SUPERANNUATION
MENTAL HEALTH
INDIGENOUS HEALTH
REGULARS
Robbed in retirement
Staffing win eases strain on mental health nurses
Indigenous kids are “warped” by incarceration
page 18
page 26
page 28
Your rights and entitlements at work Nursing research online Crossword Reviews
THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 77 NO. 5 OCTOBER / NOVEMBER 2020
AGED CARE
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CONTENTS Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including The Lamp subscriptions and change of address, contact our Sydney office. Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au
VOLUME 77 NO. 5 OCTOBER / NOVEMBER 2020
Hunter Office 8–14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962 For all editorial enquiries, letters and diary dates T 8595 1234 E lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee Brett Holmes, NSWNMA General Secretary Judith Kiejda, NSWNMA Assistant General Secretary O’Bray Smith, NSWNMA President Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Liz McCall, Byron Central Hospital Diane Lang, South East Regional Hospital, Bega Valley Printed by Ovato Print Pty Ltd 37-49 Browns Road, Clayton VIC 3168 Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Adrian Hayward, Coordinator. T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General Disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Statement The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information, please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained, you can contact the Privacy Commission. Subscriptions for 2019 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $84, Institutions $140, Overseas $150.
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8
COVER STORY
Nurses are lifesavers for the elderly Having an RN on duty would cut infection rates and deaths in facilities hit by COVID-19.
10
COVER STORY
REGULARS
COVER STORY
5 6 31 33 34 39
Asleep at the wheel The Morrison government and its federal health department failed to prepare the aged care sector after COVID-19’s deadly strike on two Sydney nursing homes.
12
Editorial Your letters Ask Judith What’s on News in brief Nursing Research Online and Professional Issues 41 Crossword 43 Book Club 45 At the Movies
Vital COVID lessons ignored A first responder nurse says the deaths of many nursing home residents could have been prevented.
18
SUPERANNUATION
Robbed in retirement The Morrison government wants to delay the increase in superannuation from 9.5 per cent to 12 per cent – a move that would cost a 30-yearold registered nurse more than $120,000.
24
PUBLIC HEALTH SERVICE
26
NSWNMA wins fit testing for mask wearers The Association has achieved a win in its campaign for better protection of health workers dealing with confirmed or suspected COVID-19 patients.
MENTAL HEALTH
28
Staffing win eases strain on mental health nurses NSWNMA members have won staffing and other improvements at a violence-plagued mental health centre in Newcastle.
INDIGENOUS HEALTH
Indigenous kids are “warped” by incarceration A host of health and human rights organisations are calling for Indigenous children to be kept out of prison.
SUPERANNUATION
MENTAL HEALTH
INDIGENOUS HEALTH
REGULARS
Robbed in retirement
Staffing win eases strain on mental health nurses
Indigenous kids are “warped” by incarceration
page 18
page 26
page 28
Your rights and entitlements at work p.31 Nursing research online p.39 Crossword p.41 Reviews p.43
THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 77 NO. 5 OCTOBER / NOVEMBER 2020
AGED CARE
LIFESAVERS FOR THE ELDERLY Print Post Approved: PP100007890
OUR COVER: Louise Molony Photographed by Penny Stephens THE LAMP OCTOBER / NOVEMBER 2020 | 3
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4
EDITORIAL
BRETT
Holmes GENERAL SECRETARY
Aged care’s moment of truth Scott Morrison’s Australia is not going to be a good place to grow old if the crisis in aged care and the threats to superannuation continue. Aged care nurses did not need COVID-19 to tell them how dangerous the aged care system is. For more than two decades the NSWNMA and the ANMF have been forthright in highlighting how dangerous understaffing in the sector had become. We warned politicians and the community what the tragic consequences would be for many older Australians and their families. Despite numerous inquiries and commissions, reports and research, discussions, conversations, media campaigns and desperate testimonies from our members, nothing has ever been done to make the necessary changes to prevent the suffering and neglect of elderly Australians in our nursing homes. The pandemic has blown up all the weak, dishonest and self-serving excuses for inaction. It has put front and centre the stark reality that the first priority of the sector must be the safety and care of residents. It should not have taken a deadly virus to tell society this obvious fact. For too many politicians and too many providers the priority has been money and profit which has led to cost cutting at the expense of care and safety. The distorted priorities of the sector have been eloquently described by the thinktank Per Capita: “The need to ensure high quality care is fundamentally at odds with the imperative to make a profit from a privatised system of care for vulnerable people.” The COVID crisis is aged care’s moment of truth. It is also a moment of opportunity to reinvent the sector and reset the priorities around safety and care instead of pretending that aged care facilities
‘ The COVID crisis is a moment of opportunity to reinvent the sector and reset the priorities around safety and care.’ are merely a lifestyle choice. The NSWNMA and the ANMF have worked tirelessly to create an alternative vision for the sector. The ACTU and other unions working in aged care – the HSU and United Workers Union – have now joined us to launch a comprehensive plan to fix our broken aged care system. The unions are united in calling for the following changes: • Mandated minimum staffing levels and required mix of skills and qualifications in every residential facility, over every shift • Transparency and accountability for government funding • Mandated training requirements (including infection control and ongoing professional development) accessible to all staff and paid for by the employer • Government funding is required to be increased, linked to the provision of care and the direct employment of permanent staff with decent pay and enough hours to live on. The Morrison government can no longer just look away. It must accept and meet its responsibilities to residents, families and staff. Our members on the frontline in aged care know that having appropriate levels of registered nurses and care workers in the right skills mix is the key to safe care for residents.
Mandated minimum staffing levels must be the government’s urgent priority.
WE HAVE TO REPEL THE ATTACKS ON SUPER We cannot allow the Morrison government to use the cover of the coronavirus to ruin workers’ retirements (see p18). Moves are well afoot by the government to renege on its election promise to raise the super guarantee from 9.5 per cent to 12 per cent by 2025 starting with an initial increase to 10 per cent next year. The increase to workers’ super is already enshrined in law and failing to implement it would be a major betrayal. Even before the COVID crisis the superannuation guarantee rate was not enough to deliver dignity in retirement for all workers. This was particularly true for many women who retire into poverty with just over half the superannuation of men. The government says the increase is unaffordable and that an increase in super would impact negatively on future wages. An army of experts has rubbished this argument. The union movement is proud of its role in the creation of industry super and we will defend our worldclass system that gives some dignity to workers in retirement. n
THE LAMP OCTOBER / NOVEMBER 2020 | 5
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The problems in aged care are not the result of COVID-19. COVID-19 has simply highlighted the long-term systemic problems of understaffing, and of providers putting profits before the residents. Whilst aged care is a federal responsibility, NSW had a unique requirement for a registered nurse to be on the premises 24/7. In 2018, the state government voted not to renew this legislation. When I asked my local Liberal MP why they chose to do this, he answered that some operators couldn’t afford to employ a registered nurse to be on duty 24/7. My answer to that is if an aged care provider can’t afford to pay a registered nurse on duty 24/7, they shouldn’t be running a facility.
Annette Alldrick, Midwife
Mental health needs action, not words Well it’s that time of year again. When workplaces are awash in a sea of yellow and black, companies are spamming us with ‘RUOK’ more times than we can count, and politicians are promoting the day everywhere. It’s the time of year that enrages most mental health nurses and those with lived experience of mental health issues. This is because ‘RUOK’ are just words for a problem which needs actions, and mental health and suicide prevention requires sustained, systemic actions. Mental health is a complex problem greatly exacerbated by real world issues of social welfare and personal crisis. We see politicians promoting RUOK day. These are the same politicians who systematically underfund the necessary solutions to the challenges of mental illness. They gut mental health funding so that mental health nurses can’t provide the care
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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.
that people desperately need. Welfare and disability payments have been stripped to below the poverty line and put shame and stigma on those who need this safety net. Affordable housing is near impossible to find, and public housing is bursting at the seams with people waiting years to have a home made available to them. Mental health care that is available on Medicare in the community is a rare sight, to the point where most people can’t afford to see a psychiatrist. And no matter how hard we fight, they government refuse to give us proper nurse to patient ratios, even though it is a fundamental contributor to nurse and patient safety. If we want to address suicide prevention, mental health care must be adequately funded both for inpatients and in the community. Now more than ever, we must band together and fight for our patients and the community so that we can prevent suicides and guarantee the best possible outcomes for the people who need it most.
Aislynn Kearney, RN
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LETTER OF THE MONTH No leadership in aged care The coronavirus has cranked up the flaws of the aged care sector to deafening decibels so politicians in Canberra can now hear nurses and aged care workers’ cry for help - cries for help that had been ignored for almost a decade! Professor Joseph Ibrahim, Head of the Health Law and Ageing Research Unit at Monash University’s Forensic Medicine Department, told the Aged Care Royal Commission that he believes that Australia’s rate of COVID deaths in residential aged care is more than 68 per cent, the second highest in the world! The aged care sector’s downward slide began when John Howard’s Coalition government implemented the Aged Care Act 1997, and the aged care sector was opened up for privatisation and deregulation. “Cut red tape!” was, and still is, the government’s mantra. “Cut red tape!” meant reduced government monitoring of what Commonwealth subsidies were
being spent on, which resulted in a reduction of nurses and qualified staff. It meant the standards of nutrition and clinical care for our vulnerable residents were not monitored. It meant poor and unreasonable working conditions and low wages for our aged care workers. And it ends with a Royal Commission where we hear tragic stories of unnecessary suffering and preventable deaths of our vulnerable older Australians. This Federal government had been very slow to act. There had been no national coordinating expertise for aged care in response to COVID since February of this year. The Victorian Aged Care Response Centre was only established in July 23, 2020. Our prime minister, Scott Morrison, has refused to accept responsibility for the deadly outbreak of COVID–19 in the aged care sector despite the sector being regulated by the Federal government. If a crisis is a test of character and leadership, then the COVID pandemic has revealed what kind of leaders we have in government. Jocelyn Hofman, RN
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THE LAMP OCTOBER / NOVEMBER 2020 | 7
COVER STORY
Nurses are lifesavers for the elderly Having an RN on duty would cut infection rates and deaths in facilities hit by COVID-19.
