Lamp March 2019

COVER STORY

ELECTION ISSUES

DISABILITY SERVICES

REGULARS

Only mandated ratios will guarantee safe staffing

Labor promises shift-by-shift ratios starting 1 July

Coalition turns its back on the severely disabled

page 10

page 18

page 28

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

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 76 NO. 2 MARCH 2019

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

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

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

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

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A clear pathway to ratios Labor has unveiled a plan for the March 23 state election that gives nurses and midwives their best chance to win minimum nurse-to-patient ratios, guaranteed in law.

COVER STORY

Only mandated ratios will guarantee safe staffing

The Liberal National Coalition has promised 5000 extra nurses and midwives but without mandated ratios how will we know where they will end up?

18

ELECTION ISSUES: RATIOS

Labor promises shift-by-shift ratios

starting 1 July The Liberal-National Coalition government refuses to improve the safety and care of patients with guaranteed ratios.

20 22

ELECTION ISSUES: WAGES Our wages system is broken

Under the NSW Liberal–National government’s pay cap, nurses and midwives’ wages struggle to keep pace with living costs.

REGULARS

5 6 6 32 36 37 39 41 43 45 47 48 50

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

ELECTION ISSUES: WORKERS’ COMP Australia’s meanest workers’ comp scheme

People who get injured at work deserve a compensation scheme they can count on.

But the Liberal–National government has given NSW the meanest workers’ compensation scheme in the country.ios

24

ELECTION ISSUES: RNs IN AGED CARE NSW government: nursing homes

26 28

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Audit Period: 01/04/2017 - 31/03/2018

COVER STORY

don’t need RNs In aged care policy, the NSW Liberal–National government has turned its back on professional advice and public opinion. ios tios

ELECTION ISSUES: PRIVATISATION Hospitals – put people before profit

The Liberal–National Coalition and Labor approach the 23 March election with public hospital policies as different as night and day.

NATIONAL DISABILITY SERVICES Coalition turns its back on the

severely disabled MPs from all parties want state agencies to keep providing specialist disability services – but the Berejiklian government isn’t interested.

OUR COVER: Erin Francis Photographed by Sharon Hickey THE LAMP MARCH 2019 | 3

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4 | THE LAMP MARCH 2019

PROFESSIONAL EDUCATION 2019

EDITORIAL

Brett

Holmes GENERAL SECRETARY

Shift-by-shift ratios are within our grasp This state election is crucial if we want to win shift-by-shift, nurse-to-patient ratios across the entire public health system.

As The Lamp goes to print the NSW Labor leader Michael Daley has announced that if he is elected to government on 23 March he will move immediately to introduce shift-by-shift nurse to patient ratios throughout the NSW public health system.

Labor’s plan is comprehensive and incorporates the vast majority of claims we have been campaigning for over the last decade and more.

The strength of Labor’s plan is in the detail.

Labor has promised to staff our medical, surgical and paediatrics wards, our emergency departments and our postnatal maternity units using the ratios model.

This will require funding of an extra 5500 nurses and midwives over the next four years.

Labor had already agreed to extend 1:3 ratios into paediatrics and emergency departments and to bring regional staffing levels up to city levels. In themselves these were major improvements that would make an enormous difference to improving the system.

But now they have gone much further.

They have promised to introduce 1:3 ratios in maternity wards, provide additional staff for specials in medical and surgical wards and make improvements in community health and community mental health. When there are uneven numbers in the calculation of ratios, the number of nurses rostered will be rounded up.

Labor’s plan should be music to the ears of all public health system nurses and midwives in this state. It is what we have campaigned so hard for, on behalf of our patients and our professions, for so long.

Michael Daley was gracious enough to say to an audience of Tweed health service members at the launch of his policy that: “I want to say to nurses and midwives – this is your win, this is your campaign.”

Labor’s plan should be music to the ears of all nurses and midwives in this state.

It is what we have campaigned so hard for, on behalf of our patients and our professions, for so long.

NUMBERS ARE TRANSIENT, RATIOS ARE PERMANENT On the cusp of the NSW state election the Liberal-National Coalition has belatedly changed its position on nursing and midwifery numbers.

They have promised to fund 5000 extra nurses and midwives over the next four years and we acknowledge that.

But, as welcome as the Government’s announcement is, it doesn’t go nearly far enough.

Nurses and midwives know from hard experience that management are manipulating the numbers to circumvent the provision of enough nurses to deliver safe care. We have seen that in hospital after hospital, across the state, over many years. We have seen patients missing out on thousands and thousands of hours of care they were entitled to.

That is why we stand by shift-byshift ratios as the policy solution that will guarantee safe nurse to patient numbers. Labor now agrees.

Both Labor and the Liberal-National Coalition have come to this election with vastly improved policies about public health that have more nurses and midwives at their core.

That owes everything to the fantastic activism of nurses and midwives the length and breadth of the state over a long period of time as we have taken our knowledge and analysis of what is happening at the frontline to the NSW public.

Our campaign has established the undeniable fact that nurse-to-patient ratios saves lives and put it at the heart of health policy.

WAGES, WORKERS COMP, AGED CARE AND PRIVATISATION ARE IMPORTANT TOO There are other issues in this election that are important to us as clinicians and union members.

The wage freeze on public sector workers including nurses and midwives – now in place for eight years – has to end.

The workers’ compensation system that was so ruthlessly dismantled by this government when it first came to office has to be rebuilt so injured workers are given the support and afforded the respect they deserve.

NSW must have a requirement for nursing homes to have an RN on duty around the clock.

And last, but not least, we are totally opposed to the privatisation of our public health services.

For all of those members in aged care, private hospitals and elsewhere it is worth considering that improvements to our public health system are a personal benefit to everyone who may need care. Importantly, standards set in public health help win the argument for the same conditions elsewhere.

When it comes to voting on March 23 I would urge you to give a high priority to all these issues and how the respective party policies will impact on your jobs and the care we can deliver to our patients.

In particular I would urge you to consider what it would mean to finally have shift-by-shift ratios implemented in our public health system across our state.

THE LAMP MARCH 2019 | 5

COMPETITION

YOUR LETTERS

Have your

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LETTER OF THE MONTH

With courage, we’ll win

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The Lamp is offering NSWNMA members the chance to win two night’s accommodation in an Executive King Room with breakfast daily and complimentary parking. Package valued at over $700. To enter the competition, simply provide your name, address and membership number and email your entry with the subject: Rydges Sydney Central to lamp@nswnma.asn.au *Conditions apply. Rooms subject to availability. Prize must be redeemed by 30 June 2019 (not valid during long weekends). The voucher is non exchangeable, non transferable and not redeemable for cash. Voucher must be presented on arrival. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 March 2019 and closes 31 March 2019. The prize is drawn on 1 April 2019. If a redraw is required for an unclaimed 6 it| must THEbeLAMP 2019from the original draw date. NSW Permit no: LTPM/18/0295 prize held upMARCH to 3 months

The professional is political, like it or not.

I feel compelled to write after following and contributing to NSWNMA activist discussions online for the past few months. We’re down to the wire now. And no, I don’t believe I am a dramatist or a conspiracy theorist – merely a pragmatic realist.

If we want safe staffing levels in NSW health care we have one shot; the NSW State election on 23 March 2019. It’s time to understand that your vote as an NSWNMA member really will count. I have been a union activist for over 40 years and have also been a part of the many wins the NSWNMA has secured for nurses and midwives in NSW. This has meant being politically astute.

Nurses and midwives across NSW use the best available evidence every day to inform their practice and advocate for communities in their care. This is no different. The evidence is clear. This by far is the best advocacy you will ever provide.

Now, more than ever, we all stand on a precipice. You can either have the courage to leap into the political arena and vote for the only party that has guaranteed at least part of what we need to achieve the staffing levels we need to keep our patients safe AND has a chance of winning, and therefore being able to legislate for Ratios.

Or ... you can step back, thinking that you’ll stick with the political party you’ve always supported even though it does not support the NSWNMA Ratios campaign. If you do that, you are politically naive. Every vote will count and every member needs to step up and become an activist for the change our communities so desperately need.

Life shrinks or expands according to one’s courage. The choice is yours.

Elizabeth McCall

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

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.

Voting for ratios may mean voting outside our comfort zone

Funding health properly a higher priority than hampers

I am a registered nurse working in an acute inpatient mental health ward in a metropolitan hospital. I work with some of the most vulnerable people in our community, suffering from a variety of mental illnesses and mental distress. An acute inpatient mental health ward can sometimes be a scary and confronting place, for both nurses and consumers.

On 1 January, the commencement of handing out the baby hampers funded by the NSW Coalition government occurred. On the outside looking in, it could be considered a great idea. But the reality paints a different picture.

A new policy on observation and engagement was rolled out last year across mental health units, making it virtually impossible to have any kind of therapeutic relationship with any of our consumers when looking after people on higher observation needs.

With our current ratios we just don’t have time, making it both unsafe for patients and staff.

Violence is a hot topic at the moment, with huge statistics coming from mental health. Acute mental health nurses face violence and aggression on a daily basis, many of us being assaulted numerous times throughout our careers. On our NHPPD ward, the sub-acute ward, staff are robbed every shift to cover other units because there are always huge numbers of unfilled nursing vacancies.

With mandated nurse-to-patient ratios in mental health we can start to ensure both patient and staff safety.

Members need to vote for ratios at this coming state election in March.

That may mean that they need to vote differently than they would normally feel comfortable doing.

I’m a new grad midwife and nurse.

I was born and raised in NSW however, I did my university training in Queensland. Throughout the entire time that I was at university, I was told about how superior the NSW health system was to the Queensland health system. “If I were you I’d study in NSW” was the usual rhetoric. When I finished university, my husband’s work brought our family back to NSW. To say I’m shocked was an understatement. I’ve seen first-hand the mess that has been the public– private consortium of Northern Beaches Hospital – the stress that it has caused my colleagues is unbelievable. Additionally, we have hospitals in this state that are vastly underfunded: we have no statewide clinical guidelines for neonatal and maternal health in place (oddly they can vary greatly from hospital to hospital, and LHD to LHD – something very new for me); we have maternity wards that go without IV pumps; and we have a critical

shortage of midwives. It’s only by the grace of incredible midwives that we still manage to give supportive care to women and their infants.

Our Victorian and Queensland counterparts are currently fighting for infants to be included in nurseto-patient ratios. Here in NSW, we are still fighting for mandated ratios across multiple sectors. We all know that nurse-to-patient ratios save lives – the evidence to support ratios is overwhelming. Yet, we hear silence from the NSW Coalition Government. Their silence on the subject speaks volumes.

I know some readers are probably thinking why doesn’t she just go back to Queensland? However, shouldn’t the question be, why won’t our state government fund real and meaningful change in the NSW health system? Flashy hospitals leased out to the private sector doesn’t cut it. Neither do baby hampers that take up precious and sparse space in hospitals.

The women in NSW deserve the best maternity care. They deserve options.

They deserve a health system where evidence-based practice is supported by overarching clinical guidelines.

We midwives, at minimum, deserve that too.

But I suppose none of it matters as long as the premier – and the Liberals and Nationals – get those hampers out to buy those votes within a few months.

Terrin Illingworth

Erin Francis

Letter of the month

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THE LAMP MARCH 2019 | 7

NURSES AND MIDWIVES VOTE MARCH 2019

A clear pathway to ratios Labor has unveiled a plan for the March 23 state election that gives nurses and midwives their best chance to win minimum nurse-to-patient ratios, guaranteed in law.

M

ost medical and surgical wards, emergency departments, paediatric wards, post natal wards and maternity units will get minimum nurse-to-patient ratios on every shift under a NSW Labor government.

Labor leader Michael Daley has promised that if elected, Labor would hire more than 5500 nurses over the next four years to deliver its plan.

Daley said ratios would give nurses and midwives more time to care for patients, reduce stress on nursing staff, reduce the risk of errors and lead to higher staff retention rates.

“I want to say to nurses and midwives – this is your win, this is your campaign,” he said.

He said Labor would staff regional and district hospitals the same as big city hospitals.

He said ratios would become law in the new Nurses and Midwives Award which starts in July 2019.

Starting dates for ratios in every ward and unit would be agreed between the Ministry of Health and NSW Nurses and Midwives’ Association.

A timetable to implement the ratios will be included in the 2019 award – with the first phase of ratios in medical and surgical wards to commence in March 2020.

8 | THE LAMP STATE ELECTION 2019

‘ Specials’ staffing will be funded in addition to ratios but will start earlier – from July 1 this year.

