNMA.ASN.AU

$10 postage for orders under $60

48 | THE LAMP JUNE/JULY 2021

Spend $60 and over to receive

FREE POSTAGE

NOTICE

NSWNMA FEE WAIVER for members on parental leave DID YOU KNOW,

if you’re going on parental leave, paid or unpaid, we’ll waive your Association fees until you return to work?

You’ll still be entitled to access advice and receive The Lamp.

Contact the Association and let us know when you plan to take parental leave so we can set up your waiver.

PHONE 8595 1234 • 1300 367 962 EMAIL gensec@nswnma.asn.au

www.nswnma.asn.au

Authorised by B.Holmes, GeneralTHE Secretary, NSWNMA LAMP JUNE/JULY 2021 | 49

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

holiday in

Vanuatu Valued at over $5,000

1/

The 2020 – 2021 NSWNMA Member Recruitment scheme prize Tamanu on the Beach Resort & Spa is a peaceful, private and secluded boutique resort located on its own private white-sand beach, just 20-minutes from Port Vila. Voted as Vanuatu’s luxury resort of the year, you will enjoy luxurious, ocean-facing villas and some of the best cuisine on the island. You and a friend will experience the following: 3/

• 7 nights’ accommodation in a beach-view villa at Tamanu on the Beach • Welcome fruit cocktail or chilled coconut on arrival • Daily a la carte breakfast for two adults • Free daily shuttle to Port Vila • Free in-house movies • Complimentary use of the resorts island facilities • Complimentary Wi-Fi.

4/

The NSWNMA will arrange return flights for two to Vanuatu Every member you sign up over the year gives you an entry in the draw!

21

Prize drawn 1 July 20 50 | THE LAMP JUNE/JULY 2021

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

Conditions apply. Prize must be redeemed by 30 June 2022 and 5/is subject to room availability. Block out dates include 1 July - 30 September 2021 and 1 December 2021 - 31 January 2022. The prize will be drawn on 1 July 2021. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/20/05518.

UPDATE YOUR DETAILS

and Win Have you recently moved house or changed jobs?

Changed your email or classification?

Log on to online.nswnma.asn.au Update your details and go into the draw to win: • Two nights’ accommodation in a superior room at PARKROYAL Darling Harbour* • Breakfast for two at Barkers Restaurant • Dinner for two at ABODE Bistro. Bar • Valet Parking for 1 car

Dive in and discover Sydney! Situated on the city side of Darling Harbour, our hotel features 340 stylish rooms and suites with superior king-sized beds, widescreen TV, and in-room amenities. Dine in our award winning ABODE Bistro. Bar, relax in our Club Lounge, or explore iconic attractions on our doorstep. PARKROYAL Darling Harbour, Sydney – your harbour side sanctuary.

Everyone who uses our online portal from 1 April 2021 – 30 March 2022 to update their details will automatically be entered in the draw to win. *Conditions apply. Prize must be redeemed by 30 March 2023 and is subject to room availability. he winner must be a financial member of the NSWNMA. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/20/05518.

Search “Ausmed” in the app store.

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