T
he chance of a nursing home resident contracting C OV I D -1 9 decreases substantially for every registered nurse employed, recent international studies show. Even an additional 20 minutes of nursing a day per resident was found to cut pandemic deaths and cases by more than 20 per cent. A report published by the Journal of the American Medical Association, which reviewed 4255 nursing homes across eight US states, found nursing homes with more nurses had fewer cases of COVID-19. Another study in the US state of Connecticut found that every 20-minute (per resident day) increase in RN staffing was associated with 22 per cent fewer confirmed cases and 26 per cent fewer deaths, the Sydney Morning Herald reported. In Canada, where more than 80 per cent of COVID cases were in aged care facilities, a study looking at the impact of private ownership of aged care homes said policy should be directed at funding, mandating and enforcing sufficient staffing levels. The Canadian report cited a Californian study that found facilities with fewer nurses than the recommended minimum standard (45 minutes per resident day) were
8 | THE LAMP OCTOBER / NOVEMBER 2020
‘ Governments need to recognise aged care as an integral part of health care, and staff with trained nurses accordingly.’ — NSWNMA Assistant General Secretary, Judith Kiejda
twice as likely to have residents with coronavirus infection than adequately staffed facilities. Assistant General Secretary Judith Kiejda said the US and Canadian findings vindicated our ongoing national campaign for ratios in aged care. In submissions to the Royal Commission t he A NM F ha s advocated for minimum mandated staffing with a skill mix of RNs, ENs and Assistants in Nursing. Previously, the NSWNMA had run a state-based campaign to ensure RNs were employed in nursing homes around the clock after federal legislation removed the distinction between high and low care in 2014. This led the NSW government to decide that no aged care operator would be required to employ an RN or appoint a DoN.
Decisions regarding staffing would be left for operators to make, and the aged care regulator to monitor. “The government’s move ignored the fact that increasing numbers of high-care residents were being admitted to residential facilities,” Judith said. “Also, a growing number of highcare residents were being cared for in former low-care ‘hostels’ where RNs were not legislated.” The campaign gathered over 25,000 community signatures.
NATIONAL CAMPAIGN FOR MINIMUM STAFFING CONTINUES The state government implemented a transitional regulation that ‘grandfathered’ the requirement for an RN to be on duty at all times, and a DoN in facilities that were classified as nursing homes prior to 1 July 2014.
COVER STORY
Public homes safer in pandemic However, its continuation relies upon annual lobbying from the NSWNMA and community groups. “This provides only a tenuous safeguard for highcare residents and RNs employed in former nursing homes,” Judith said. “G ove r n m e n t s need to recognise aged care as an integral part of health care, and staff with trained nurses accordingly. “Our national campaign will continue for minimum staffing ratios of RNs, ENs and AiNs/care workers, including a clinical director or director of nursing who is an RN. “COV I D -19 ha s a lso h i g h l i g hte d t he ne e d for facilities to appoint a clinician responsible for infection prevention and control, who could also be the DoN or an RN with additional qualifications.” n
Non-government nursing homes in Victoria, which have no legislated staff ratios, have experienced 40 times more cases than public homes that have mandated ratios for nurses. In August, Victorian Premier, Daniel Andrews, said government-run nursing homes, which have about 5400 beds, had six cases of COVID-19, a rate of about 0.1 per cent. In contrast, there had been 1923 cases in non-government homes with 44,600 beds, a rate of 4 per cent.
Regulators failed to plan for COVID-19 During hearings at the aged care royal commission in August, counsel assisting the commission, Peter Rozen QC, criticised the Aged Care Quality and Safety Commission (ACQSC) for failing to plan for COVID-19. “The evidence will reveal that neither the Commonwealth Department of Health nor the aged care regulator developed a COVID-19 plan specifically for the aged care sector,” Mr Rozen said. “Given that it was widely understood that recipients of aged care services were a high-risk group, this seems surprising.” He also said it was surprising the ACQSC had not investigated the circumstances of the Dorothy Henderson Lodge and Newmarch House outbreaks in Sydney, despite incident investigations being “normally one of the key tasks of any regulator”. Monash University professor Joseph Ibrahim, a leading authority on aged care, told the royal commission: “The system is broken. And what we’ve seen with COVID is that the system is broken at a high level because it’s not the aged care workers that have failed us in this. “It is our people who are in governance roles – and I’m not going to call them leaders because they’re not leading – the people in governance positions who are accountable for what happens is where we have failed. “They have not recognised the magnitude of the problem staring them in the face.”
‘It’s not the aged care workers that have failed us in this.’ — Professor Joseph Ibrahim
THE LAMP OCTOBER / NOVEMBER 2020 | 9
COVER STORY
Asleep at the wheel The Morrison government and its federal health department failed to prepare the aged care sector after COVID-19’s deadly strike on two Sydney nursing homes.
T
he Morrison government and its bureaucrats failed to act to defend nursing homes even after COVID19 tore through facilities in Europe and the USA, and 25 residents died at Newmarch House and Dorothy Henderson Lodge in Sydney. Federal government inaction was exposed during hearings at the aged care royal commission. Counsel assisting the commission, Peter Rozen QC, said the federal government “was firmly on notice early in 2020” about the challenges the aged care sector would face from COVID-19. However, the sector had been “hindered in its response by a lack of coordinated planning by all levels of government.” Rozen said there was “reason to think that in the crucial months between the Newmarch House outbreak in April and mid-June, a degree of self-congratulation and even hubris was displayed by the Commonwealth government.” He noted that the federal health minister, Greg Hunt, claimed in late July that “aged care around the country has been immensely prepared”. Rozen said aged care minister, Richard Colbeck, wrote to nursing
10 | THE LAMP OCTOBER / NOVEMBER 2020
‘A degree of selfcongratulation and even hubris was displayed by the Commonwealth government.’ — Peter Rozen QC
home operators on 7 July telling them they had “responded incredibly well to the unprecedented challenges of COVID-19”.
sibility for the sector it is supposed to regulate, the Morrison government tried to distance itself and blame the Victorian government.
“Although the minister urged continued vigilance and warned that the battle was not yet over, there was no real sense of urgency in the letter,” Mr Rozen said.
COV ID -19 had k illed 550 Victorian nursing home residents by 10 September.
“There was no suggestion, for example, that providers should consider asking their employees to wear masks.” Lessons from Newmarch House and Dorothy Henderson Lodge “were not properly conveyed to the sector and as a result the sector was not properly prepared in June 2020 when we witnessed high levels of community transmission of the virus in Melbourne”. “Based on the evidence you have heard the sector is not properly prepared now.” (14 August) Rather than accepting respon-
FEDERAL GOVERNMENT FAILED TO LEARN LESSONS As political commentator Niki Savva noted in The Australian newspaper: “No one seriously believes or expects that every one of those deaths could have been avoided. However, the question not properly answered is why it took so long for the Morrison government to act in an area it controls. “It was the federal government’s duty to develop a rapid-response plan months ago, particularly after (deaths) in Newmarch House and Dorothy Henderson Lodge in NSW in March and April. It still hasn’t been done,” Savva said (20 August).
COVER STORY
‘The question not properly answered is why it took so long for the Morrison government to act in an area it controls.’ — Niki Savva
The federal Department of Health commissioned Professor Ly n Gilber t, cha ir person of the depa r t ment ’s Infect ion Control Exper t Group, to do an independent study of t he COV ID 19 outbreak at Dorothy Hender son L o dge “to understand what occurred and what could be learned from the experience”. Prof Gilbert’s report warned of problems in keeping staff, recruiting agency nurses and sending residents to hospital during the nation’s first major COVID-19 outbreak in an aged care home. Her report went to the department on 14 April, but it did not make it public until August, when Victorian nursing homes had already suffered almost 200 deaths. Federal health department secretary, Brendan Murphy, argued in July that authorities could not foresee the sudden withdrawal of most workers from the St B a s i l ’s hom e in Melbourne because it had not happened elsewhere.
However, three months earlier, Prof Gilbert’s report had wa rned Mur phy ’s department of lessons from Dorothy Henderson Lodge and Newmarch House, where an estimated 87 per cent of workers had to go into quarantine. Secretary Murphy and M inister Colbeck a lso maintained that the public had no right to know which Victorian aged care facilities had COVID-19 cases. At a hearing of the Senate committee monitoring the government’s response to the pandemic, Greens senator Rachel Siewert sought this information, asking for details of providers, cases and deaths. Murphy asked if he could provide the information to the committee in secret. “Some of the facilities don’t want it publicly known that they have outbreaks,” Murphy said. “And they’re obviously worried about reputational issues.”n
Minimum staffing levels top Labor’s agenda Federal Labor has put aged care reform high on its agenda and issued an eight-point plan for the sector. Federal Opposition leader, Anthony Albanese, said the government had failed to adequately prepare the sector for the pandemic and “failed to protect” older Australians. The eight Labor proposals are: 1. Minimum staffing levels in residential aged care 2. R educe the home care package waiting list so more people can stay in their homes for longer 3. Ensure transparency and accountability of funding to support high quality care 4. Independent measurement and public reporting as recommended by the Royal Commission 5. E nsure every residential aged care facility has adequate personal protective equipment 6. Better training for staff, including on infection control 7. A better surge workforce strategy 8. Provide additional resources so the aged care royal commission can inquire specifically into COVID-19 across the sector, while not impacting or delaying the handing down of the final report.