AN HISTORIC ANNOUNCEMENT NSWNMA General Secretary Brett Holmes described Labor’s announcement as historic.

“This is the first time a major NSW political party has supported ongoing calls from nurses and midwives to guarantee ratios on every shift,” Brett said.

“L a b or ’s c om m it ment to introduce mandated, minimum nurse-to-patient ratios will provide a clear and accountable system that patients can rely on and nurses can trust at all times.”

Labor governments have already introduced ratios in Victoria (2000) and Queensland (2016).

In NSW, Labor has promised to give most country nurses the same patient loads as their city colleagues, with at least one nurse for every four patients across all A, B and C hospitals on morning and afternoon shifts and 1:7 at night.

“Specialling within numbers” will be banned in medical/surgical wards in A, B and C hospitals.

‘Specials’ staffing will be funded in addition to ratios but will start earlier – from July 1 this year.

1:3 RATIOS IN MATERNITY All maternity units will get a minimum ratio of 1:3 for postnatal patients on morning, afternoon and night shifts.

All paediatric wards will get a minimum 1:3 ratio across all shifts.

Minimum ratios (1:3 plus in-charge plus triage) will apply in all Level 3 to 6 adult and paediatric emergency departments.

In community health and community mental health services, Labor will take steps to ensure nurses and midwives are replaced when they take leave.

Michael Daley said Labor would require all community health services to publish the number and percentage of shifts replaced to cover nurses and midwives taking annual, sick, long service and parental leave.

STATE ELECTION 2019

Labor leader Michael Daley meets nurses and midwives from the local Tweed Hospital at the launching of Labor’s historic ratios plan on 25 February.

LIBERALS/NATIONALS REFUSE RATIOS BUT PROMISE NUMBERS The Liberal/National Coalition has promised to employ 5000 more nurses but has ruled out introducing nurse-to-patient ratios.

Brett Holmes said it was unclear what the Coalition’s promise would mean in practice without a transparent, legally enforceable ratios system that left no room for managements to manipulate the system to lower costs.

He said Labor’s ratios plan would also ensure that nursing numbers automatically kept up with patient numbers – regardless of political promises.

“We need a clear and accountable rostering system that patients can rely on and nurses can trust at all times. It is disappointing that the government chooses to ignore this,” he said. ■

The key points of Labor’s ratios plan • “Specialling within numbers” will be banned in medical/surgical wards in A, B and C hospitals from 1 July this year.

• Introduce a new mandated, shift-by-shift ratio system starting from 1 July 2019 • Fund an extra 5500 nurses and midwives • Introduce 1:3 ratios in EDs, paediatrics and maternity • Bring regional staffing levels up to city levels

‘ I want to say to nurses and midwives – this is your win, this is your campaign.’ — Labor leader Michael Daley

THE LAMP STATE ELECTION 2019 | 9

NURSES AND MIDWIVES VOTE MARCH 2019

Only mandated ratios will guarantee safe staffing The Liberal National Coalition has promised 5000 extra nurses and midwives but without mandated ratios how will we know where they will end up?

We need a ratio system that guarantees nurse numbers will grow along with our health system – not a oneoff sweetener to get our vote on election day,” says president of NSWNMA and midwife O’Bray Smith.

She says it’s time political parties listened to nurses and midwives on health care issues.

“It’s fine for the government to pull a number out of the air and say, you can have so many nurses, but they’re not actually listening to what we need.

‘ Ratios will ensure that as our wards increase and patients increase our staff numbers also increase.’

— O'Bray Smith

“We are the ones on the hospital floor and we’re the ones who know what we need to do our jobs safely.

“After 17 years in the health system, I have never seen nurses so desperate for safe staffing levels. I have never seen the despair on their faces like I do now.

“We’ve been saying for a long time that only mandated ratios will guarantee safe staffing into the future because governments can’t take them away.

“We have mandatory ratios in child care so I don’t understand why the government refuses to accept we also need them in health care.

“It’s time for us to use our votes to get ratios mandated in law.”

GOVERNMENT’S PROMISE IS UNCLEAR O’Bray says it is not clear what the government’s promise of 5000 nurses really means.

“How will we know where the nurses and midwives will end up?

Will they be working on the floor or assigned to new projects?

“We don’t know how long these 5000 nurses will stay in the system.

Will they be replaced if they leave?

Will their positions be maintained?

“Without ratios, there is no guarantee that in five years, funding for the extra 5000 nurses will still be there.

10 | THE LAMP STATE ELECTION 2019

“In the past it’s sometimes been ha rd to k now where t he n e w l y- a p p o i n t e d staff have gone. They don’t always work on the f loor where they are needed.”

O’Bray points to recent examples of local health districts deliberately keeping staff levels below the nursing hours per patient day (NHPPD) minimum in order to cut costs.

“How can we believe the LHDs will place the extra 5000 nurses where they are needed most when we can’t trust them to follow the current NHPPD system?” she asks. ■

STATE ELECTION 2019 / GET INVOLVED

Make a difference NSWNMA activists have been pounding the footpaths, staffing the phones, leafleting railway stations and markets, doorknocking and using countless other methods to get our message out to the community about the need for shift-byshift ratios.

Here some of them talk to The Lamp about what it has been like, the response of the community and how you can get involved.

‘CALLING’ PARTIES

“Go for it. It’s easier than you think” Kylie Tastula, branch secretary at the Royal Prince Alfred Hospital, has been bringing members together for “election call centre parties”.

“We’ve made it a wine and cheese night and we have four to six nurses coming each time for a couple of hours. We’ve been making phone calls to other members across the state in marginal seats.

“It is a lot easier than I thought it would be. Everyone gets really nervous because you are cold calling people, but most nurses are really happy to speak to you. You are ringing people just like yourself, and it is social at the same time.

“So far the calls have been gathering information about who people have voted for in the past and who they are considering voting for in this election.”

Members are also asked if they have heard of the Ratios: It’s a Matter of Life or Death campaign.

The issue of ratios is very important to nurses, Kylie says.

Currently, ‘A’ hospitals have the highest NHPPD and other hospitals have less.

“What the union wants is for ratios to be the same in all hospitals, and for ratios to be extended to all areas in all hospitals.”

For anyone thinking of getting behind the campaign, Kylie’s message is “go for it. It is a lot easier than you think”.

‘ We’ve made it a wine and cheese night, and we have four to six nurses coming each time for a couple of hours.’ — Kylie Tastula

From left to right: Jacquie Myers, Eleanor Romney, Kylie Tastula, Sabrina Sharp from RPAH branch.

THE LAMP STATE ELECTION 2019 | 11

NURSES AND MIDWIVES VOTE MARCH 2019

‘CALLING’ PARTIES

A call to arms I n the marginal state seat of Coogee, held by the Liberal MP Bruce Notley-Smith by just 2.9 per cent, nurses and midwives have been speaking to the public about the upcoming state election.

Erin Francis, NSWNMA councillor and an RN in mental health, said they are asking people to sign a pledge that they will vote for better ratios.

Erin says “most of the conversations [we’re having] are very positive. At the McIver Women’s Baths we found that the ladies are really happy to support our campaign. Dads pushing prams are also really keen to sign the pledge.”

Erin says that this election will be an important one for nurses. “The Labor Party has agreed to support one-to-four ratios in medical and surgical wards and one-to-three in emergency department and paediatrics. The Greens have agreed, but the Liberal Party haven’t agreed to any of our claims.

“The general public understand that nursing is a really hard profession, but they don’t understand how dire the situation is and are quite shocked to hear what we have to deal with on an everyday basis.”

Nurses from the four Randwick campus branches have also been surveying NSWNMA members, says Erin. “We’ve been making calls both at the Association offices and meeting up at our homes. We call it a ‘call party’, and people bring a plate of food.”

So far Erin and other members have made more than 1,000 calls.

“The call parties have been quite a positive experience for most people. Our branch is finding it really useful to find out how other members are feeling.

“I’d encourage everyone to get involved (in this campaign). It can’t be achieved by just a handful of

12 | THE LAMP STATE ELECTION 2019

people. It is not as scary as you might think: it is actually quite fun and enjoyable. At the end of the day we are all nurses and everyone has been quite receptive to it.”

‘ I’d encourage everyone to get involved (in this campaign). It can’t be achieved by just a handful of people.’ — Erin Francis Sonja Ojala and Erin Francis

STATE ELECTION 2019 / GET INVOLVED STALLS AT NIGHT MARKETS

Strong support from the public Katrina Bough, the president of the Wyong branch of the NSWNMA, recently set up a stall at the Niagara Park twilight markets to educate the public about the issue of safe ratios.

At the most recent stall she met a woman whose mother had been admitted to hospital after a stroke and was in an acute phase.

“The daughter said she could see the nurses were overworked, and another patient was screaming at the nurse who was trying to look after her mother.

“The daughter said the nurse was in tears, and explained they were so overloaded, but the nurse felt responsible for not being able to provide basic nursing.”

Katrina and other delegates from Wyong have been taking time outside of their work hours to have these sorts of conversations with the public and educate the community about their rights to ratios.

“The feedback from community members is pretty strong: they want clear ratios,” Katrina said. “They don’t understand nursing hours per patient day, which is the current formula.”

She says the nursing hours formula can be “manipulated by the interpretation”, and is dependent on the hospital category. “People are mortified when you explain to someone that how much nursing care you will get depends on where they live”.

Katrina is part of a group of about 25 Wyong members who have been out speaking to voters in the Entrance and Gosford electorates to raise awareness before the state election. The reception has been “very good”, Katrina says.

“People are interested to know what is going on and they are glad that we are out there supporting them and educating everybody about how things work in our world.”

‘ People are interested to know what is going on.’

— Katrina Bough

Katrina Bough and her daughter Charlotte

THE LAMP STATE ELECTION 2019 | 13

NURSES AND MIDWIVES VOTE MARCH 2019

FRONTING A RADIO AD

Getting involved is empowering Skye Romer, a mental health nurse, is the nurse’s voice in the Association’s radio ad, calling on the public to support ratios when they vote in this month’s state election.

“I’m super excited to be involved in this campaign. It’s been really empowering. Today I’ve been talking in a radio ad which I never thought in my wildest dreams I’d be doing as a nurse.

“It’s an amazing opportunity to be part of such a strong union and to make such an impact. Sometimes we think we are just a little fish in the sea but together we can make a huge difference.

“The Association has done a fabulous job going out to the community. It’s making people think about where they’ll put their vote in this election.”

Skye says it is a passion for ratios in our hospitals that drove her to get involved in our campaign.

“I work in an acute mental health unit and ratios are very important for the safety of nurses and patients,” she said.

Skye has also participated in “home call centre” activities – contacting other nurses to hear their concerns and to encourage them to help out in the campaign.

“A lot of nurses want to be heard.

The stories they are telling are about high levels of stress, high levels of aggression, not having enough nurses to provide the care and all the issues that come with that.”

She says she has learned a lot from being part of the campaign.

“You feel more in charge, you feel more inspired. The campaign has been so much fun. You meet likeminded people who have the same values and the same goals in nursing and in life as you and I’ve met people who will be lifelong friends.

“I think nurses have the power to make a difference. We have the

14 | THE LAMP STATE ELECTION 2019

strongest union in Australia. We back each other up. And the community is willing to listen to what nurses have to say.”

Skye says there is no room for complacency in this election if we are to achieve our goal of shift-byshift ratios across the whole public health system.

“This election is so crucial. Our current Liberal government doesn’t even want to talk about ratios. We need to get a government that

supports us. I believe the only way to do that is to vote the current government out.

“The alternative is to vote for a political party that supports nurseto-patient ratios, that supports the backbone of our health system – which is our nurses – and that will ensure that our public health system runs strongly.”

‘ Sometimes we think we are just a little fish in the sea, but together we can make a huge difference.’ — Skye Romer

STATE ELECTION 2019 / GET INVOLVED ENGAGING WITH THE PUBLIC

We need to talk to the community…

…and the community is doing its bit

Mary Ann Niones, an NSWNMA branch member, says she is not a ‘political person’. But the importance of the issue of hospital staffing has seen her spending her own time out of hours at Nepean Square and Penrith Train Station speaking to the community.

“We want people to know there is no legislation that a nurse should only look after a certain amount of patients, because if you exceed that number it becomes a risk,” Mary Ann said.

“The majority of people tend to agree with us if they have been in the hospital themselves – they might have seen how it is short-staffed, even if they really don’t know why.”

Mary Ann and other local nurses have been asking people if they are willing to sign a pledge to vote for ratios.

Mary Ann has found that talking to people becomes easier over time.