THE LAMP OCTOBER / NOVEMBER 2020 | 11
COVER STORY
Vital COVID lessons ignored A first responder nurse says the deaths of many nursing home residents could have been prevented.
D
uring four week s in qua ra nt ine, reg istered nurse Louise Molony had time to reflect on the events that led to her becoming infected with COVID-19 at a Melbourne nursing home. Her i n fe c t ion , a nd t he infection and deaths of many aged care residents, could have been avoided by heeding lessons learned at Sydney’s Newmarch House, Louise believes. Louise, an NSWNMA member, was a first responder at Newmarch and two Melbourne facilities hit by the virus. Her experiences in these facilities were reported by the Sydney Morning Herald and The Age. Louise worked as a public hospital and aged care RN for 30 years in regional NSW and Canberra before taking a contract job with Aspen Medical, an agency contracted by the federal government to help facilities deal with COVID-19 outbreaks. Aspen sent her to Newmarch for three weeks, followed by a stint at Lynden Aged Care in the Melbourne suburb of Camberwell, a standalone, 12 | THE LAMP OCTOBER / NOVEMBER 2020
‘I’m angry and frustrated that so much of this tragedy could have been avoided.’ — Louise Molony
not-for-profit facility. Her final assignment was at forprofit Estia Health’s facility in the suburb of Heidelberg. She quit at the end of the first day. “Newmarch gave Melbourne the template but they didn’t use it,” she says. “I never dreamed that Estia would be worse than Newmarch. It was just too dangerous to stay,” she says. A week later she tested positive for COVID-19, contracted at Estia Heidelberg. It had recorded 118 COVID-19 cases and 10 deaths by 11 September. By that date, a total of 554 aged care residents in Victoria had died from COVID-19 out of 581 deaths nationwide.
A V ic tor i a n gover n ment breakdown of 2281 healthcareacquired COVID-19 cases (as of 10 September) showed that 61 per cent (1407) worked in aged care. “I’m angry and frustrated that so much of this tragedy could have been avoided,” Louise says. Louise quarantined at home, separated from her husband and son by curtains hung in a hallway. The men had to walk out the front door and down the side of the house to get to the kitchen. Her husband Michael cooked her meals and pushed them under a curtain. Out of quarantine, Louise told The Lamp she arrived at Anglicare’s Newmarch House on 2 May. The facility had lost many of its employees and was struggling to provide care to about 100 residents,
COVER STORY
‘They all talked too much and wouldn’t listen to the people actually looking after the patients.’
without adequate staffing and support, as an inquiry headed by Professor Lyn Gilbert found (see story page 10-11). “PPE wasn’t being distributed properly and some of it wasn’t appropriate,” she says. “Infection control was poor; people were working across both COVID and non-COVID wings, and bins were overflowing with used PPE. “Communication and clinical organisation were poor. “Aspen had no aged care experience and didn’t want to listen to their aged care RNs on the floor. “It took over a week to fix Anglicare’s roster, which wasn’t able to coordinate the various staffing agencies and ensure that a person only worked on one wing. “That was necessary to prevent cross-infection and get continuity so staff could become familiar with patients and report back to families.” Louise said Anglicare Newmarch management expected nurses to
keep track of how much PPE was used and write on a board how much would be needed each day. “I told them we are supposed to be looking after patients and they should have at least two people just to keep track of how much PPE is needed and distribute it to each wing. “It wasn’t until Commonwealth infection control liaised with NSW Health infection control that we got the right PPE, including N95 masks, and got PPE stations and distribution set up properly. “Each of the Aspen RNs were put in charge of a wing but we had no input into the frequent meetings between Anglicare Newmarch, Aspen and government agencies in the front office. “They all talked too much and wouldn’t listen to the people actually looking after the patients.” Louise’s account is reinforced by Prof Gilbert’s findings. She reported it was often unclear who was in charge at Newmarch. A host of government agencies
and providers were engaged in an “onerous” daily round of meetings that were “often not conducive to collaboration” and put further stress on frontline staff “attempting to manage an unprecedented crisis,” Prof Gilbert found. Louise was shocked at the way doctors were treated at Newmarch by Anglicare. “We had good doctors who were trying to get teams going with the nurses to get things done. That’s how I’m used to working. “But Anglicare management would pull doctors and nurses aside and demand to know, ‘Why are you spending so much time doing this?’ “I was told off for interrupting a meeting to get a doctor to attend to a patient in pain who had waited a long time for treatment.” T he outbrea k k i l led 19 Newmarch residents, with 17 deaths directly attributed to COVID-19 – a mortality rate of 46 per cent of infected residents. At Lynden in Camberwell, Louise said she “got into trouble” CONTINUED OVER THE LAMP OCTOBER / NOVEMBER 2020 | 13
COVER STORY
VITAL COVID LESSONS IGNORED CONTINUED. with Aspen management for attempting to pass on lessons from Anglicare Newmarch. “Lynden had PPE distribution working well but had lost almost all of its staff. Aspen wanted to send something to the effect of three AiNs and two RNs as the total surge workforce for about 100 residents. “I said they needed double the usual staff levels to make sure PPE goes on properly and extra cleaning is done. “Extra staff were also needed to spend time with residents who were locked in their rooms, with no companionship or opportunity to exercise.” She said Aspen management reluc t a nt ly accepted her proposal that an RN be placed in charge of each wing of Lynden to ensure continuity and better communication. The situation at Estia Heidelberg, which had lost all its regular employees, was even worse. The Age newspaper reported on notes made by a doctor who attended the Heidelberg home the morning before Aspen and Louise got there. The doctor wrote that crosscontamination was rife. By 11 am, no resident had been fed or given medication. Three patients who didn’t have COVID-19 needed to be transferred to hospital.
On the day Aspen took over Heidelberg there were only four staff – Louise, a recent graduate, an EEN and a care worker – plus two Estia managers, who were also RNs, who were doing admin and dispensing pills. They were expected to care for 50–60 residents, including some infected with COVID19. Some needed oxygen and intravenous fluids. “They should have had five carers on each of the three wings to provide safe care,” Louise says. Louise said more Aspen staff were available but confusion as to who should do the roster, Aspen or Estia, meant they did not arrive as they had not been given a roster. There were no N95 masks and the wrong gowns. Louise had to convince a young and uncertain doctor to send a woman with breathing difficulties to hospital to get oxygen. O ut side t he bu i ld i ng , families were clamouring for information. Louise spent most of the day – 12 hours without a break – on the phone to relatives and the hospital. N95 masks arrived later that day but Louise – and, she suspects, other workers forced to use inadequate surgical masks – had already been infected. n
STOP PRESS Contact us if you worked at Newmarch House during the COVID-19 outbreak. The NSW Coroner is investigating the deaths at Newmarch House. Police are seeking statements from all nurses who worked there during the COVID-19 outbreak. If you’re asked to provide a statement or attend an interview by your employer, a police officer representing the coroner, or the HCCC, please contact the Association first on (02) 8595 1234 or bit.ly/ContactNSWNMA 14 | THE LAMP OCTOBER / NOVEMBER 2020
Government ‘had no plan’ The federal government would have been better prepared for COVID-19 outbreaks at Newmarch House and other nursing homes if it had acted on the 2019 interim findings of the Aged Care Royal Commission, a leading aged care authority said. Monash University Professor Joseph Ibrahim told Newscorp’s Aged Care News360: “We knew about the lack of coordination between federal and state departments and the providers were not up to managing a COVID pandemic, yet we hand over the residents as if they are possessions to be owned by the provider to make money from but not provide the care that’s needed.” He said the federal government had no plan only a set of “farcical” guidelines that “they put a disclaimer to.” He said the guidelines were framed so providers had to negotiate with hospitals, arrange for PPE and “organise the entire program”. “If the government had looked to what Hong Kong did with the SARS epidemic, we would have known well in advance what to do with having infection control nurses present, better training, better surge workforce, better coordination between state and federal public health units, and we would have avoided all the messing about that has led to the deaths of people.”
COVER STORY
Staff cuts continue despite pandemic Rather than employing more workers to cope with COVID-19, many nursing homes have cut staff numbers.
S
ixty-four per cent of aged care workers reported staff cuts since the beginning of March, a survey by the Australian Nursing and Midwifery Federation (ANMF) revealed. ANMF federal secretary, Annie Butler, told the Aged Care Royal Commission that it took more than a month, and media attention, to be granted a meeting with the federal aged care minister, Richard Colbeck, to discuss the “astonishing” issue. “There was supposed to be money dedicated specifically for increasing staffing and skills but there’s no accountability. There’s no checking of where that money has gone,” Annie said. “I n Q ue en sla nd , S out h Australia, Tasmania, Victoria and some parts of NSW, aged care providers are actually cutting staff. “We were told at the time we did our survey that some providers had cut staff from 1 March but over the last month or two, the feedback from members and even from
employers directly, is that their cutting [of] staff has increased.” Annie also said members had reported “incredible breaches of infection control”, with workers telling the union “they could only use one glove rather than two” to conserve PPE while others were “told to reuse equipment – put it in collective plastic bags”. Most of the 1513 members who took part in the ANMF survey were from NSW, Queensland and Victoria, were AiNs/PCWs, were women, and worked part-time. Prominent victims of staff cuts were casual workers forced to choose between employers as they were only permitted to work at one facility. Agency staff were also reported to be particularly impacted by cuts. Staff cuts were more common at facilities owned by forprofit providers. Almost half (43 per cent) of participants did not feel prepared for a COVID-19 outbreak in their workplace. n
‘There was supposed to be money dedicated specifically for increasing staffing and skills but there’s no accountability’— Annie Butler, ANMF Federal Secretary
Minister doesn’t want to know ANMF federal secretary, Annie Butler, has called on the Morrison government to work with nursing unions to fix the crisis in aged care. “Since the start of the pandemic the ANMF has written and been in contact with aged care minister, Richard Colbeck, on at least eight occasions, offering our help and advice on the mounting issues plaguing the sector, particularly around inadequate staffing, shortages of PPE and other workforce support measures,” she said. “Unfortunately, the government has not responded and has not implemented actions, which may have provided better protections for elderly Australians. “The untold grief and trauma that too many have already had to experience cannot be undone, but the government has the power, and the responsibility, to take our advice and act immediately on our action plan.” The plan includes: • No more cuts to nursing and care. • Ensure sufficient numbers of qualified staff with the right skills mix and mandate minimum nursing/care hours, to properly prepare a suitably skilled workforce in the event of further infection outbreaks. • Ensure enough PPE and clear guidance, education and training for all aged care staff. • Guarantee paid pandemic leave for all workers who need to stay home because they need to get tested and self-isolate due to exposure to COVID-19 or they’re feeling unwell.
THE LAMP OCTOBER / NOVEMBER 2020 | 15
COVER STORY
Battling the ‘stigma’ of aged care Aged care workers should be appreciated and recognised more for their commitment and care for the elderly, says Susan Ginty. “I am an aged care worker” is a statement many may find hard to express these days, says RN Susan Ginty. Susan works at an aged care facility in Sydney. A former theatre nurse, she “fell in love” with aged care when she returned to nursing after a decadelong stint running a hotel. She says many aged care workers feel “demonised” in the current climate of the COVID-19 pandemic, the Royal Commission into Aged Care and “an aggressive media that only focuses on the negative stories”. Sydney’s Newmarch House facility was subjected to “trial by media” during its COVID-19 outbreak, she believes. “The media bombarded us with images of distressed families unable to see their relatives and the ‘inadequate response’ of Newmarch House. “Meanwhile Premier Gladys Berejiklian used further negative phrases such as ‘aged care must lift their game’. “There was nothing positive said about the many nursing homes and thousands of nurses and carers working hard and giving really good care to their residents. “The virus had just spread to Australia and mistakes were being 16 | THE LAMP OCTOBER / NOVEMBER 2020
made in many sectors, such as the cruise ship fiasco, hotel quarantine errors and the government itself not taking control of the issue. “Governments and the community were unprepared for this silent killer.” Aged care workers continue to feel stigmatised by the media, she says. “We are mentioned in relation to outbreaks and lead cluster-related morbidity charts. “We are mentioned in relation to elderly abuse perpetrated by a very few people in relation to the total aged care workforce. “We are mentioned in a gruesome account of a domestic murder where the public is informed that the perpetrator is ‘a worker in aged care’. “The public take all this on board and aged care workers are seen as being uncaring or callous. This is so far from the truth.” Susan contrasts the “stigma” of working in aged care with public
appreciation for hospital staff. “Hospital nurses are hand clapped en masse, have teddy bears put out on verandahs in appreciation, are thanked by politicians and portrayed with angel wings on advertisements – accolades which they truly deserve. “However, all nurses have the same goal – to help the sick or dying – regardless of where they work.” Susan says staff at her facility have worked hard to take extra steps to safeguard residents against COVID-19. Susan says it’s impossible to know if these measures will prevent a COVID outbreak. However, “families of residents are very thankful their parent or family member are in a well-run and caring facility”. “Our facility is not unique – there are so many great nursing homes with wonderful staff who give their residents genuine warmth, compassion and kindness.” n
‘ All nurses have the same goal – to help the sick or dying – regardless of where they work.’ — Susan Ginty
COVER STORY
Pandemic exposes weak clinical care The coronavirus pandemic has highlighted the importance of quality clinical care for elderly residents, says Loureene Kelly, a South Coast aged care worker. “Before COVID, people tended not to appreciate the clinical side of aged care,” says Loureene, who has worked as an aged care assistant in nursing for several years and is studying for a nursing degree. “More people are starting to understand that aged care is a lot more than just helping someone get dressed and making them cups of tea. “Providing a good home and lifestyle activities are important, but so are the clinical and medical aspects of the job. “COVID has made families more aware of the isolation that can happen in aged care. I’m definitely noticing more people trying to visit their parents, which means they can get a better idea of the work we do to care for them.” Loureene was surprised by the absence of nurses at night and on weekends when she started at her current facility. She came to realise this is the reality for many aged care homes. “Since COVID my facility has taken on more RNs and an EN, so there is more nursing coverage, which takes the pressure off AiNs.
‘ AiNs are constantly put at risk due to lack of staffing support and increased responsibilities beyond their training.’ — Loureene Kelly “If there are not enough nurses, then AiNs have to take on responsibilities they are not adequately trained for, including aspects of medication, wound care and palliative care. “They are big responsibilities with serious outcomes for our residents if they are not performed correctly. “AiNs are the backbone of aged care and the first responders to their residents, but they are constantly put at risk due to lack of staffing support and increased responsibilities beyond their training, which is not reflected in their wages. “Caring for the elderly – including end-of-life care – can be quite complex. AiNs need to be sufficiently supported on the floor by nursing staff and by upper management, and given opportunities for further training and education.”
Loureene says the pandemic has also highlighted the need for staffing ratios in aged care. “Every facility I’ve worked in has had staffing issues but since the virus, we’ve really struggled to keep adequate staff on the floor.” The pandemic has forced the closure of Loureene’s twice-weekly university classes, and she has had to switch to remote learning. “There is little opportunity to speak directly to a lecturer, even online,” she says. “As a result of remote learning, lecturers are under a lot of pressure to deliver a brand-new curriculum with greater time restraints. “It’s harder for students to pick up practical skills, and exams have been replaced by assignments, which are more time consuming.” n
THE LAMP OCTOBER / NOVEMBER 2020 | 17
SUPERANNUATION
Robbed in retirement The Morrison government wants to delay the increase in superannuation from 9.5 per cent to 12 per cent – a move that would cost a 30-year-old registered nurse more than $120,000.
O
n 1 July 2021, your super will increase without you having to do anything.
for super to be optional for workers, or to be used to live on during the coronavirus crisis or to buy a house.
Unless, that is, an influential group of federal Liberal MPs gets its way and torpedoes the rise.
If implemented, these proposals would fundamenta lly change A u s t r a l i a’s world-re spected superannuation system.
Increasing employer contributions to super – known as the “super guarantee” – has already been legislated. The super guarantee is scheduled to rise from 9.5 per cent to 10 per cent next year and to 12 per cent by 2025.
The ACTU has calculated a further delay in the super guarantee would cost a 30-year-old registered nurse $121,807 at retirement and a 30-year-old aged care AiN $67,435 in retirement savings.
The increase was legislated to come into effect in 2015 but was delayed by the Abbott government. Now Prime Minister Scott Morrison, Treasurer Josh Frydenberg, and assistant superannuation minister, Jane Hume, have put into doubt the super increases, arguing they are unaffordable and would hurt wages and cost jobs. A group of Liberal Party backbenchers goes even further. They too have called for the increase in the super guarantee to be delayed or cancelled. But they have also called 18 | THE LAMP OCTOBER / NOVEMBER 2020
EMPLOYERS “ARE LICKING THEIR LIPS” While these prominent members of the Liberal Party, along with sections of the financial media and business groups, argue a rise in super
would lead to lower wages, other economists strongly disagree. “The argument that if you just give up your super increase, you’ll get more in your pay packet, that’s utopian dreaming. What you will get instead is none of both,” says economist Jim Stanford from the Australia Institute. He says that the sluggish growth in real wages over the past few years, even though there’s been no increase to super, shows the link doesn’t exist. The share of profit enjoyed by business owners “has hit all-time records since 2017”, Stanford says. “Because of the pandemic and how it’s shaped the labour market, I think employers are licking their
‘ The argument that if you just give up your super increase, you’ll get more in your pay packet, that’s utopian dreaming. What you will get instead is none of both.’ — Jim Stanford, Australia Institute
SUPERANNUATION
Work without end Even though she has been nursing since she was 18 years old, RN (and acting CNC) Jacquie Myers still won’t have enough super to fully retire.
lips at the prospect of both freezing and restricting wages and restricting super increases.”
THE LIBERALS’ “FRAUDULENT ARGUMENT” The claim that the super increases are unaffordable has also been rubbished by former prime minister Kevin Rudd. Rudd labelled it a “fraudulent argument” to claim the super rises would come at the expense of wages. He said wage increases “had been negligible” in the years before the COVID-19 pandemic. “It has no statistical foundation, no logical foundation, no data to support it,” he said. Experts point out that the scheduled increases are a third of the most recent increase in the minimum wage, and a sixth of the one before that.
“I started work at 18 years old. I was in the public health sector, so I joined NSW State Super. But back in the 1980s, when I fell pregnant with my children, you could only come back to full-time work. I had to go to private sector work so I could work part-time while I was caring for children. State Super paid me out in 1983; I couldn’t leave my super in there because I wasn’t … in the public sector. They paid seven and a half years’ worth of super into my bank account. My husband was working in the Electricity Commission then, and he was on strike for eight months, and so we had to use that money to live and pay the mortgage and electricity. We had one baby and
another one about to be born. We considered ourselves lucky that we got that seven and a half years’ super then. But if I had kept it in State Super, I would have a motza now. Kids today who are in this COVID world, I don’t blame them for dipping into their superannuation. I was in the same situation, and it isn’t fair. I’m one of about 10 women in a group of friends where we all had our babies in the ’80s, and the only way you could work full-time and have children was to work nights. I didn’t go back to full-time work until my kids were in high school. We don’t have enough to retire on comfortably, so my plan now is that we [myself and my husband] will probably still continue to work part-time. My husband will work part-time as a bus driver and I will do agency work. My friends and I are supposed to be retiring, but we are all doing agency work to make life a little bit more comfortable.”