“Initially when we started we would feel rejected because the majority of people didn’t want to speak to a random person. But in time you get over it, you keep going and eventually you will find people who are really interested and want to know what your aim is.”

The hit TV series M*A*S*H featuring a wartime army field hospital was a comedy about deadly serious situations.

It inspired Chris Sadrinna to organise a three-day M*A*S*H-themed event at Avalon’s Dunbar Park on 15-17 February.

“I heard so many bad stories (about the relocation of local hospital services to the privatised Northern Beaches Hospital) I thought, are we going to have to put up a M*A*S*H tent on Dunbar Park and look after ourselves?” he said.

“Then I thought, why not erect an old army tent and invite people to come and share their stories about how they are coping with the new hospital setup.

“Instead of M*A*S*H we’ll call it S*H*A*M. If the government can’t take the community seriously, why should we be serious?”

People were invited to record their stories in a variety of ways including postcards pinned to a wall, on a Facebook page via supplied laptops, and on video. There was music and children’s games.

‘The majority of people tend to agree with us if they have been in the hospital themselves’ — Mary Ann Niones

‘ I heard so many bad stories I thought, are we going to have to put up a M*A*S*H tent on Dunbar Park and look after ourselves?’

— Chris Sadrinna

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NURSES AND MIDWIVES VOTE MARCH 2019

Resources to help you The NSWNMA has numerous resources online to help you take our message about shift-by-shift ratios out to the public during this election campaign.

Visit our Ratios – it’s a matter of life or death website and facebook page Here you will find our TV commercials on ratios: Watch them! Share them!

There are also other great videos that are informative, funny and insightful featuring nurses and midwives who share their experiences working in grossly understaffed environments.

Plus news, actions, ideas and resources.

https://www.ratioslifeordeath.org.au https://www.facebook.com/safepatientcare/

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STATE ELECTION 2019 / GET INVOLVED

Download a sign Download one of our Ratios signs below, fill them out, snap a photo of yourself or with colleagues and send them to photos@nswnma.asn.au so we can post it on Facebook.

NSWNMA Activists Facebook page This is a closed group that you have to join. Sign up and find out what other nurses and midwives are doing: there are plenty of ideas here for you to get up and run with to make shift-by-shift ratios a prominent election issue.

https://www.facebook.com/groups/ NSWNMAactivists/

Authorised by B.Holmes, General Secretary, NSWNMA

Want to get involved?

There are plenty of ways to make a contribution to our campaign for shiftby-shift ratios leading up to the NSW state election on 23 March.

Want to help win ratios?

Get in touch with us and let us know what you are prepared to do. Fill in our form and we’ll help put you in touch with like-minded people and away you go!

https://actionnetwork.org/forms/thank-youfor-supporting-nurses-and-midwives

If you would like to get involved email: winratios@nswnma. asn.au

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NURSES AND MIDWIVES VOTE MARCH 2019

Labor promises shift-byshift ratios starting 1 July The Liberal-National Coalition government refuses to improve the safety and care of patients with guaranteed ratios.

L

ast year, NSW Labor promised to introduce a new ratios system in NSW. At the heart of their plan was the introduction of shift-by shift ratios, equity for most rural hospitals with their metropolitan counterparts and the extension of 1:3 ratios to emergency departments and paediatrics.

The ALP’s policy for the March 2019 state election retains these key features beefed up by a number of new improvements announced by opposition leader Michael Daley.

has promised to fund an extra 5000 nurses over the next four years but steadfastly refuses to improve nurse to patient ratios.

In off ice since 2011, the Coalition has repeatedly rejected improved ratios under three leaders including the current premier, Gladys Berejiklian.

Nurses and midwives in cities and rural areas have consistently told the NSWNMA their highest priority is a stronger ratios system.

• A ll maternity units will get ratios of 1:3

The public has backed NSWNMA campaigns for safe ratios on every ward and every shift and there is overwhelming international evidence that ratios save lives, reduce errors and keep skilled staff in the system.

• Additional staff will be provided for "specials"

The Coalition has ignored both the public and the experts.

• W hen there are uneven numbers in the calculations of ratios – the number of nurses rostered will be rounded up.

Labor has promised to legislate for a better system of minimum ratios in both city and regional NSW.

Labor has now promised: • 5 500 extra nurses within a mandated shift-by-shift nurse to patient ratios system

In community health and community mental health Labor says it will improve accountability and transparency around staffing arrangements.

It will require all health services to publish the number and percentage of shifts replaced to cover nurses and midwives taking annual, sick, long service and parental leave.

The Liberal-National Coalition

18 | THE LAMP STATE ELECTION 2019

Michael Daley pledges Labor will deliver thousands more nurses in regional NSW through new nurse-to-patient ratios in A, B and C hospitals, that bring their staffing levels up to city ones.

This will improve patient care in about 60 separate hospitals – most of them outside Sydney, Wollongong and Newcastle, he says. ■

‘ In office since 2011, the Coalition has repeatedly rejected improved ratios under three leaders including the current premier, Gladys Berejiklian.’

STATE ELECTION 2019 / THE ISSUES

MEDICAL AND SURGICAL PEER GROUP A, B, C

Morning and afternoon shifts 1 NURSE : 4 PATIENTS

Night shifts 1 NURSE : 7 PATIENTS

+ SPECIALS IN ADDITION TO NUMBERS + IN-CHARGE

POSTNATAL

Maternity 1 MIDWIFE : 3 MOTHERS

LEVELS 3-6 ED

Emergency Department 1 NURSE : 3 PATIENTS + IN-CHARGE + TRIAGE

PAEDIATRIC WARDS

Paediatrics 1 NURSE : 3 PATIENTS + IN CHARGE ON 2 SHIFTS

WHERE THE PARTIES STAND ON RATIOS NSW LABOR • Introduce a new mandated, shift-by-shift ratio system starting 1 July 2019 enshrined in law through the Award • Fund an extra 5500 nurses and midwives • Introduce 1:3 ratios in EDs, paediatrics and maternity • Bring regional staffing levels up to city levels • Fund additional staff for “specials” • A fully funded plan NSW GREENS • Support increased nurse-to-patient ratios and skills mixes that ensure patient safety, better health outcomes, high recruitment retention, continued professional development and adequate training of staff.

• Have not published a plan or a funding mechanism • Provide sufficient funding for the priority areas of midwifery and mental health nursing especially in rural areas.

LIBERAL-NATIONAL COALITION • Has consistently rejected ratios.

• Health Minister Brad Hazzard was particularly critical of the Labor Opposition’s promise to introduce 1:3 nurse-to-patient ratios in emergency departments.

• Has promised to fund 5000 extra nurses and midwives over the next four years.

SHOOTERS, FISHERS & FARMERS • Support increased nurse-to-patient ratios however, have not published a plan or funding mechanism.

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NURSES AND MIDWIVES VOTE MARCH 2019

Our wages system is broken Under the NSW Liberal–National government pay cap, nurses and midwives’ wages struggle to keep pace with living costs.

W

age increases for NSW public sector nurses and midwives used to be set by the NSW Industrial Relations Commission (IRC) after a period of negotiations between the government and NSWNMA. That changed in 2011 when the Coalition government took away the IRC’s powers and restricted pay increases to a maximum 2.5 per cent per annum for government workers.

To achieve a pay increase over the cap requires “trading away” existing award entitlements.

Si nc e t hen , gover n ment employees have struggled to get a decent pay rise.

As NSWNMA General Secretary Brett Holmes said: “Our members have increasingly been asked to do more with less. Yet, their increase in productivity has not been rewarded for many years.”

The Coalition’s wage cap has only worsened a national problem: profits are surging but wages are stagnant or barely keep pace with living costs.

Power bills, housing, transport, child care and health insurance premiums have risen much faster than wages.

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‘Our jobs have been casualised, offshored and outsourced.’

— ACTU Secretary Sally McManus The ave r a g e Au s t r a l i a n household has less disposable income in real terms than when the Liberal–National Coalition took power federally in 2013, The Guardian newspaper reported.

Three decades of changes to Australia’s wage-fixing systems, laws and rules have stopped workers from getting decent wage increases, according to Professor John Buchanan, the chair of business analytics at Sydney University.

A s ACT U Secreta r y Sa lly Mc M a nu s s a id : “O u r j ob s have been casualised, offshored and outsourced.”

“Forty per cent of the workforce is now in insecure work. A whole generation does not know what it is like to have a paid sick day or a paid holiday.”

Federally, the Labor Opposition has pledged support for new rules aimed at raising wages and recovering lost protections for workers.

It’s not only union members who are worried about persistent low wage growth.

Authorities such as the Reserve Bank and the International Monetary Fund say the whole economy needs bigger pay rises.

Reserve Bank governor Philip Lowe described low-wage growth as a “crisis” that hurts many businesses by depressing consumer confidence.

He said he hoped relatively low unemployment would re-energise workers to demand higher wages.

“At some point, one imagines that’s going to lead to workers being prepared to ask for larger wage rises,” he said. “If that were to happen it would be a good thing.”

The International Monetary Fund also described weak wages growth as a risk.

“Lower wage growth and lower household income growth is one of the risks we are concerned about,” said Thomas Helbling, the head of the IMF’s Asian division. ■

STATE ELECTION 2019 / THE ISSUES

WHERE THE PARTIES STAND ON

WAGES

LABOR WILL REMOVE THE 2.5% PAY CAP • Labor says it will rescind the current Public Sector Wages Policy and replace it with “a principled and collaborative framework for dealing with claims by workers and unions for improved pay and conditions”.

The difference between Labor and the Liberals/ Nationals on public sector wages 4.0 3.5

2.5 2.0

NSW GREENS SUPPORT: • Repealing the “unfair and arbitrary” public sector pay-freeze legislation and returning wage setting powers to the Industrial Relations Commission.

• Restoring the Industrial Relations Commission as the independent umpire in industrial disputes.

• Ensuring that successful tenderers for government work or services pay their workers at least the equivalent of public sector workers.

• Ensuring that the state government and local councils set the standard for best practice wages and conditions across NSW.

1.5

LIBERAL–NATIONAL COALITION 0.5 0.0

2012 2013 2014 2015 2016 2017 2018

1.0

2008 2009 2010 2011

PERCENTAGE PAY INCREASE

3.0

• Labor also says it will outlaw “wage theft” and enact a new law that will include criminal penalties, including fines and the possibility of jail for up to 14 years, for individuals found to be “purposefully taking part in systematic, ongoing and widespread failure to pay money and other employment entitlements”.

RNs/RMs pay increase: what the Coalition delivered in the past seven years compared to Labor in the previous four

Since 2011, when they made their Public Sector Wage Policy law, the Liberal–National government has restricted public sector pay increases to 2.5 per cent per year. Any higher increase is banned unless nurses and midwives agree to “pay” for it by “trading off” existing Award conditions.

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NURSES AND MIDWIVES VOTE MARCH 2019

Australia’s meanest workers’ comp scheme People who get injured at work deserve a compensation scheme they can count on. But the Liberal–National Coalition has given NSW the meanest workers’ compensation scheme in the country.

I

n 2012, the Liberal-National Coalition government abolished journey accident insurance for workers in NSW. S u d d e n l y, people were dangerously vulnerable if they injured themselves travelling to or from work.

The burden of workers’ comp shifted to employees

Nurses and midwives were disadvantaged more than most. An NSWNMA submission pointed out: “Excessive workloads are a major problem for (nurses) that can result in sheer exhaustion at the completion of shifts. In addition, working night duty often means nurses will have to wander a deserted car park or catch public transport at night when travelling to or from work.

“Many (nurses) work in rural locations that necessitate travel on highways, which can involve high speeds, heavy carriage and are frequently poorly lit or maintained. Rural roads are also generally more dangerous during inclement weather.”

The NSWNMA stepped in to establish a safety net for members by providing journey accident insurance as part of their membership fee.

However, the Coalition’s heartless changes extended way beyond

22 | THE LAMP STATE ELECTION 2019

journey accidents.

Their ‘reforms’ cut income support to workers regardless of when they were injured. Benefit payments declined 25 per cent in just five years, according to the Australia Institute.

This has had a profound impact on NSW workers and their families.

For instance: • Tens of thousands of injured

workers have lost medical cover.

• Just four per cent of workers in the scheme are eligible to receive weekly payments after five years.

• Medical procedures need to be preapproved by an insurance clerk (rather than by the treating medical professional), causing delays and refusal of necessary treatment.

• P ayments are reduced or cut off based on how much income

STATE ELECTION 2019 / THE ISSUES

WHERE THE PARTIES STAND ON

WORKERS’ COMPENSATION NSW GREENS SUPPORT: • Reinstatement of benefits lost by injured workers as a result of Coalition reforms in 2012.