‘ My friends and I are supposed to be retiring, but we are all doing agency work to make life a little bit more comfortable.’ — Jacquie Myers
Federal politicians have a 15.4 per cent government contribution into their parliamentary retirement accounts. n
THE LAMP OCTOBER / NOVEMBER 2020 | 19
SUPERANNUATION
Super withdrawal scheme puts burden of COVID crisis on the young Many experts see the super early release scheme as poor policy.
M
ore than 600,000 young people under the age of 35 have completely drained their superannuation accounts following the introduction of the government’s super early release scheme. The Morrison government says the early release scheme allows people access to their money to help them in a time of financial hardship. But Paul Keating, the key architect of compulsory super, says the opposite is true: early access to super savings is not about the government helping people through a time of hardship but about those people helping the government through a time of hardship by shifting much of the cost of stimulus on to workers, particularly the young. “Of the income support to date, in this COVID emergency, $32 billion has been paid for by the most vulnerable, lowest paid people in the country – that’s the people who have taken $20,000 out – and $30 billion has been provided by the government under JobSeeker and JobKeeper,” he told an Industry Super Australia (ISA) seminar. According to the Australian Prudential Regulatory Authority (APRA), Australian workers took more out of their super accounts in the June quarter than what they put 20 | THE LAMP OCTOBER / NOVEMBER 2020
Early access to super savings is not about the government helping people through a time of hardship, but about those people helping the government through a time of hardship by shifting much of the cost of stimulus on to the young. — Paul Keating in. It is the first time there has been negative net contributions since the compulsory retirement scheme was introduced in 1992. Matt Linden, deputy chief executive of ISA, says all members of super funds are negatively impacted by the early release scheme, not just those who withdraw from their accounts. He says super funds have had to “shift their asset allocation from growth assets into cash, which basically earns members nothing, almost nothing” in order to meet the demand for the early release of super. “No one doubts that there is real financial hardship out there and superannuation has an important role to play – but the system was never designed to be a broad-based social insurance model. The level of contributions to sustainably support that would be at least twice
the current levels,” he told The Saturday Paper. A survey by analytics consultancy Alpha Beta and credit bureau Illion showed that much if not most of the money released under the scheme did not even go towards relieving hardship. It found 40 per cent of these people saw no drop in their income during the COVID-19 crisis and spent the money on nonessential consumption. “On average, people withdrew around $8000 and spent an extra $2855 in two weeks, compared with the same group’s average spending in a normal fortnight,” their survey found. “Sixty-four per cent of the additional spending was on discretionary items such as clothing, furniture, restaurants and alcohol.”
SUPERANNUATION
‘ In terms of taking money out of superannuation during COVID, (people in their 20s and 30s) might not think of the consequences.’ —Annie Smoker
“Asking young people to dip into their super now is a total cop out”
Super creates jobs
Inadequate super compounds the financial losses from the NSW public sector pay freeze, says RN Annie Smoker. “Superannuation is not really something that people in their 20s or 30s really think about. In terms of taking out money out of their superannuation during COVID, they might not think of the long-term consequences. They see a dollar figure and think ‘Great, let me access that’ without thinking of the future. “Then some people wouldn’t feel the pressure to take out their money. It makes me really mad that the government is asking us to go above and beyond in high-risk areas during COVID, while they are not supporting us financially. “Nurses are really fortunate that we still have jobs, but we shouldn’t have to take on added pressures. The government is giving bonuses and pay rises to people who are already earning over $300,000, but nurses who are on the frontline are being asked to take a pay cut in real terms. “Asking young people to dip into their super now is a total cop out. This is an economic crisis. The government should be able to manage the budget and pay frontline workers properly. The lost money is noticed by someone who is on $60,000 or $80,000 a year.”
Superannuation not only provides the basis for a comfortable and dignified retirement for workers; it also works for the national economy and creates jobs. Industry Super Australia forecasts it will be investing $19.5 billion in projects that will create over 200,000 direct jobs between 2020 and 2023, which will turbocharge our economic recovery from the coronavirus. Industry super funds also support the industries they are invested in. HESTA recently committed to building an expanded residential care facility, which directly supports the employment of their members. Australian Super and other funds have committed to building affordable housing that will employ thousands of workers. THE LAMP OCTOBER / NOVEMBER 2020 | 21
SUPERANNUATION
Abbott’s super freeze cost Australian workers $5,425 each After the Abbott government delayed the super increase in 2014 the money ended up in the pockets of employers not workers, according to a report by thinktank Per Capita.
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he Morrison government is repeating the same arguments used by Tony Abbott in 2014 to justify delaying the super increase after promising in the 2019 federal election campaign to implement it.
So as a result of the last freeze on the Super Guarantee, the average Australian worker has lost $4,333 in super, and their take-home pay has declined by $1,092.00 a year in real terms, giving them a net loss of $5,425.
When asked in parliament about his reasons for freezing the rate at 9.5 per cent for seven years, the then prime minister, Tony Abbott, said: “Money that would otherwise be squirrelled away in superannuation funds will instead be in the pockets of the workers of Australia.”
Emma Dawson, the executive director of Per Capita says “contrary to Abbott’s promises that the money would go into workers’ pockets, it has been pocketed by their employers instead”.
An analysis by the thinktank Per Capita this year showed what nonsense that promise was. Since the super freeze of 2014, a worker on the full-time median wage has lost $4,325 in superannuation. Over the same period, the median wage rose from $52,000 to $55,432 a year. However, when adjusted for inflation and looking at real wage growth, the median wage actually fell – from $56,524 in today’s dollars to $55,432.
“A nd while the Morrison government – whose members receive superannuation contributions of 15.4 per cent – considers again blocking an increase to 12 per cent for the rest of us, perhaps the PM can explain why the low- and middle-income Australians who have worked tirelessly to provide essential care and services during this pandemic deserve a second-class standard of living in retirement.”
‘ Perhaps the PM can explain why the low- and middle-income Australians who have worked tirelessly to provide essential care and services during this pandemic deserve a second-class standard of living in retirement.’ — Emma Dawson, executive director of Per Capita 22 | THE LAMP OCTOBER / NOVEMBER 2020
What you can do Sign the petition: Australian unions won superannuation for it to be the best retirement income system in the world. We need to protect these hard won gains and to strengthen our superannuation system. Show your support and sign the ACTU petition: https://www.megaphone.org. au/petitions/don-t-let-themorrison-government-ruinour-retirement
More information
Read: The ‘Herstory’ of Superannuation: This report by Per Capita looks at the history of superannuation for Australian women to mitigate women’s vulnerability to poverty in retirement. https://percapita.org.au/ our_work/the-herstory-ofsuperannuation/ FAQs on super and COVID-19: Industry Super Funds answers all your questions on how your fund is responding to the coronavirus. https://www.industry super.com/super-to-help/ questions-on-super/ Calculate: the amount of your super after the increase to 12 per cent. https://www.industrysuper.com/campaigns/ yoursuperguarantee/
NSWNMA
LIVE WEBINARS
NMA
nNSW o i t a c u d e / y bit.l
PROFESSIONAL EDUCATION Other Webinar Topics: We have some exciting new webinars from a range of presenters. Topics include:
Documentation
Flattening the climate change curve: what every nurse/midwife needs to know
Continuing Professional Development (CPD): Your Annual Obligations
Responding to the climate health emergency – are we ready?
Law in Nursing and Midwifery Practice
Everything a nurse needs to know about vaping
Co-Regulatory Model in NSW
The Science of Misinformation: Know the difference between fake news, misinformation and disinformation
Assertive Communication
Determining Credibility: Cut through the noise to determine the truth Aged care and burnout – exploring the research Mental health and well-being in the new normal
Communication Medication Principles
Coronial Inquests Professional Obligations for nurses and midwives Social Media and your professional obligations
We also have webinars that we have developed specifically for newly graduating nurses and midwives: Student to New Graduate: What you need to know Guide to Registering for the first time with the NMBA
Search the date and times for the range of upcoming webinars at
bit.ly/educationNSWNMA
CPD hours for these courses can be calculated by the time you spend actively learning. This will vary between individuals, as further THE LAMP NOVEMBER 2020 | 23 self-directed learning can be included (e.g. reviewing the associated resources and completing theOCTOBER reflective/ questionnaires).
PUBLIC HEALTH SERVICE
NSWNMA wins fit testing for mask wearers The Association has achieved a win in its campaign for better protection of health workers dealing with confirmed or suspected COVID-19 patients.
T
he Clinical Excellence Commission (CEC) has ruled that all NSW public sector health workers wearing P2/N95 masks must be fit tested. Fit testing is done to ensure that a specific make, model and size of respirator achieves an adequate seal against the face of an individual wearer. The union has been campaigning for fit testing since March. An NSWNMA survey revealed that almost half the state's nurses required to wear a P2 or N95 mask had not been tested to ensure they fitted properly. NSWNMA General Secretary Brett Holmes described the CEC decision as “an important win for members and a great achievement for those who have been active in the campaign to ensure safety at work”. “It is a huge acknowledgement of the importance of fit testing in protecting healthcare workers by reducing the risk of potential exposure to any pathogens.” He advised members: “If your management has not already implemented fit testing in line with these new requirements, it's important for you to let us know and we can make it happen together.” The CEC is the lead agency supporting safety improvement in the NSW health system. The CEC said all Local Health Districts must implement respirator fit testing in their facilities for all 24 | THE LAMP OCTOBER / NOVEMBER 2020
‘ Our group chat was continually going off with questions about PPE and fit testing.’ — Max Moore workers performing respiratory aerosol generating procedures (AGPs) on patients with COVID19 or providing clinical services to patients on airborne precautions in high-risk areas.
in playing a more active role by becoming stewards for their ward or unit.
The CEC said health workers required to wear a respirator must be trained and assessed for competency in the use of all PPE as part of an ongoing training program.
Max said that with changing COVID guidelines, “our group chat was continually going off with questions about PPE and fit testing”.
Illawarra Shoalhaven Local Health District (ISLHD) is one of the first districts in the state to implement fit testing. NSWNMA Shoalhaven branch vice-president Ma x Moore, a clinical nurse specialist, is one of 10 staff members across the ISLHD who have been trained to use a PortaCount machine to test whether their colleagues' masks are properly sealed. Ma x told a union online seminar that the COVID-19 outbreak prompted the branch to strengthen its capacity to push for improved PPE. The branch expanded its executive from three members to about 20 by mapping Shoalhaven District Hospital to identif y NSWNM A members interested
The expanded executive makes use of frequent WhatsApp chats in between monthly meetings.
He said the NSWNMA asked the LHD to implement fit testing but got a “non-committal answer”. “Our strengthened branch was able to mobilise the same day and pass a resolution requesting that fit testing be done on all hospital staff required to wear N95 masks. “We sought an answer by close of business that day and had a back-up resolution to send to the minister for health saying we would be prepared to walk off the job if we had to.” He said there was no need to send the second resolution because the LHD quickly agreed to fit testing.n
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THE LAMP OCTOBER / NOVEMBER 2020 | 25
MENTAL HEALTH
Staffing win eases strain on mental health nurses NSWNMA members have won staffing and other improvements at a violence-plagued mental health centre in Newcastle.
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‘ I say goodbye to my family every day and hope I come home in one piece.’
The additional nurses are rostered for a six-bed locked area within the 22-bed unit.
in August.
number of code blacks.
Michelle said staff had suffered severe psychological and physical injuries and five experienced nurses had left the centre due to violence this year.
However, management was now talking about reducing staffing in the MHUOP six-bed area because of the recent reduction in code blacks, Michelle said.
“One staff member has had five assaults so far this year; he is often the only male on shift and is the designated code black responder. Another senior nurse lost teeth after being kicked in the face.
“They don’t seem to realise that code blacks have dropped because having extra staff has raised the level of care and safety of patients.”
he Wa r a t a h me nt a l health centre’s NSWNMA bra nch ha s ach ieved the employment of an additional nurse on every shift in the Older Persons’ Mental Health Unit (MHUOP).
The unit houses elderly men diagnosed with Tier 7 BPSD (behavioural psychological symptoms of dementia) – the highest level of dementia-related behavioural problems. Aggression in BPSD patients can be triggered by a wide range of circumstances such as fatigue, an over-stimulating environment, too many strangers, failure at simple tasks and being asked too many questions at one time. The Waratah centre also contains a psychiatric emergency care centre (PECC), an 8-bed intensive care unit (MHICU) and two 21-bed acute wards. Branch secretar y Michelle Birkett said the Waratah centre had experienced an upsurge in patient violence since November 2019. This included 11 serious assaults in the PECC and MHICU over 15 days 26 | THE LAMP OCTOBER / NOVEMBER 2020
— Michelle Birkett
“Staff are getting injured but not recording it because they don’t want to go on restricted duties, which would put an even greater burden on their colleagues. “Personally I’ve never felt so unsafe. I’ve had chairs cracked over my head. I say goodbye to my family every day and hope I come home in one piece.”
MORE STAFF MAKES A SAFER ENVIRONMENT The introduction of an additional nurse led to a dramatic fall in the
This was reinforced by NSWNMA General Secretary Brett Holmes in a letter to David McLeod, Director of Mental Health Nursing in the Hunter New England Local Health District. Brett said the increased staffing levels were the minimum required to ensure the safety of staff and patients. “Given the frequency and severity of assaults against staff under staffing levels prior to 21 August 2020 the Association believes that the current staffing levels should remain on an ongoing basis,” he said. The branch has also won a cap
MENTAL HEALTH
‘ Management say we don’t need our own security but they are not on the floor dealing with this stuff.’ — Michelle Birkett
of five people in the PECC waiting room which is staffed by two nurses.
SAFETY INSPECTION STRENGTHENED CASE Michelle said the small area was previously packed with up to 15 people waiting for care. She said a NSWNMA health and safety inspection of the PECC and MHUOP strengthened the branch’s case for staffing and design improvements. Management agreed to negotiate the redesign of a small antiquated bathroom used to shower and toilet patients who can be both aggressive and incontinent. Management also agreed to support the election of workplace health and safety representatives (HSRs) and the formation of a Union Specific Consultative Committee to negotiate further improvements. And the Waratah centre’s NSWNMA branch has grown stronger by recr uit ing more members. However, access to security staff remains a problem for the centre.
The centre is attached to the Calvary Mater Hospital under a decade-old public private partnership and shares three security staff with the hospital. “This so-called partnership is a root cause of many of our problems,” Michelle said. “The security guards do the best they can to look after us but they have to cover the whole hospital and can take several minutes to arrive in response to a code black. “This has caused unnecessary injuries to our nursing staff. We are trained in de-escalation and humane restraint but most of us don’t have the physical strength needed to restrain our patients. “Management say we don’t need our own security but they are not on the floor dealing with this stuff.” n
Morisset closure adds to pressure The state government’s closure of Morisset Hospital’s Ibis Lodge Unit in 2019 put more pressure on the Waratah centre. The Ibis unit cared for patients with severe behavioural and psychological symptoms of dementia. In October 2019, Hunter New England LHD acknowledged that Ibis staff had provided “wonderful care” to patients but said the model of care was “no longer considered contemporary” and the building was old and hard to maintain. Ibis unit patients would therefore be sent to the “more homely environment” of a nursing home. But Hammond Care in Cardiff refused to accept them when it realised the difficulty of managing their behaviour.
October is Safe Work Month. For resources on how to report violent incidents go to www.nswnma.asn.au/ safer-work-safer-care
“The Ibis patients were sent to us because they had nowhere else to go,” Michelle Birkett said.
THE LAMP OCTOBER / NOVEMBER 2020 | 27
INDIGENOUS HEALTH
Indigenous kids are “warped” by incarceration A host of health and human rights organisations are calling for Indigenous children to be kept out of prison.
O
‘ Prisons are not a healthy environment for our kids.’
f the close to 600 children aged 10 to 13 years who are imprisoned each year in Australia, 65 per cent are Aboriginal and Torres Strait Islander children. Aboriginal and Torres Strait Islander organisations, expert United Nations bodies, human rights organisations, medical and legal bodies and academics are calling on Australian governments to raise the minimum age of criminal responsibility. Associate Professor Kris RallahBaker, President of the Australian Indigenous Doctors’ Association, told The Lamp that Indigenous doctors and health practitioners are seeing “the effects of youth incarceration echoed in poor health outcomes, including mental health. The current policy sees children as young as 10 warped by a justice system explicitly designed to root out and reform adult criminals”. The Australian Indigenous Doctors’ Association is one of many organisations supporting the Raise The Age campaign, which is calling on the age at which children can be arrested or locked up to be raised from 10 to 14 years. Prisons are “not a healthy environment for our kids”, Associate Professor Kris Rallah-Baker said. “We need to find culturally and medically safe alternatives as soon as possible. Following the signing of the National Agreement on Closing 28 | THE LAMP OCTOBER / NOVEMBER 2020
Associate Professor Kris Rallah-Baker, — President of the Australian Indigenous Doctors’ Association
the Gap in July this year, AIDA hopes to see reform in this regard over the coming years.”
AUSTRALIA OUT OF STEP INTERNATIONALLY Australia’s low age of minimum criminal responsibility is out of step with international standards. Children aged 10 to 13 years old are going through significant growth and development. It is also rare for children aged 10–13 years to be charged with a serious offence of violence. The majority of children funnelled into the criminal legal system are dealt with for offences of theft, burglary and propertyrelated crime. Rather than criminalise trauma in young children’s lives, the Change the Record organisation is calling on governments to address the underlying causes of their behaviour and help them to thrive, and provide health, education and social services that are therapeutic and developmentally appropriate, rather than punitive.
Cheryl Axleby, Co-Chair of Change the Record said: “If governments were serious about ending the mass imprisonment of our people, then they could have taken the straightforward step at the meeting of attorneys-general in July to raise the minimum age of criminal responsibility from 10 years old to 14. We are disappointed in their failure of leadership. “But this campaign is not over. We have seen an outpouring of support for Raise The Age – over 136,000 people have signed our petition calling for change. “We have the support of the majority of Australians; now each state and territory must show leadership and take urgent action to raise the minimum age of criminal responsibility from 10 years old to 14 years old and keep hundreds of children every year out of the quicksand of the criminal legal system.” n
INDIGENOUS HEALTH
Things you can do to support the Raise the Age campaign Watch: the film In My Blood It Runs, about 10-year-old Arrernte boy Dujuan. It follows Dujuan as he grows up in Alice Springs, runs away from school and tries to reconnect with his culture while coming close to being incarcerated. The film’s producers have set up a website www.inmyblooditruns.com where you can download the film and hold virtual screening parties with discussion resources. Dujuan recently addressed the United Nations Human Rights Council and the United Nations Committee on the Rights of the Child to call on the Australian Government to treat kids like him better. Write: to your government and attorney general asking them to take action for Indigenous education and juvenile justice reform www.inmyblooditruns.com/ takeaction/ Sign: the Raise The Age Campaign petition www.raisetheage.org.au/home#petition
Who is behind the #RaiseTheAge campaign? The campaign has been developed by a coalition of legal, medical and social justice organisations, including Australian Indigenous Doctors Association, Australian Medical Association, Royal Australasian College of Physicians and Public Health Association of Australia, National Aboriginal and Torres Strait Islander Legal Services, Change the Record, Human Rights Law Centre, Law Council of Australia and Amnesty International Australia.