• Extending benefits to cover workers injured on a journey to or from work.

• Restoring injured workers’ lump-sum benefits.

• Giving injured workers the right to have their claims heard by an independent tribunal.

NSW LABOR SAYS: the insurer thinks an injured worker could earn – even if no work is available.

The cuts were not only harsh – they were unnecessary.

The government claimed the compensation system known as WorkCover was in financial crisis.

However, the government’s prediction of a $4 billion WorkCover deficit was based on temporary low yields from the scheme’s investments as a result of the Global Financial Crisis.

Unions said at the time that the scheme’s finances would soon recover in line with general economic trends.

In fact, the ‘crisis’ lasted just one year. A 2018 study by the Australia Institute’s Centre for Future Work found that: “Even as injured workers suffered the consequences of these benefit cuts, the financial position of the workers’ compensation system suddenly transformed from ‘famine to feast’: the supposedly dire deficit which justified the cutbacks disappeared entirely within one year, and by mid2013 the fund was already back in surplus. The system’s total surplus now exceeds $4 billion.” ■

It will repeal the current workers compensation system and replace it with a system that reflects the following principles: • Workers compensation should be available on a no-fault basis where an injury “arises out of or in the course of employment”.

• WorkCover must be properly resourced to carry out its functions properly, including an increased emphasis on prevention and compliance.

• Trade unions must have the power to enforce non-compliance with workers’ compensation law together with rights of entry, inspection and other investigative powers.

• Return to work should be elevated as a central tenant of workers’ compensation including by placing an absolute obligation on employers to provide suitable duties.

LIBERAL–NATIONAL GOVERNMENT The Liberal–National government remains committed to their workers’ compensation system that resulted in tens of thousands of injured workers losing medical cover and only four per cent of workers in the scheme eligible to receive weekly payments after five years. Their scheme also denies the right to compensation for workers injured on their way to or from work.

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NURSES AND MIDWIVES VOTE MARCH 2019

NSW government: nursing homes don’t need RNs In aged care policy, the NSW Liberal–National government attempted to turn its back on professional advice and public opinion.

B

y abandoning the requirement for nursing homes to have a registered nurse on duty around the clock, the state government ignored appeals from a wide range of nursing, seniors and health advocacy groups.

It went against the views of 25,000 citizens who signed an NSWNMA petition.

It even went against the unanimous recommendation of a parliamentary inquiry supported by the government’s own MPs. In 2015, the NSW government proposed that it would withdraw its legislation requiring RNs 24/7 for licensed nursing homes because the federal government holds responsibility for aged care.

Federal regulations do not specify the number and skill mix of staff in aged care facilities and therefore fail to ensure safe staffing levels for frail residents and workers.

As former Greens MP Jan Barham pointed out: “Some of these facilities have over 300 residents. Now there’s no guarantee they’ll have a registered nurse on site during the day, overnight or on weekends.”

“Without 24/7 registered nursing, residents can wait for hours or days for pain relief or to have a catheter changed or have the specialised care that recognises symptoms of an emerging condition.”

In an open letter, 15 organisations called on the state government to keep the requirement for RNs. They included the Council on the Ageing, Cancer Council NSW, A lzheimer’s Austra lia, National Seniors, the Australia and New Zealand Society for Geriatric Medicine and the Combined Pensioners and Superannuants Association (CPSA).

24 | THE LAMP STATE ELECTION 2019

‘ Without 24/7 registered nursing, residents can wait for hours or days for pain relief or to have a catheter changed.’

— Former Greens MP Jan Barham Dr Lyndal Newton of the Australian & New Zealand Society for Geriatric Medicine said registered nurses were integral in providing skilled, clinical care to nursing home residents with complex, high level needs.

“The roles of a registered nurse and director of nursing in nursing homes with high care residents are vital to the NSW health system," Dr Newton said.

“We cannot rely on industry self-regulation for our most vulnerable Australians. Though many service providers will do the right thing, we need to make sure that they all do.”

NSWNMA General Secretary Brett Holmes agreed.

"The removal of the 24/7 registered nurse requirement would only lead to increased profits for nursing homes.

But it would come at a high cost to elderly residents and their families," he said.

“Nursing homes would have no choice but to transfer residents to already overwhelmed hospital emergency departments for basic treatment if there wasn't a nurse on duty.”

“The legislation continues to exist only as a result of our campaigning but is limited to certain nursing homes not all aged care facilities.” ■

STATE ELECTION 2019 / THE ISSUES

WHERE THE PARTIES STAND ON RNs

IN AGED CARE

LIBERAL–NATIONAL COALTION The Liberal–National Coalition parties used its numbers in state parliament to defeat a Bill supported by Shooters, Fishers and Farmers’ party requiring nursing homes to have registered nurses on duty 24 hours a day.

Aged care residents on average need a minimum

4hrs 18mins of care each day.

However, they only get

2hrs 50mins of care each day.

Over the last 13 years, chronic understaffing has seen an increase of

400%

in preventable deaths of elderly Australians in aged care – many from falls, choking and suicide.

NSW GREENS Voted in favour of requiring aged care facilities to always have a RN on duty.

NSW LABOR Labor supported the 2017 proposals of Shooters, Fishers and Farmers’ party to ensure aged care facilities have an RN on duty at all times.

SHOOTERS, FISHERS & FARMERS • Supports RNs 24/7.

• Proposed a Bill to make it law.

Last year owners of aged care facilities racked up over

$1 billion in profits.

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NURSES AND MIDWIVES VOTE MARCH 2019

Hospitals – put people before profit The Liberal–National Coalition and Labor approach the 23 March election with public hospital policies as different as night and day.

T

he Liberal-National Coalition claims its “partnerships” with private operators will deliver a more “efficient” health system.

It tried to sell five NSW public hospitals – Wyong, Goulburn, Shellharbour, Bowral and Maitland – but fierce public opposition forced it to backtrack.

In northern Sydney, residents lost two public hospitals – Manly and Mona Vale – in return for the Healthscope-operated Northern Beaches Hospital.

As the media widely reported, its opening weeks were a shambles.

NS W NM A memb er s have campaigned strongly against privatisation in their communities.

They have made it clear they did not want their local public hospital turned into a profitmaking operation.

Labor and the NSW Greens strongly oppose hospita l privatisation.

Labor leader Michael Daley has promised: “Under Labor, the sell-offs will stop. There will be no privatisation of NSW hospitals, water, elect r icit y or public transport services.”

Since elected in 2011 the Liberal– National government has sold off

26 | THE LAMP STATE ELECTION 2019

electricity services, bus services, ports, housing, land and property information, recreation facilities, museums and court operations – to name a few.

In health care, privatisation has even extended to residential disability services and palliative care. Ignoring the pleas of staff and families the government flogged off services provided to some of the state’s most vulnerable citizens.

On the Northern Beaches fiasco, NSWNMA General Secretary Brett Holmes wrote: “The privatisation of the Northern Beaches Hospital was undertaken without any serious public debate.

The tendering process was shrouded in secrecy. The public was lied to about what it would cost. Now the hospital has opened in a state of chaos due to completely inadequate planning and preparation.

“This is largely due to a failure to engage with staff and a management that lacks experience in running public hospitals. It was arrogant to think that private corporations would do a better job of running a public hospital.

“The government responsible for this debacle deserves to be made accountable.” ■

STATE ELECTION 2019 / THE ISSUES

WHERE THE PARTIES STAND ON

PRIVATISATION The Liberal-National Coalition tried to sell five regional NSW public hospitals but fierce opposition by nurses, midwives and their local communities forced it to backtrack.

NSW GREENS • Oppose Public–Private Partnerships in provision of public hospital services.

• Support keeping all current and future public hospital developments and land in public ownership.

NSW LABOR Labor leader Michael Daley says: “Under Labor, the sell-offs will stop. There will be no privatisation of NSW hospitals, water, electricity or public transport services.”

LIBERAL–NATIONAL COALITION Privatised the Northern Beaches Hospital and tried to sell six regional public hospitals.

Why we oppose the Liberal–National Coalition’s hospital privatisation • Private operators have a duty to reward their shareholders by making a profit on their investment.

• They can only do that through cuts to staffing and resources.

• Privatisation of public health care has never delivered better services.

• Privatisation will starve our public hospitals when nurses and the public want to see them grow.

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PRIVATISED DISABILITY SERVICES

Coalition turns its back on the severely disabled MPs from all parties want state agencies to keep providing specialist disability services – but the Berejiklian government isn’t interested.

S

everely disabled people who can’t get the care they need under the National Disability Support Scheme (NDIS) will have to rely on general hospitals, homeless shelters and prisons.

That’s the NSW Coalition government’s heartless message to hundreds of people with complex care needs – and their carers – who depend on government disability and accommodation services.

The government is privatising all specialist disability services and requiring clients to find non-government alternatives under the NDIS. However, a pa rlia menta r y committee of enquiry described the government’s exit from the disability sector as “fraught with challenges”.

The committee, made up of Liberal, National, Labor and Greens MPs, unanimously called on the government to “reinstate its role as a public sector safety net to capture people with disability, particularly those with complex and challenging needs”.

The committee’s final report said the state government should be “a service provider of last resort” to the NDIS “to ensure crisis situations

28 | THE LAMP MARCH 2019

‘ We must look beyond the NDIS and ensure that the support available outside of the scheme is adequate and responsive to the needs of all people with disability in NSW.’ — Greg Donnelly MP

are managed appropriately”.

The report recommended that the government “address service gaps by investing in services and supports for people with disability, regardless of their eligibility for the NDIS”.

Committee chairperson Greg Donnelly said: “Ultimately, we must look beyond the NDIS and ensure that the support available outside of the scheme is adequate and responsive to the needs of all people with disability in NSW, regardless of their participation in the NDIS.” “To this end, we look to the NSW government to recognise and fulfil its responsibilities under the Disability Inclusion Act 2014 as a priority.”

The committee’s unanimous recommendations are contained in a

214-page report based on 352 written submissions and public hearings.

However, the state government has effectively rejected the report in a brief letter to the committee.

Minister for Disability Service Ray Williams wrote: “The committee’s recommendations that the NSW government be established as a service provider of the last resort to ensure crisis situations are appropriately managed and reinstate its role in delivering specialist disability supports, particularly for those with complex and challenging needs, are noted.”

“In effect, NSW mainstream ser vices continue to provide both of these roles when there are service gaps for participants,

PRIVATISED DISABILITY SERVICES

‘ NSW mainstream services continue to provide both of these roles (a service provider of last resort and delivering specialist disability supports) … when participants are admitted to hospitals, homeless shelters and prisons.’

— Ray Williams, Minister for Disability Service

when participants are admitted to hospitals, homeless shelters and prisons.”

NSWNMA Assistant General Secretary Judith Kiejda said the government had dismissed in a sentence or two the overwhelming evidence gathered by the inquiry and some of its most important recommendations.

“How reassuring for those with profound and complex disability needs or moments of crisis – who simply crave (and deserve) service continuity by a NSW government-operated disability service,” she said.

Judith made the comments in a letter to NSWNMA members transferred from the government’s Family and Community Services (FACS) to NGOs and other members waiting to be transferred from FACS. Before the NDIS started to roll out in 2017, FACS employed about 1000 nurses who helped to deliver about 40 per cent of disability services in NSW. Private operators supplied about 60 per cent of disability services.

The government is shifting nurses and other public servants from FACS to private providers. ■

Nurses driven out of disability care Privatisation of NSW disability services is eroding nursing models of care and pushing experienced disability nurses to quit the sector.

In evidence to the parliamentary inquiry, NSWNMA officer Dennis Ravlich said the private sector had always played a role in disability services but rarely had to care for profoundly disabled people with multiple clinical conditions requiring qualified nursing care.

He said nursing models of care transferred from Family and Community Services (FACS) to non-government providers relied mainly or entirely on nursing classifications to staff certain group homes.

However, these models were already being eroded through use of non-nursing staff – “partly because (providers) say they cannot attract nurses, partly (due to) an economic decision to try to manage their costs”.

Dennis said former FACS nurses were supposed to keep their rates of pay and conditions for two years following their forced transfer to the private sector.

FACS had sought to reassure staff they would be in a “powerful negotiating or bargaining position” following their transfer because of high demand for nursing positions among private providers.

However, some providers were already trying to shift nurses – particularly casual employees – to the inferior federal nurses’ award, which is regarded as a minimum “safety net”.

The pay gap between the FACS award and federal nurses award is as much as $27,500 for a registered nurse at the top grade.