AUSTRALIAN NURSING & MIDWIFERY FEDERATION FEDERAL OFFICE
Financial Report
From 1 November 2020, the ANMF Federal Office Financial Report for the year ended 30 June 2020 will be available at www.anmf.org.au. Members without internet access may obtain a hard copy of the report by applying in writing to: Australian Nursing & Midwifery Federation Finance Officer Level 1, 365 Queen Street Melbourne VIC 3000
Australian Nursing & Midwifery Federation NSW Branch
FINANCIAL STATEMENTS & DISCLOSURES From 8 October 2020, the Australian Nursing and Midwifery Federation New South Wales Branch will make available to members the following reports and disclosures for the year ended 30 June 2020: • Audited Financial Statements • Officer & Related Party Disclosures They will be available on Member Central’s Member Resources – Governance page at online.nswnma.asn.au. Members without internet access may obtain a hard copy of the statements by applying in writing to: Brett Holmes, Branch Secretary ANMF NSW Branch 50 O’Dea Avenue, Waterloo NSW 2017 THE LAMP OCTOBER / NOVEMBER 2020 | 29
Your voice is vital in helping us to advocate for improvements that will lead to better workforce wellbeing, job satisfaction and quality of care. As Australia continues to deal with the impacts of the pandemic, share your experiences as a nurse, midwife or personal care worker in the national COVID-19 Workforce Survey.
30 | THE LAMP OCTOBER / NOVEMBER 2020
For more information about the study: (08) 8302 2129 | RBRC@unisa.edu.au unisa.edu.au/research/rbrc
YOUR RIGHTS
Ask
Judith Investing in your future Superannuation is again in the news, as a push is on to stop the super increases occurring next year. This would mean that rather than employer contributions going to 10 per cent from 1 July 2021, it will stagnate on the current 9.5 per cent. Union members fought for superannuation to be paid on top of wages because all workers should retire with dignity. It was part of a compact made decades ago with the Hawke/Keating governments. It was to provide not only a retirement income for all workers, but also reduce the reliance on sustaining retirement solely on a pension (and in turn reduce the drag on the public purse). In addition, your superannuation funds amount to billions of dollars invested in Australian infrastructure projects that create jobs here. That’s an important contribution to helping Australian families and communities. Super is not perfect. Women now retire on average with 47 per cent of the superannuation of men. Women over 50 are the fastest growing group of homeless people in Australia. There are real and growing barriers that women face in getting a good retirement. Freezing employer super contributions under the guise of COVID-19 is misconceived and will only worsen this divide. It robs from your future to supposedly address a problem of today (setting aside it just doesn’t end up as additional profits). This is simply not good enough when wage increases are scarce or resisted. Your future, and that of our country, is too important to become prey to short-termism. P.S. For those approaching retirement, make sure you do not have any super accounts sitting idle from earlier periods of employment. For example, if you resigned and were lost to SASS, and when resuming employment became part of First State, your previous monies may not have been automatically rolled over.
When it comes to your rights and entitlements at work, NSWNMA Assistant General Secretary Judith Kiejda has the answers.
Aged care retention payment – complaints I work occasional shifts at an aged care facility but have not received the aged care retention bonus. How do I follow up or complain? If you meet the eligibility criteria, and believe that you are owed the retention payment, you can utilise a complaint process now established by the Commonwealth Department of Health. It requires you to complete an Aged Care Workforce Retention Payment enquiry form. On receipt of the form, the department will let you know if they can help or not. If they can help you, they will contact your employer, if you let them, to find out more (they will tell you when they do this). They will look at all the information from you and your employer and make a decision and let you know the outcome. If the evidence shows wrongdoing by your employer, the department may also take audit action. The enquiry form can be accessed at the following link: https://www.health.gov.au/ resources/publications/agedcare-workforce-retentionpayment-enquiry-form
Suitable duties I injured myself at work and require modified duties, which the workplace was providing. However, the insurer has rejected the claim and the duties have been withdrawn. I have been left in limbo on my own leave. Is this right? Without going into the detail and complexity of the legislation that covers all injured workers in NSW, if an insurer has rejected your claim, you have a right to challenge this decision. When you challenge their decision, you are required to
be treated as if the claim had been accepted (pending its resolution). Accordingly, the workplace has an obligation to pursue and hopefully identify suitable duties that is in keeping with any medical restrictions to facilitate your return to work. However, this is general advice and as a member you can contact the Association and we can provide a referral to NEW Law, who will assess the refusal by the insurer and assist with any appropriate appeal. If that was to occur, the Association can make representations to the employer for your return on suitable duties.
Service Check Register I work at a public hospital and recall reading in The Lamp last year about a review of the Service Check Register used by LHDs. How did that work out as a colleague of mine was unfairly placed on the SCR a few years ago and it was a nightmare to get off it? Due to COVID-19 and a few other hold ups, the revamped Service Check Register Policy Directive is yet to be finalised by the Ministry of Health. However, it is still anticipated that after persistent representations and agitation by the Association, a revised Policy Directive will be issued in the coming months and one that we anticipate will reflect a more targeted use towards the more serious situations/events, and not as some default setting (or as a form of punitive action in itself). Watch this space!
THE LAMP OCTOBER / NOVEMBER 2020 | 31
Marion Smith
(1891–1957)
“Our island home, no matter where we roam, if near or far from home. Let us be always one.” Marion Leane Smith was an Australian-Canadian nurse. She was of Dharug descent and the only identified Aboriginal Australian woman to serve in the First World War, volunteering among the 3141 Canadian nurses. In 1917, Marion enlisted with Queen Alexandra's Imperial Nursing Service and served with the No. 41 Ambulance Train in France. The ambulance trains were designated to transport injured soldiers from the front lines to military hospitals, and were known to be difficult environments in which to work. Afterwards, she went to Italy with the Italian Expeditionary Force and to the University War Hospital in Southampton, UK. Marion returned to Canada in 1919 and married veteran Victor Walls. The couple moved to Trinidad, where Victor served as headmaster of Naparima College. Marion wrote the school's hymn and created its dormitory infirmary. She served as commandant for the first iteration of the Red Cross at the Second World War, as well as leading the Nurses Council. Marion was awarded a Distinguished War Service Medal for her service.
torical nurses g hidiswives n i t b r a nd m Cele a
Photo courtesy of UCCA (United Church of Canada Archives), 76.001P/6954 Rev. Victor B. Walls and Mrs. Walls, Trinidad, B.W.I., [193-?] Authorised by B. Holmes. General Secretary, NSWNMA 32 | THE LAMP OCTOBER / NOVEMBER 2020
fr e
R, 4PM E B ew CTO O RE 5 1 ebinar binar GIS e w TER ork w r e f AT bit.ly/sa
With increased rates of infection among health workers during COVID-19, it’s important to know how to protect yourself from exposure and learn what you can do to make your workplace safe. This Safe Work month Webinar will look at the research around how the virus transmits, what this means for workers and how you can best protect yourself.
Register to find out: What we are learning about COVID-19 transmission in healthcare settings What this means for healthcare workers and PPE Infection control measures The importance of fit testing How the NSWNMA can help you achieve improved access to PPE and fit testing
Guest speakers: Professor Raina MacIntyre is Head of the Biosecurity Program at the Kirby Institute, UNSW. She leads a research program in control and prevention of infectious diseases, spanning pandemics and emerging infections, epidemiology, vaccinology, biosecurity, risk analysis, personal protective equipment, mathematical modelling, public health and clinical trials.
Dr Michelle Ananda-Rajah is an infectious diseases and general physician at The Alfred Hospital. She is an MRFF TRIP Fellow with research interests in artificial intelligence and health services research.
OCTOBER IS SAFE WORK MONTH Get involved to help promote safer working environments and put an end to workplace violence. For more information on events and resources, visit
www.nswnma.asn.au/safer-work-safer-care Authorised by B. Holmes, General Secretary, NSWNMA
THE LAMP OCTOBER / NOVEMBER 2020 | 33
NEWS IN BRIEF
UNITED STATES
COVID-19 will be tamed by end of 2021 says Bill Gates In the meantime millions will die, mostly from the strain on healthcare systems and struggling economies, he says. In an interview with The Economist Gates said that there was hope in the medium term for taming the coronavirus, predicting that by the end of 2021 there would be a reasonably effective vaccine in mass production and a large enough share of the world’s population would be immunised to halt the pandemic in its tracks. But in the short term, he says, lockdowns will reduce access to immunisation and medicine for other diseases. Deaths from malaria and HIV will rise. Lower agricultural productivity will see hunger spread and education rates fall. The Gates Foundation has pledged more than $350 million to the COVID-19 response, mainly aimed at reducing its impact in the developing world. Wealthy countries need to do much more to stem the epidemic, he says. “We all need to spend billions to get the vaccine out to save the trillions that the economic damage is doing,” he said. Gates called on rich countries to buy vaccines for poor ones. This is not entirely altruistic. “If some countries remain reservoirs for the disease, it will continue to pop up again in others. If vaccines are priced high enough in rich countries to cover the fixed costs of production –clinical trials, building factories and so on – then the marginal cost of supplying poor countries would be relatively modest: of the order of $10-12 billion in total.”
‘ We all need to spend billions to get the vaccine out to save the trillions that the economic damage is doing.’