Some employers were also backfilling nursing positions with unlicensed workers and any new nurses employed were only taken on as casuals or permanent part-time workers.

“It is little wonder that these providers are having difficulty in a very competitive marketplace to attract and retain registered nurses,” Dennis said.

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PRIVATISED DISABILITY SERVICES

Funding squabble hits privatised disability care A funding dispute linked to privatisation has cast a shadow over the care of severely disabled people with complex medical needs in NSW.

T

he NSW government and National Disability Insurance Agency (NDIA) are in dispute over who should pay for vital care at the Summer Hill Accommodation and Respite Centre in Sydney.

This fol low s t he state government’s privatisation of its disability services in 2018.

Summer Hill centre is the statewide safety net for disabled people with the most difficult and complex medical needs.

T he c ent re p er m a nent ly accommodates about 20 residents and provides 10 respite beds.

All residents use wheelchairs and have significant communication limitations.

Almost all receive nutrition via a stomach tube and almost half receive palliative care or have end-of-life plans of some kind.

Com mon condit ions include osteoporosis, epilepsy and major respiratory problems.

Residents depend on the centre’s specialist nursing staff and services to maximise their participation in the community.

The state Ageing, Disability and Home Care service (ADHC) ran the 30 | THE LAMP MARCH 2019

‘ The disputed cost gap is greater than $70,000 per annum for some residents.’ centre until the government sold it to a not-for-profit agency Achieve Australia, which took control in November.

Achieve Australia initially told residents’ families it would provide whatever services the NDIS funds.

However, the NDIS does not pay for medical care.

As a result, the NDIA and state government failed to agree on who should pay for equipment and consumables that fall in a “grey area” between medical and disability support.

The disputed cost gap is greater than $70,000 per annum for some residents.

The government and NDIA have since agreed on a one-year interim arrangement while they try to settle the dispute.

A LACK OF COMPASSION In January, the NDIA told families it would approve 12-month care plans “based on existing s upp or t s ” p end i n g f u r t her

“conversations” with the government and Achieve Australia.

An NDIA email to families said “consumables and assistive technology” that were “clearly the responsibility (of) NSW Health” would not be included in the plans.

Families would have to access this support through NSW Enable, a state government agency.

“Where the responsibility of equipment is not clearly defined it will be funded under the NDIS plan as a continuation of support for the current participants. This will be a transitional arrangement for a period of 12 months,” the NDIA email said.

Nurse Gary Dunne worked at the Summer Hill centre until January when he retired after 40 years of disability nursing.

Gary has been a CNE, group home manager and long-term acting Residential Unit Nurse Manager at Summer Hill.

He told The Lamp that staff pleaded with the state government’s FACS branch to keep Summer

PRIVATISED DISABILITY SERVICES

‘ Now that the service is privatised the argument is, who’s paying for it?’

— Gary Dunne

Gary Dunne and Ken Adderley at the ADHC Summer Hill centre.

Hill open until NDIS funding problems had been solved.

AN UNCERTAIN FUTURE FOR THE DISABLED AND THEIR FAMILIES

He said Association representatives, including himself, and Summer Hill parents’ group representatives also raised these issues when they met the state Minister for Disability Services, Ray Williams, before Achieve Australia takeover.

He said the interim agreement left families and staff unsure about the centre’s long-term future.

“However, the government had a deadline to sell us by a certain date no matter what problems we had with the NDIS,” Gary said.

Last year, Gary and another Summer Hill nurse, Mary Sweeten, made a joint submission to the NSW parliamentary inquiry into the provision of disability services.

“Our staff were amazed at how lacking in compassion FACS were in the last few months.

“The government’s approach was like trying to sell a house when you haven’t sorted out what the property boundaries are.

“Now that the service is privatised the argument is, who’s paying for it?

“The new owners are discovering that the bucket of money coming in is less than the bucket of money they’re having to spend on services.

“And staff and families are dealing with an organisation (Achieve Australia) that doesn’t f ully understa nd what t he problems are.”

“Pre-privatisation staffing levels and wages are guaranteed for two years but current levels of service can’t be maintained long term with the current level of funding.”

Their submission outlined the case of a young man, Liam*, who suffered a traumatic brain injury and spent the next 11 years in various nursing homes – mostly indoors, in bed or a water-chair, without access to a wheelchair.

Since coming to Summer Hill eight years ago, Liam’s life has completely changed.

He now uses a powered wheelchair to enjoy outings and shopping and is exploring augmented communication devices with an occupational therapist.

However, t he submission warned, “Given the complexity of accessing medical goods and services within the NDIS framework, a non-government service provider could, as many have in the past, easily say no to taking on this kind of client.” “ The intensive prov ision of nursing and allied health services needed to achieve the kind of lifestyle now enjoyed by Liam would simply be beyond the available budget.

“Neither the minister nor their department can make a nongovernment service provider take any particular client.”

Gar y and Mar y told the parliamentary committee they were concerned that young people such as Liam would end up in inappropriate accommodation, such as a nursing home, and get the “bare medical necessities within a framework of whatever is available through NDIS funding”.

They urged the government to cover the funding gap if NDIS funding fell short of a client’s current needs. ■ *Name changed for privacy reasons.

THE LAMP MARCH 2019 | 31

NEWS IN BRIEF

WORLD

Massive insulin shortage predicted Type 2 diabetes is soaring worldwide thanks to the obesity epidemic and access to insulin is increasingly inadequate.

Research published in the Lancet Diabetes and Endocrinology journal (Nov 2018) shows that 79 million people with type 2 diabetes will need insulin by 2030 and that half of them will not be able to get it. About 33 million people who need insulin currently do not have access to the drug.

“These estimates suggest that current levels of insulin access are highly inadequate compared to projected need, particularly in Africa and Asia, and more efforts should be devoted to overcoming this looming health challenge,” said Dr Sanjay Basu from Stanford University, the lead researcher.

“Despite the UN’s commitment to treat noncommunicable diseases and ensure universal access to drugs for diabetes, across much of the world insulin is scarce and unnecessarily difficult for patients to access. The number of adults with type 2 diabetes is expected to rise over the next 12 years due to ageing, urbanisation, and associated changes in diet and physical activity. Unless governments begin initiatives to make insulin available and affordable, then its use is always going to be far from optimal.”

The scientists predict the need for insulin will rise by 20 per cent in the next 13 years. The drug reduces the risk of complications such as blindness, amputation, kidney failure and stroke.

‘ Unless governments begin initiatives to make insulin available and affordable, then its use is always going to be far from optimal.’

32 | THE LAMP MARCH 2019

IRELAND

Older people would benefit from pumping iron Weight training and protein are effective to avoid frailty in older age, study finds.

A new study has found that “a combination of strength exercises and protein supplementation is the most effective and easiest to implement intervention to delay or reverse frailty".

The research involved a review of 46 studies involving 15,690 adults on interventions to improve frailty in older people.

Roughly two-thirds of all studies demonstrated that interventions improved frailty.

Interventions that included strength training and increased protein intake or supplementation were consistently rated highest in terms of effectiveness and ease of implementation.

Interventions that were similarly easy to implement but in the mid-range of effectiveness included tai chi, health education and increased calories.

Treatments such as hormone replacement or osteoporosis medicines were also in the mid-range of effectiveness, but harder to implement.

Home visits and geriatric assessments seemed to be among the less effective interventions.

The study's authors said GPs should prescribe 20-25 minutes of exercises four days a week at home.

These are made up of 15 workouts to strengthen the arms and legs - as well as improving balance and co-ordination.

Diet also plays a key part in staying strong over the age of 70. Scientists advised eggs, milk, tuna and chicken should be on a pensioner's menu as they are high in protein.

The study was conducted by researchers from St Vincent's University Hospital and Trinity College Dublin. It was published in the peer-reviewed British Journal of General Practice.

FIND OUT MORE Delaying and reversing frailty: a systematic review of primary care interventions – https://bjgp.org/ content/69/678/e61

NEWS IN BRIEF

AUSTRALIA

Effective supervision a key component of care Quality of care is linked to resources and work pressures says medical lawyer.

Medical complaints show a clear correlation between workforce pressures and underresourcing – what lawyers refer to as systemic issues – and poor clinical outcomes, says health and medical lawyer Catherine Henry.

“How junior doctors and newly trained nurses learn, and who should be responsible for mistakes, is an important medico-legal issue,” she wrote in the Newcastle Herald.

“Litigation involving junior or inexperienced health personnel does and should focus squarely on issues of supervision.

“When those who are meant to supervise inexperienced health personnel are subject to legal scrutiny, it is likely that supervision will improve, resourcing will increase and the incidence of injury caused by inexperienced health personnel will diminish.”

Henry says the NSW Clinical Excellence Commission (CEC) looked at the role of supervision in the cause of medical error.

“The Commission's Clinical Supervision at the Point of Care report shows that the old-fashioned approach to clinical education – learn on the job and hope for the best – poses significant medico-legal risk.”

Henry says that many medico-legal cases highlight the difficulties associated with supervision in the public healthcare system.

“It is not easy for senior staff to achieve the balance of assisting trainees to gain adequate experience and responsibility while ensuring patient safety.”

AUSTRALIA

Working mothers’ mythical work/life balance Neither flexitime nor working from home significantly lower working women’s stress levels according to a new study.

Working mothers are 18 per cent more stressed than other people according to a major study conducted by the Institute for Social and Economic Research at Essex University published in the journal Sociology. The study examined biological data taken by nurses from 6025 participants in the UK Household Longitudinal Survey and analysed 11 key indicators of chronic stress levels.

Neither working from home nor flexitime had an effect on women’s chronic stress levels. But reducing the number of hours they worked did have a positive impact.

The researchers found that the biomarkers indicating chronic stress, including hormone levels and blood pressure, were 40 per cent higher for women working full time while bringing up two children, than among women working full time with no children. Women who were working full time and bringing up one child had 18 per cent higher levels of stress than women with no children.

“The use of reduced-hours flexible work arrangements appeared to moderate some of the association of family and work stressors. But there was little evidence that flexiplace or flexitime working arrangements were associated with lower chronic stress responses,” one of the researchers, Dr Michaela Benzeval, told the Guardian.

‘ Biomarkers indicating chronic stress, including hormone levels and blood pressure, were 40 per cent higher for women working full time while bringing up two children, than among women working full time with no children.’

‘ It is not easy for senior staff to achieve the balance of assisting trainees to gain adequate experience and responsibility while ensuring patient safety.’

THE LAMP MARCH 2019 | 33

NEWS IN BRIEF

AUSTRALIA

Real wage growth stuck at record low Real wage growth remains at around 0.5 per cent per year, according to the latest CPI figures released by the ABS. The ACTU says this continues the Morrison government’s “long-term pattern of historically low wage growth, slow jobs growth and steadily increasing costs of living”.

ACTU Secretary Sally McManus said real wage growth of less than 1 per cent per year is “totally inadequate” and shows “the wage growth crisis shows no sign of ending”.

“The Morrison government keeps telling working people to wait for the pay rises to trickle down, but we can’t wait any more. The last five years have been a disaster for working people,” she said.

Meanwhile, new research released by the Centre for Future Work has shredded the Morrison government’s overblown claims about its job creation record.

The report, What’s a Million Anyway has found that job creation under the Abbott/Turnbull/Morrison government has in fact been weak.

The report says the current government has the worst job creation record of any government in the last 60 years that did not have to navigate a recession or a major financial crisis.

The research further revealed that nearly half the jobs created under this government were part-time, at a time when many people working part-time desperately need more hours to stay ahead of the rising costs of living.

The number of hours worked under the Coalition government fell to a 30-year low with an average of only 20 hours per week of work available to the 14 millionodd people in the labour force.

READ THE FULL REPORT What’s a million anyway – the Centre for Future Work’s report on job creation at https://www.futurework. org.au/what_s_in_a_million_anyway

34 | THE LAMP MARCH 2019

AUSTRLIA

Night owls more prone to schizophrenia People who are genetically programmed to be early risers have a lower risk of schizophrenia or depression, according to a large new genetics study.

“Being a morning person is causally associated with better mental health,” an international team of researchers has reported in the journal Nature Communications.

The study of nearly 700,000 people found 324 new genes associated with the body clock on top of the 24 genes already known to influence whether someone is an early riser or a night owl.

The study found that being biologically programmed to wake up early is linked to greater happiness and a lower risk of schizophrenia and depression.

The researchers said night owls may be at greater risk from the mental toll of having to fight their natural body clock due to most schools and workplaces having early start times.

Ian Hickie of the Brain and Mind Centre at the University of Sydney told the ABC that the genetic study backed up what psychiatrists had long thought: that mood disorders were linked to circadian rhythms, not sleep disorders.

“They’ve finally cracked the nut by saying ‘you know what, we were looking at the wrong thing’. It’s not sleep, it’s the body clock,” he said.

Being an evening person does not mean you are poorly motivated, Professor Hickie said.

“There is an idea that morning people are all good, hardworking people, but they are just genetically set that way.”

‘ We were looking at the wrong thing.

It’s not sleep, it’s the body clock.’

NEWS IN BRIEF

AUSTRALIA

UNITED STATES

Labor promises 300-bed hospital for Sydney’s North West

Commonplace pollution can increase risk of miscarriage by 16 per cent

Labor says new hospital would take some pressure off Blacktown, Westmead and Mt Druitt hospitals.

A study conducted by the University of Utah’s department of emergency medicine is the first to assess the impact of short-term exposure to air pollution.

It found that raised levels of nitrogen dioxide (NO2) pollution that are commonplace around the world increased the risk of losing a pregnancy by 16 per cent. NO2 is a by-product of fuel burning, particularly in diesel vehicles.

The research was published in the journal Fertility and Sterility (Feb 2019).

“If you compare that increase in risk to other studies on environmental effects on the foetus, it’s akin to tobacco smoke in first trimester pregnancy loss,” said Dr Matthew Fuller, one of the research team.

The research team combined with population health scientists to analyse the records of more than 1300 women who attended the emergency department after miscarriages from 2007 and 2015.

The strongest link with a lost pregnancy was the level of NO2 in the seven days before the miscarriage.

To confront the problem the best action was to cut overall levels of pollution in urban areas, Dr Fuller said.

But he said women could choose to time their pregnancies to avoid the most polluted times of year. They could avoid exertion on polluted days and consider buying indoor air filters.

Labor Opposition Leader Michael Daley has promised a 300-bed hospital for Sydney’s North West.

The hospital will cost $700 million, be based at Rouse Hill and will cover Marsden Park, Schofields, Box Hill and Kellyville. These are some of the fastest growing suburbs in the city and have a relatively young population.

Labor’s shadow health spokesperson Walt Secord said construction would begin within the first term of a Labor government.

“We’re adapting the hospital plan to suit the local needs of the community – maternity services, obstetrics, paediatric wards, a special care nursery and a women’s clinic,” he told the Sydney Morning Herald.

Secord says the 300-bed hospital, which would also include an emergency department, operating theatres and diagnostic services, would be “networked” with Blacktown and Westmead hospitals.

Health Minister Brad Hazzard responded to Labor’s announcement by saying the government had committed $300 million in its 2017–18 budget towards a “stage one” Rouse Hill Health Service, which would be integrated with Blacktown and Westmead hospitals.

“The land has been identified, the critical services plan has already been developed – that’s working with doctors and local health staff to determine what the range of services are,” he said.

‘ We’re adapting the hospital plan to suit the local needs of the community – maternity services, obstetrics, paediatric wards, a special care nursery and a women’s clinic.’

— Walt Secord, Labor health spokesperson

Pollution is as bad as smoking as a risk for pregnant women.

READ THE REPORT Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study https://www. sciencedirect.com/ science/article/pii/ S001502821832154X

ARE YOU A REGISTERED NURSE WITH A REFUGEE BACKGROUND? I would like to talk to you about your resettlement journey and experiences becoming an RN in Australia To be a part of this research study please contact Harrison Ng Chok (PhD candidate) PHONE: (02) 4734 3180 EMAIL: h.ngchok@westernsydney.edu.au TWITTER: #Refugee2RNStudy This study has been approved by the Western Sydney University Human Research Ethics Committee. Approval no H12410. For complaints or reservations about the ethical conduct of this research, contact the Ethics Committee (Office of Research Services) on 4736 0229 or humanethics@westernsydney.edu.au

THE LAMP MARCH 2019 | 35

PROFESSIONAL EDUCATION March to May 2019 Education

NSW REGIONAL

SYDNEY METRO

Blacktown Ageing and Disability: New Challenges in Service Delivery, Friday 8 March, $95 / $190, 6 CPD Hours

Clinical Communication and Documentation, Thursday 11 April, $95 / $190, 6 CPD Hours

Your Annual CPD Obligations, Thursday 21 March, $50 / $100, 4 CPD Hours, RN, EN, MW

Wound Care: Negative Pressure Wound Therapy, Friday 15 March, $95 / $190, 6 CPD Hours

How to get that dream job (Portfolio/CV, Job Application and Interview Skills), Monday 15 April, $95 / $190, 6 CPD Hours

Wound Care: Pathophysiology, Skin Tears and Pressure Injury Prevention, Wednesday 15 May, $95 / $190, 6 CPD Hours

Increasing Resilience in Stressful and Changing Times, Monday 29 April, $95 / $190, 6 CPD Hours

Dee Why

Alcohol and Other Drugs: The Current Situation – an update for all nurses and midwives, Thursday 21 March, $95 / $190, 6 CPD Hours Know where you stand with Law, Ethics and Professional Standards in Nursing and Midwifery, Thursday 28 March, $95 / $190, 6 CPD Hours

Medications: How we do it better, Thursday 9 May, $95 / $190, 6 CPD Hours

Environmental Health Seminar, Friday 5 April, $60 / $120, 5.5 CPD Hours

Understanding the Four Human Behavioural Styles, Thursday 23 May, $95 / $190, 6 CPD Hours

Practical, Positive Leadership Series, 4-Day Course, Mondays, 8 April, 6 May, 3 June and 8 July, $340 / $600, 24 CPD Hours (across 2 CPD years)

CENTRAL COAST Gosford

Standard Mental Health First Aid, 2 Day Course, Monday 8 and Monday 29 April, $190 / $380, 12 CPD Hours

HUNTER NEW ENGLAND Newcastle

Foot Care: A Nurses Role, Wednesday 13 March, $95 / $190, 6 CPD Hours Alcohol and Other Drugs: The Current Situation, an update for all nurses and midwives, Friday 5 April, $95 / $190, 6 CPD Hours

Scone

Know where you stand with Law, Ethics and Professional Standards in Nursing and Midwifery, Wednesday 29 May, $95 / $190, 6 CPD Hours

Self-Care Seminar, Friday 17 May, $60 / $120, 6 CPD Hours

Enrolled Nurses’ Seminar, Friday 24 May, $60 / $120, 6 CPD Hours, EN

Clinical Communication and Documentation, Wednesday 8 May, $95 / $190, 6 CPD Hours

Gymea

Medications: How we do it better, Wed 20 March, $95 / $190, 6 CPD Hours Bullying: Let’s put an end to it, Wed 15 May, $50 / $100, 4 CPD Hours

Hornsby

The Deteriorating Client, Monday 8 April, $95 / $190, 5 CPD Hours

Your Annual CPD Obligations, Thursday 30 May, $50 / $100, 4 CPD Hours, RN, EN, MW

Clinical Communication and Documentation, Thursday 2 May, $95 / $190, 6 CPD Hours

ILLAWARRA SHOALHAVEN Dapto

MURRUMBIDGEE Albury

Medication Administration for Clinical Staff, Friday 15 March, $95 / $190, 5 CPD Hours

Wound Care: Understanding Wound Care Products, Monday 15 April, $95 / $190, 6 CPD Hours Dementia Management Training, Wed 15 May, $95 / $190, 7 CPD Hours

MID NORTH COAST Port Macquarie

Medications: How we do it better, Wed 1 May, $95 / $190, 6 CPD Hours

Medications: How we do it better, Wed 3 April, $95 / $190, 6 CPD Hours Clinical Communication and Documentation, Thursday 4 April, $95 / $190, 6 CPD Hours

Wagga Wagga

Dementia Management Training, SOLD OUT Thursday 28 March, $95 / $190, 7 CPD Hours

NORTHERN NSW Ballina

Aged Care Seminar, Thursday 23 May, $60 / $120, 6 CPD Hours

For full details of courses including course content, venue & times, please go to www.nswnma.asn.au CPD

REGISTER ONLINE bit.ly/educationNSWNMA

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

36 | THE LAMP MARCH 2019

YOUR RIGHTS

Ask

Judith Breaking News Make the state election a referendum on safe patient care Everywhere I visit, whether to public or private hospitals, disability services or nursing homes, the daily struggle that members face with inadequate staffing levels or poor skill mix is obvious.

And it is getting worse. Hardly a week passes without a nursing home operator out there trying to cut nursing hours.

Members in private hospitals face similar challenges. Current award minimums for nursing hours continue to be flouted in many public hospitals.

We as a profession must stand up for our patients and residents, as well as for our own wellbeing and safety. We as union members must mobilise and ensure that in any debate or discussion, whether at a local or state or federal level, our voice is not only heard but also listened to. We need mandated staffing ratios to ensure the best possible care is provided first time and every time.

In the coming weeks there will be a state election. Shortly afterwards, a federal election. Seize these opportunities to make sure politicians and political parties across the spectrum heed our demands and promise to introduce systems that allow the delivery of safe patient care.

Real choices exist. There is a battle on to get your vote. It’s going to be a tight contest. Make sure your vote counts on 23 March at the state election by making it a referendum on who will best allow you to deliver safe patient care in a safe workplace. The community needs. You need it. And we need it now.

Surrogacy leave I am a registered nurse working in a public hospital. I am currently exploring becoming a parent via an altruistic surrogacy arrangement. If I become the primary carer of the child, what are my entitlements?

If you are to be the primary care giver, you would be eligible for 12months’ leave, of which 14 weeks is paid, similar to the provisions for adoption leave. Further details, including the documentation that would be sought to validate your

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

eligibility is set out in Section 5.2.3 of PD2018_046 (Leave Matters for the NSW Health Service).

Pay for In-charge

I work in a hospital operated by Healthscope. What should I be paid if asked to be in-charge of shift?

Under Clause 11(b) and Table 2 of the Healthscope and NSWNMA/ ANMF - NSW Nurses and Midwives’ - Enterprise Agreement 2015 - 2019, a registered nurse or midwife in charge of a shift in a ward or unit in the absence of the Nursing/ Midwifery Unit Manager shall be paid, in addition to their normal salary, the sum of $29.71. This shall only apply where the registered nurse is in charge of one or more other nurses in the ward or unit.

Querying sick leave

When can my manager query my sick leave record? I work in a public hospital.

Under Section 3.2.5 of PD2018_046 (Leave Matters for the NSW Health Service), certain review points are identified for sick leave absences.

These include absences within the first three months of employment (with three separate absences without a medical certificate being considered unsatisfactory) and frequent short-term absences, with managers able to initiate discussions with an employee after five separate unsupported absences.

Eight unsupported absences in any 12-month period is considered an unsatisfactory level.

In all cases, the employee concerned should be provided an opportunity to discuss their reasons for the absence levels. Appropriate documentation must be kept of any discussion or agreed actions following a review of an employee’s sick leave record.

Changed role in a disability

Last year my employment was transferred from FACS to an NGO provider. I work in a disability residential facility. A suggestion has been floated that my role will be changed soon or deleted. Can they do that?

Not in the short term. As part of the transition process, all

NGO providers are required to maintain terms and conditions of employment as they were immediately prior to your transfer for the initial two years. Further, they are also not permitted to terminate your employment during this period (except for serious misconduct). In any event, even after the two-year period elapses, consultation would be required about any workplace change under the copied state award whilst it remains in place.

Flexible working arrangements at Uniting

I work in a nursing home run

by Uniting. What are my rights to access flexible working arrangements?

Under Clause 12 of the Uniting Aged Care Enterprise Agreement (NSW) 2017, an employee can request flexible employment arrangements for various circumstances. These include being a parent, or having responsibility for the care of a child who is of school age or younger; having a disability; being 55 or older; or providing care or support to a member of the immediate family or household.

Clause 12 sets out the full parameters, who can apply, and how such an application should be made.

Journey accident insurance

What is the waiting period under the Association’s journey accident insurance when travelling to and from work?

The Association provides to members journey accident insurance in case you are injured in an accident while travelling to or from work. This attempts to cover the gap created when the current NSW Liberal and Nationals Government ripped this entitlement away from most workers when it slashed workers compensation laws in 2012.

After a 14-day waiting period, you are entitled to a weekly benefit of up to 85 per cent of your average gross weekly salary for a period of up to 104 weeks for temporary disablement. If you are involved in such an accident and injured, check in with the Association so we can discuss your possible entitlements.

THE LAMP MARCH 2019 | 37

FREE TO ATTEND

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Empowering Nurses to be Change Leaders and Use Informatics to Achieve Quality Improvements

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DIABETES UPDATE EVENING for nurses

Learn while you earn CPD points Broken Hill

Wednesday 27 February

Port Macquarie

Thursday 14 March

Wollongong

Tuesday 19 March

Forster

Monday 25 March

Ticke ts $20

More dates and locations available on our website.

Diabetes NSW & ACT is offering a diabetes evening workshop (including a light dinner) for nurses working within a hospital, medical practice, community health or aged care setting.

The training will provide participants with an increased understanding of diabetes and the services available to their patients. This session is suitable for Enrolled Nurses and Registered Nurses.

CPD points for this seminar will be available with the Australian College of Nursing (ACN) and Australian Primary Health Care Nurses Association (APNA).

For more information or to register visit diabetesnsw.com.au/events or call 1300 136 588.

The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. The NDSS agent in New South Wales and the ACT is Diabetes NSW & ACT.

SOCIAL MEDIA

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

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

We welcome your ideas at nurseuncut@nswnma.asn.au nurse-and-midwives-welcomehigh-court-decision-to-maintainfreedom-of-speech/

New on our Support Nurses YouTube channel

Want to improve care in nursing homes? Mandate minimum staffing levels MEL’S STORY New mum Mel tells us why she supports safe staffing ratios in maternity units http://bit.ly/ melonratios

SUSAN AND PAUL’S STORY Susan and Paul tell us why they think it’s time for safe nurse-topatient ratios. http://bit.ly/ susanpaulonratios Connect with us on Facebook Nurse Uncut www.facebook. com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association www.facebook.com/nswnma Ratios put patient safety first www.facebook.com/ safepatientcare Aged Care Nurses www.facebook.com/ agedcarenurses Look for your local branch on our Facebook page www.facebook.com/nswnma

Julie Henderson and Eileen Willis from Flinders University argue that nursing homes will only be improved with mandated staff-to-resident ratios. https://www.nurseuncut.com.au/ want-to-improve-care-in-nursinghomes-mandate-minimum-staffinglevels/

Burnt-out and overworked, Australia’s nurses and midwives consider leaving the profession Peter Holland and Tse Leng Tham from Monash University explore why nurses and midwives are leaving the profession in droves. https://www.nurseuncut. com.au/burnt-out-and-overworkedaustralias-nurses-and-midwivesconsider-leaving-profession/

Follow us on Twitter @nswnma / @nurseuncut

Nurses and midwives welcome High Court decision to maintain freedom of speech

Share on Instagram by tagging @nswnma and don’t forget to use the hashtag #nswnma!

Nurses and midwives in NSW celebrate a recent High Court win that allows them to continue their advocacy for safe patient care. https://www.nurseuncut.com.au/

5 things we’ve learned from California’s nurseto-patient ratios 15 years on, Nurse Uncut explores what’s happened since California enacted safe nurse-to-patient ratios. https://www.nurseuncut.com. au/5-things-weve-learned-fromcalifornias-nurse-to-patient-ratios/

Why I’m an advocate for pill testing Drug and alcohol nurse Annie Smoker tells Nurse Uncut why she’s an advocate for pill testing and harm minimisation strategies. https://www.nurseuncut. com.au/why-i-am-an-advocate-forpill-testing/

“We are 153 shifts short in February” – Three midwives speak out Three midwives from across NSW speak out about what it’s like working in understaffed wards, and why it’s time for ratios in maternity units https:// www.nurseuncut.com.au/we-are153-shifts-short-in-february-threemidwives-speak-out/

Listen to our podcast Garling After 10 – Jeff Furolo and Tony Sara http://bit.ly/ garlingjefftony

THE LAMP MARCH 2019 | 39

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40 | THE LAMP MARCH 2019

SOCIAL MEDIA

your

Say

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

desperately need better staf-to-patient ratios. Good on the nurses for speaking out, and to the union for backing all the nurses.

Plenty of support for brave midwives Midwives spoke out on A Current Affair about the state of maternity staffing levels in NSW. Here’s your reaction to the story.

This is great – midwives are speaking out. I just hope the public listen. Mothers’ and babies’ lives are put at risk every day without the mother’s knowledge and under the assumption they are safe. It’s just the midwives trying to do their best in unsatisfactory staffing conditions.

If something goes wrong you know it will be the midwife who has her registration cancelled.

If life-saving technology is created then there must be a responsibility to staff its use safely.

Why must babies and mothers die before anything gets done?

Our health care system is suffering because of poor planning from this current Liberal government.

Women deserve better.

Babies deserve better. Why has this got so much worse in the last 15 years? Myself and midwifery friends are no longer happy to do this anymore, and to put our registrations at risk.

These are unsafe practices that put mothers and babies at risk.

Nurses have been trying to get this message across for as long as I can remember.

What will it take? We

The heavy burden driving nurses and midwives out Research has shown that overwork and burnout is leading to nurses and midwives leaving the profession in droves.

Here’s what you had to say on this issue.

I don’t think I’ve heard of a nurse in Australia that has particularly good working conditions. High nursepatient ratios, double shifts, staff shortages for busy shifts, bosses and senior nurses that bully younger nurses. I feel sorry for them!

Last week, I and all staff of the ward I was working on were asked to do a double shift. There are not enough staff to fill the weekly ward vacancies where I work. I feel guilty when circumstances beyond my control make me cancel a shift.

We need more opportunities for new grads and for safe staffing laws across the board.

We need to teach each other and help each other.

Instead, younger nurses or new nurses don’t get the proper support.

Decent ratios would be great but they are not the only answer. What about stripping beds when a patient is discharged, running around trying to find a patient a meal after hours, doing the jobs of other health professionals who don’t work after hours or weekends such as physio etc? I could be here for hours writing all the new duties of a nurse/midwife – but there are just too, too many.

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Rage at Liberals’ distorted priorities We posted about the current Liberal government’s recent $200 million advertising splurge, while health and aged care remain neglected. Nurses and midwives were outraged.

How about you spend the $200m ON HEALTH. We have enough ads.

This can’t continue! This is not appropriate and wrong on so many levels.

The rules or laws need to be changed now, they are outdated, especially those involving politicians’ perks, tax deductions, rent assistance, nannies, family holidays and early exorbitant pensions.

They’ve been cutting back on all essentials for the public and they say we’re in debt. So where’s all the money gone, LNP? I dread to think how we’d have fared if the LNP was in when the GFC was happening!

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/5 1/ Nepean Hospital Branch are joined by Labor Leader Michael Daley and local candidates to support safe staffing at their local hospital 2/ F inley Branch are joined by Shooters, Fishers and Farmers Party candidate Helen Dalton to campaign for safer staffing at their local hospital 3/ S hire Labor candidates Maryanne Stuart and Teressa Farhart join with local nurses to fight for nurse-to-patient ratios 4/ E ast Hills Labor Candidate Cameron Murphy joins nurses from Bankstown and Banks House branches to commit to our claim for patient safety 5/ C entral Coast nurses and midwives join with local Labor MPs Liesl Tesch, David Mehan, David Harris, Jeff Sundstrom and Yasmin Catley to fight for patient safety on the Coast.

THE LAMP MARCH 2019 | 41

Dreaming of Fiji?

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

Experience a holiday in paradise. Relax and unwind.

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

Recruiter’s note: Join online at www.nswnma.asn.au If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entered in to the NSWNMA Member Recruitment scheme draw.

PRIZE DRAWN 30 JUNE 2019

Conditions must be redeemed 42 | apply.

THEPrize LAMP MARCH 2019 by 30 June 2020 and is subject to room availability. Block-out dates include all Australian and NZ school holidays and Christmas / New Year period. The prize will be drawn on 30 June 2019. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/18/02955

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

Perceived barriers and enablers to conducting nursing assessments in residential aged care facilities in Victoria, Australia Bauer, M., Fetherstonhaugh, D., Winbolt, M. Assessment is the foundation of nurses’ clinical practice in that it identifies patient needs; informs care planning, decision making and choice of interventions; and allows the recognition and monitoring of risk (clinical and other) and deterioration of health status.

A nursing assessment takes into account the physical, functional, psycho-social and environmental domains of care (Jarvis et al.

2016) and can be undertaken on admission, at a time of deterioration or when there is a health issue or, as part of a daily focused assessment.

It is well recognised that older people are often frail (Clegg et al 2013), have health problems affecting multiple body systems and are at risk of increased morbidity and mortality (Stuck and Iliffe 2011), particularly if they have dementia (Draper et al. 2011).

This increased medical acuity and complexity of care needs is very evident in the residential aged care sector where common conditions such as dementia (48 per cent), depression (22.5 per cent), arthritis (14.2 per cent), cerebrovascular disease (22.5 per cent), diabetes (6.9 per cent) and pain, falls and urinary incontinence (17 per cent) have a significant impact on care needs (Hillen et al. 2017).

For nurses working in aged care settings this presents many challenges, not least of which is their ability to assess, identify and meet the unique needs of the older person. Both registered

nurses (RNs) and enrolled nurses (ENs) have a vital and central role to play in data gathering and the assessment of residents (Nursing and Midwifery Board of Australia 2016a, 2016b).

Exploring the experiences of internationally and locally qualified nurses working in a culturally diverse environment

linguistically diverse (CALD) backgrounds (NSW Health 2017; Multicultural NSW 2016; NHMRC 2005).

Studies demonstrate that expanding the cultural diversity of health professionals increases effective communication, satisfaction and access to culturally competent health care for patients from CALD backgrounds (Institute of Medicine 2004; Stevens et al.

2003; Hawthorne et al. 2000; Snowden et al. 1995).

O’Callaghan, C., Loukas, P., Brady, M., Perry A.

http://www.ajan.com.au/ Vol36/Issue2/3OCallaghan.pdf

Hospitals are culturally diverse environments due to the cultural diversity of the Australian population and the recruitment of internationally qualified health professionals.

The proportion of the population born overseas has increased from 2011 to 2016 in Australia from 25 per cent to 26 per cent (ABS 2016a), and in New South Wales (NSW) from 26 per cent to 28 per cent (ABS 2016b).

Internationally Qualified Nurses (IQNs) are routinely recruited from overseas to assist with shortages in Australian hospitals (Health Workforce Australia 2012).

As a result, the percentage of overseas-born nurses has increased in Australia, from 25 per cent in 2001 to 33 per cent in 2011 (ABS2013). In 2016, the percentage rose to 38 per cent (Australian Government 2016). ‘Overseas born’ is defined as those who have gained qualifications overseas and then migrated as well as those who have migrated then gained qualifications in Australia.

Australian and NSW multicultural policies acknowledge the importance of language and intercultural skills of culturally diverse staff in working with clients from culturally and

Analysis of interviews to uncover the effects of nurse prescribing on the doctornurse relationship

http://www.ajan.com.au/ Vol36/Issue2/2Bauer.pdf

Pritchard, M. A review of the literature on nurse prescribing would reveal a dichotomy of views, from support of nurse prescribing as a way to improve patients’ care to doctors viewing such a proposal as a step too far.

Yet despite the medical professions opposition the UK government pushed forward with the proposals (DOH 2003; 2002; 2001; 2000; 1999a, 1999b).

Having lost the initial argument the medical profession’s shifted its objections to questioning nurse prescribing in terms of its safety, its comparability and even if it was really necessary (Funnell et al. 2014; Carey et al. 2009, Watterson et al 2009; Bradley and Nolan 2007; Ladd 2005; Fisher and Vaughan-Cole 2003; Rodden 2001; Luker et al. 1998).

What has not been debated or discussed in any great depth is how the introduction of the nurse prescriber may affect the relationship between the nurse and the doctor.

THE LAMP MARCH 2019 | 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 THE LAMP MARCH• 2019 Professional Indemnity Insurance: the limit per claim is now $5 million

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ACROSS 7. Cessation of digestio 8. An inexperienced, naive or gullible person 9. The cavity in the blastula of a developing embryo 13. Symbol for nickel 14. Symbol for europium 15. Chill or rigor; coldness 17. Turning white or greyish 20. Thought, view 21. A highly contagious sexually transmitted

disease 23. Tissue destruction induced by extreme cold 24. Symbol for astatine 25. Electron volt (1.1) 26. Never again 27. To make wet and limp 28. The jerky dancing or leaping that sometimes occurs in chorea 30. A standard of perfection 32. Inspiratory

capacity (1.1) 33. Dystopia; abnormal placement 35. The unit of a hospital in which acute, severe, or urgent illnesses and/or injuries are treated 39. Gums 40. Abnormal falling in of the walls of a part or organ DOWN 1. Any one of the 31 pairs of nerves that arise from the spinal cord

2. A cleft or crack 3. A highly addictive narcotic derived from morphine 4. Tarsi 5. A digit of the foot 6. To penetrate the interstices of a tissue or substance 9. Blood that flows freely through the circulatory system 10. A device for assessing the x-ray machine’s timer accuracy (8.3) 11. The formation and development of tumours 12. The part of a chromosome that is active in gene expression 16. Retinitis pigmentosa (1.1) 18. Automatic Network Operator (1.1.1) 19. Self-centred 22. The soft bottom edge of the outer ear containing no cartilage 23. A medication that reduces fever 29. Sour; sharp to the taste 31. A surgical procedure on the cornea 34. Comply, follow 36. A stunned or bewildered condition 37. A molecule that transfers information essential for protein synthesis from DNA

THE LAMP MARCH 2019 | 45

EARLY BIRD RATES UNTIL 16 APRIL Save up to $10 per registration

Calling all runners, joggers & walkers join us on SUNDAY 12 MAY for the To register

The Mother’s Day Classic held on 12 May is a national fun run raising money for the National Breast Cancer Foundation.

Come along and join in the fun on Mother’s Day as we make our way around the Domain in Sydney, or around any one of the events held across NSW. There are running and walking events to cater for all levels of fitness.

Register and nominate the Association as your team.

All participating members will receive a NSWNMA team running shirt for the day*.

1 www.mothersdayclassic.com.au/register 2 Enter your details and select the event and race 3 When prompted with the page asking if “you would like to join a team” select YES 4 Search and select our team name – NSW Nurses & Midwives’ Association using team password NSWNMA if prompted. *To be eligible for the team running shirt, please register by 10 April.

Volunteers Needed

We are also looking for volunteers at the NSWNMA-sponsored water stations to hand out water and refreshments at the Domain and Parramatta events. Please contact Miriam Galea at events@nswnma.asn.au

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

Card no Signature of Cardholder 46 | THE LAMP MARCH 2019

$

$

Name on Card Expiry Date

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

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Minette Walters, Allen & Unwin Pty Ltd: booktopia.com.au RRP $32.99 ISBN 9781760295875

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The Turn of Midnight

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book club

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

Midwifery at a Glance Eleanor Forrest Blackwell Publishing: booktopia.com.au RRP $104.99. ISBN 9781118874455

This practical guide provides coverage of normal pregnancy, maternal and foetal physiology, and pre-existing medical conditions and how these affect pregnancy and birth. It also features vital information on the role of the midwife, evidence-based practice, health promotion education, and perinatal mental health, as well as neonatal care and an overview of emergency situations.

Midwifery at a Glance, contains superb full-colour illustrations, is written specifically for midwifery students and includes all the concepts found on the midwifery curriculum and demonstrates links with other relevant multidisciplinary healthcare professionals.

Coping and Thriving in Nursing – An Essential Guide to Practice Peter Martin Sage Publishing: sagepub.com RRP $55.99.

ISBN 9781526423610

A unique guide to coping and thriving

in the NHS today. The book is wholly practice-focused, speaking to current standards of care for patients, and current working conditions for staff in the NHS. Written by academics who specialise in mental health, nursing and wellbeing, each chapter provides guidance and support to pre- and post-registration nurses to manage and persevere as a nurse today. This essential first edition includes case studies, reflective practice and mindfulness exercises.

Nursing and Midwifery Research Zevia Schneider and Dean Whitehead Elsevier Australia: booktopia.com.au RRP $102.95. ISBN 9780729542302

Nursing And Midwifery Research: Methods And Appraisal For Evidence-Based Practice 5th Edition has been fully revised and updated to include the latest developments in Australian and New Zealand nursing and midwifery practice. It is an essential guide to developing research skills, critically appraising research literature and applying research outcomes to practice.

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As the year 1349 approaches, the Black Death continues its devastating CI AL course across England. In Dorsetshire, the quarantined people of Develish IN T E question whether they are the only survivors. Guided by their beloved young mistress, Lady Anne, they wait, knowing that when their dwindling stores are finally gone they will have no choice but to leave. But where will they find safety in the desolate wasteland outside?

One man has the courage to find out. Thaddeus Thurkell, a free-thinking, educated serf, strikes out in search of supplies and news. A compelling leader, he and his companions quickly throw off the shackles of serfdom and set their minds to ensuring Develish’s future – and freedom for its people.

Pocketbook of Mental Health, 3rd Edition Eimear MuirCochrane, Patricia Barkway and Debra Nizette Elsevier: http://www.elsevier.com.au RRP $ 59.95 ISBN 9780729542852

With an estimated 450 million people worldwide suffering from mental health problems, more health care workers now need a range of mental health skills in order to provide sufficient care across a variety of settings.

Written by leading authors in their fields, The Pocketbook of Mental Health is a quick-reference resource that delivers practical strategies and skills for allied health and nursing students, health professionals, general practitioners, paramedics, police and allied health workers to implement.

With a focus on social inclusion, recovery, culture and the promotion of consumer rights, this mental health textbook is a guide for holistic modern health care practices.

THE LAMP MARCH 2019 | 47

REVIEWS

Destroyer

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Sharon Ketelaar, RN retired, ex St George Hospital is this month’s reviewers. If you would like to be a movie reviewer, email lamp@nswnma.asn.au

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Dealing with demons In the crime thriller, Destroyer, Nicole Kidman plays Erin Bell, a Los Angeles detective forced to face the past she’s tried hard to forget. When she receives purple ink-stained currency posted to her workplace she realises a dangerous figure has resurfaced from her days as a young FBI agent.

Layer by layer Destroyer reveals the events that haunt Erin from seventeen years before. Erin and another FBI agent, Chris, had been placed undercover into a brutal criminal gang in the Californian desert with disastrous results.

The story is told in two distinct timeframes - flashbacks to a youthful Erin and Chris as accepted members of the gang, and the present day with Erin now a hardened detective with little regard for the rules. She is clearly blind-sided by the re-emergence of Silas, the gang’s unstable and vicious leader, and the fact she is on his radar. Her determination to find him brings her into contact with other past gang members, and her memories flood back to overwhelm her and turn her search to obsession. In seeking revenge she must also face her own culpability in the tragic events of that time.

The flashback scenes highlight Erin’s deterioration by comparison and draw us to empathise and hope that she can find closure. Erin is also struggling in her relationship with her estranged teenage daughter who she fears is slipping into a perilous life with an older man. Despite Erin’s clumsy attempts to heal the rift, there’s no doubt she loves her daughter and she goes out on a limb for a chance to save her.

48 | THE LAMP MARCH 2019

As the story unfolds it is clear Erin’s regrets over past choices have severely impacted her life, and fearing the same fate for her daughter drives her to fully confront her own mistakes.

Ms Kidman excels in this gritty role, a character so unlike those she usually plays. So complete is her transformation into the worn-out and world-weary LAPD cop Erin Bell, she’s hardly recognisable as Kidman.

Destroyer also stars Bradley Whitford (The West Wing) in a small but pivotal role, and Jade Pettyjohn (United States of Tara) who brilliantly plays Erin’s sixteen-year-old daughter Shelby. Sebastien Stan from I, Tonya is Erin’s FBI partner Chris.

Destroyer takes us on a quest for atonement and keeps us guessing. The characters live on the edge and that translates to unrelenting tension that lasts from the opening right through to the final frames.

In cinemas March 21 Email The Lamp by 20 March to be in the draw to win one of 10 double passes to Destroyer thanks to Madman Entertainment.

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

REVIEWS

at the movies Schitts Creek

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Email The Lamp by the end of March to be in the draw to win one of 10 copies to Schitts Creek thanks to Acorn Media. Email your name, membership number, address and telephone numberto lamp@nswnma.asn. au for a chance to win!

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This month’s DVD giveaway is Season 4 of the critically acclaimed series from father/son duo Eugene and Dan Levy.

As season four begins, the Roses are making the most of life in Schitt’s Creek, and —Moira’s constant talk of escaping aside— are finally starting to feel at home in the town. Johnny is busy running the motel with Stevie as his partner. Business is booming, but it’s a challenge for him to balance work and family, while dealing with Roland’s antics. Moira is carrying out her duties with Town Council and the Jazzagals and is also looking for new ways to utilize her talents, whether it’s through a theatrical performance, or by helping Alexis navigate event planning. David is managing his store and attempting to maintain a brand-new relationship, but between struggling to find the time for romance, and overcoming the anxieties of his dating past, this is proving to be a challenge. Meanwhile, Alexis is putting all of her energy into school and her career but is finding it difficult to focus when she still has lingering feelings for her ex-fiancé, Ted.

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Member Benefits THE LAMP MARCH 2019 | 49

DIARY DATES

make a date

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

EVENTS: NSW Omnicare Alliance: The RED Conference A Regional Experience in Practical Dementia Care 28–29 March 2019 Sails Port Macquarie, Port Macquarie red.omnicare.org.au The Art and Science of Spiritual Care Friday, 5 April 2019 The Shalom Centre, 157 Balaclava Rd, Marsfield www.ncf-australia.org Nurses’ Christian Fellowship Professional Breakfast Saturday, 4 May 2019 Neringah Hospital, 4–12 Neringah Ave, Wahroonga www.ncf-australia.org 42nd Australian Association of Stomal Therapy Nurses Conference: Power of Connections – Coming Together 19–22 May 2019, SMC Conference and Function Centre Sydney. http://www.stomaltherapyconference. com/ 2nd Women’s and Newborns Health Conference 3–4 May, 2019, Westmead Hospital Marjan.Khajehei@health.nsw.gov.au EVENTS: INTERSTATE 15th National Rural Health Conference 24–27 March 2019, Hobart, Tasmania www.ruralhealth.org.au/15nrhc/ Lowitja Institute Indigenous Health and Wellbeing Conference 17–20 June 2019, Darwin, NT http://www.nirakn.edu.au/

50 | THE LAMP MARCH 2019

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

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

Priority is given to non-profit professional events.

event/2019-lowitja-instituteinternational-indigenous-healthand-wellbeing-conference/ INTERNATIONAL World Vaccine Congress 14–17 April 2019 Washington DC https://www.terrapinn.com/conference/ world-vaccine-congress-washington/ index.stm Council of International Neonatal Nurses Conference Enriched family – enhanced care 5–8 May 2019, Auckland, New Zealand www.coinn2019.com 7th World Congress on Nursing and Healthcare Recent Innovations for Better Healthcare and The Facets of Nursing 17–18 June 2019 London, UK https://www.scientificfederation.com/ wcnh-2019/ International Council of Nurses 2019 Congress 27 June–1 July 2019 Marina Bay Sands Expo and Convention Centre, Singapore http://www.icn.ch/events/ ICN-Congress-Singapore-June-2019/ International Council of Nurses (ICN) 21st International Conference on Nursing 25–26 September 2019 London, United Kingdom www.icn.ch/ EVENTS: REUNIONS NEC Group February 1976 Intake Reunion – 40 Years since Graduation Possibly March 2019

Marie Sansotta-Allen tealhealthsolutions@gmail.com 0408 979 465 Royal Canberra Hospital PTS March 1979 40-Year Nursing Reunion Saturday 16 March 2019 Canberra Ruth Snowball: 0417062019 ruthsnowball@outlook.com Kerry Taliaferro (Hockley): Kerry.Taliaferro@act.gov.au RPAH April ’79 Graduate Nurses Reunion Saturday 6 April graemechead@gmail.com St Vincent’s Hospital Darlinghurst March 1979 PTS Group 40-Year Nursing Reunion Saturday 4 May 2019 6 pm Polo Lounge, Darlinghurst Mary Norman (Anderson) mary_norman@me.com CROSSWORD SOLUTION

Welcome to

Improved communication channels and engagement

MEMBER CENTRAL

Seamless access to membership details Functionality at your fingertips

THE NEW ONLINE SYSTEM FOR NSWNMA MEMBERS

Unique NSWNMA member login with email

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

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

THE TRANS RESORT BALI, SEMINYAK

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

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

online.nswnma.asn.au

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

Prize drawn 1 Feb 2020

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

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Join the health fund that’s all about you.

At Nurses & Midwives Health, we're all about you.

We're not-for-profit, so it means we're focused on your health and the health of your family. The great news is, as a member of the NSWNMA, you're eligible to join Nurses & Midwives Health.

And, because we know how important family is, they can join us too.

For your free, side-by-side comparison, and our latest offers, visit nmhealth.com.au or call 1300 344 000

Eligibility criteria and conditions apply. Nurses & Midwives Health Pty Ltd ABN 70 611 479 237. NMH-NSWNMA-02/19