WORLD
Alcohol consumption spikes during lockdown The epidemic has led to new habits of increased drinking. An Alcohol and Drug Foundation survey of more than a thousand people has found one in eight Australians have been drinking every day since the coronavirus outbreak began – much more than usual. One in 10 people reported consuming more than 10 standard drinks per week. Nearly one in five people said they wished they’d drunk less during the COVID-19 lockdown, with half hoping to cut down in the future. The release of the survey coincided with the launch of a campaign by the foundation called “Break the Habit”. It encourages people to consider their recent drinking patterns, help them recognise problem signs and how to turn them around. The campaign will also highlight that it takes just 66 days on average to form a habit, about the same period many Australians have spent in lockdown. The Alcohol and Drug Foundation chief executive, Dr Erin Lalor, said it was unsurprising people had looked for different ways to cope during the epidemic. “(It has) been incredibly hard for everyone, particularly for those who have lost work, social connectedness and ... lost loved ones. We’ve all been trying our best under challenging, never-before-seen circumstances.” She encouraged people to reach out for practical support. “Even small steps such as introducing alcohol-free days into your week, or having one less drink a day, can have a powerful impact.”
‘It takes just 66 days on average to form a habit, about the same period many Australians have spent in lockdown.’ 34 | THE LAMP OCTOBER / NOVEMBER 2020
NEWS IN BRIEF
AUSTRALIA
Lifestyle changes could reduce dementia cases Excessive drinking and exposure to pollution are among the risk factors. A report by the Lancet Commission on dementia prevention, intervention and care estimates that up to 40 per cent of dementia cases worldwide could be delayed or prevented by addressing 12 lifestyle factors. Previous studies had found that a third of dementia cases could be prevented by addressing nine lifestyle factors including midlife hearing loss, depression, less childhood education and smoking. The new report adds a further three risk factors to the list: excessive midlife alcohol intake, midlife head injuries and exposure to air pollution in older age. “Dementia is potentially preventable – you can do things to reduce your risk of dementia, whatever stage of life you are at,” said Gill Livingston, professor of psychiatry of older people at University College London and a co-author of the report. The incidence of dementia in Europe and North America has fallen by around 15 per cent per decade for the past 30 years. This has been attributed to lifestyle changes such as a reduction in smoking – even though the numbers of people with dementia are rising as people live longer. The researchers say that the impact of lifestyle interventions is likely to be greatest among the most deprived individuals and in low- and middle-income countries.
‘ Dementia is potentially preventable – you can do things to reduce your risk of dementia, whatever stage of life you are at.’
AUSTRALIA
Unions combine with residents to save historic maternity hospital The NSWNMA has joined with the North Parramatta Residents Action Group and the CFMEU to save the Willow Grove and St George’s Terrace heritage sites. Willow Grove, a villa built in the nineteenth century, is an iconic former maternity hospital. Along with the neighbouring St George’s Terrace, it is slated for the wrecking ball, as part of the Berejiklian government’s $1.17 billion Parramatta Powerhouse proposal. NSWNMA Assistant General Secretary, Judith Kiejda, said the planned demolition of the two sites was devastating for the Parramatta community and the colonial history of maternity services. “Western Sydney is rich with heritage, yet the Berejiklian government appears hell bent on stripping that history away and burying it under a multi-million-dollar monument,” said Ms Kiejda. “Instead of prioritising hard hat and highvis ribbon cutting opportunities, the government should be preserving these properties and their historical significance for future generations. “The Parramatta light-rail project has been enough of a circus for the nearby Female Factory Precinct and efforts to obtain its world heritage listing. We won’t stand by and watch Willow Grove and St George’s Terrace go under a bulldozer without a fight.” The construction union, the CFMEU, has placed a green ban on the two sites. It is also promoting a petition in solidarity with the people of Parramatta to save the two sites. You can show your support for the campaign at: https://nsw.cfmeu.org/campaigns/ save-parramattas-heritage
‘The Berejiklian government appears hell bent on stripping that history away.’ — Judith Kiejda THE LAMP OCTOBER / NOVEMBER 2020 | 35
NEWS IN BRIEF
AUSTRALIA
A jobs plan is needed post-COVID, says ACTU Australia needs a national economic reconstruction strategy, including a comprehensive jobs plan, in response to the pandemic, argues the ACTU. In a pre-budget submission sent to the Treasurer, the ACTU says the Morrison government’s fiscal response has been smaller as a proportion of GDP than Canada, New Zealand, Japan, Singapore, South Korea, USA, Hong Kong, Germany and the United Kingdom. The submission calls on the government to adopt a national economic reconstruction plan. AUSTRALIA
The ACTU has put forward five practical proposals in its job plan:
Illawarra Shoalhaven LHD to partner Birthing on Country
•A national strategy for early childhood education and care including free, universal, accessible childcare
Studies have shown Aboriginalcentred care can reduce preterm births by 50 per cent.
•A n initiative to help out travel and hospitality sectors and regions recover and survive
The Birthing on Country program is preparing to sign a statement of commitment with the Illawarra Shoalhaven Local Health District (ISLHD). Birthing on Country is a model of care provided to Aboriginal women and their families. It offers wraparound maternity support in the community and in hospital by providing intrapartum birth care and then postnatal care for up to six weeks. The program has been running at Waminda, a women’s health and welfare service on the New South Wales South Coast since 2018. “It is giving us ownership of our health and birthing babies on country in a place that they feel safe and there is no judgement,” said Melanie Briggs, a senior midwife at the centre. “Then they can have beautiful, healthy, chunky babies and be able to practise culture and community care and be looked after aunties and elders and mums.” ISLHD chief executive Margot Mains said it would provide greater maternity care options that were safe and respectful of culture and spirituality. “This includes the implementation of a long-term plan of action, targeted at addressing the maternal and perinatal gap in health outcomes for Aboriginal and Torres Strait Islander mothers and their babies,” she said.
‘ It is giving us ownership of our health and birthing babies on country in a place that they feel safe.’ — Melanie Briggs 36 | THE LAMP OCTOBER / NOVEMBER 2020
•A training for reconstruction plan which includes 150,000 free TAFE courses and a 50 per cent government wage subsidy that goes for the life of apprenticeship or traineeship
•A plan to significantly boost investment in public capital projects by increasing public capital spending back to 6.5 per cent of GDP • A sustainable manufacturing strategy. ACTU President, Michele O’Neil, says “the Morrison government has been consistently slow to act … and the crisis has been made worse by persistent uncertainty about the economy”. “We stand ready, as we have for months, to work with government to create jobs and support Australian industries,” she said.
‘We stand ready, as we have for months, to work with government to create jobs and support Australian industries.’ — ACTU President, Michele O’Neil
NEWS IN BRIEF
AUSTRALIA
Victorian health workers catching COVID on the job A Victorian government report has found that 70–80 per cent of the state’s health workers testing positive to COVID-19 were infected at work. That’s compared to 22 per cent in the first wave. The report found infection of healthcare workers was greatest in areas where there were many patients with COVID-19 being cared for together, and where health-care workers congregated, such as tea rooms. Other contributing factors were the increased risk associated with donning and doffing personal protective equipment (PPE), staff moving between healthcare facilities, and poor ventilation systems with inadequate air flow. The report found health-care workers in aged care accounted for around two in five infections, and hospital workers around one-third. By the end of August the number of health workers infected with COVID-19 in Victoria had exceeded 2800. “Controlling the number of new healthcare worker infections is essential, not only for healthcare workers but for the sustainability of our healthcare system, and to reduce the overall number of cases,” commented Alicia Dennis, an Associate Professor at the University of Melbourne in The Conversation. The Victorian government has convened a Healthcare Worker Infection Prevention and Wellbeing Taskforce bringing together infection control experts and workforce representatives to formulate a response to the report.
— Associate Professor Alicia Dennis
Opioids still the leading cause of overdose deaths in Australia
Over 2000 Australians are dying from drug overdoses every year and there is a clear trend upwards. Australia’s Annual Overdose Report, compiled by the independent health research unit, the Penington Institute, found that 1556 of the 2070 fatal overdoses were unintentional. It found 70 per cent of victims were men and 400 more Australians died from an overdose than on the nation’s roads, with the gap widening. The largest number of overdose deaths (more than 1000) involved opioids such as heroin, morphine, oxycodone and fentanyl followed by benzodiazepines such as Valium. Opioid-related deaths in Australia have been on an upward trend in recent years, having doubled since 2006. A large driver of increasing opioid deaths internationally has been the increase in prescribing and use of pharmaceutical opioids, with Australia ranked tenth worldwide. Australia has introduced a range of strategies to manage and restrict supply, including re-scheduling codeine to prescription-only, introducing smaller pack sizes, and setting up systems to track prescribing. As many of these changes have only been implemented recently, it’s too early to know whether they’re having a positive effect. “Overdose is our hidden health crisis – and it’s a crisis that is costing us billions. And what’s worse is these deaths are preventable,” the Penington Institute’s chief executive, John Ryan said.
‘Overdose is our hidden health crisis – and it’s a crisis that is costing us billions.’ — John Ryan, Penington Institute CROSSWORD SOLUTION
‘ Controlling the number of new healthcare worker infections is essential, not only for healthcare workers but for the sustainability of our healthcare system.’
AUSTRALIA
THE LAMP OCTOBER / NOVEMBER 2020 | 37
OBITUARY
VA L E
Susan Patricia Rose 1 9 5 8–2 0 2 0
S
usan commenced her nursing training in 1977 at Lismore Base Hospital. She graduated three years later. On completion of her training, she began work in the operating theatres and she remained working in operating theatres for the rest of her working life – some 40 years. She married her husband, John, in 1980 and was the proud, loving, devoted mother to three boys: Daniel, Matthew and Michael, and proud grandmother to two young boys. She was due to welcome two more grandchildren in October, including the arrival of her first granddaughter. A devoted follower of the Parramatta Eels, Liverpool, and Brisbane Royal, she loved sport and encouraged her boys to partake in sporting activities. Her nursing career encompassed all facets of perioperative nursing, from anaesthetic, recovery and scrub/scout. Her skills were beyond par and provided her fellow colleagues with confidence knowing they were in good hands. She was an exceptional perioperative nurse without question, but Sue also ensured the wisdom of perioperative practice over her 40 years was passed on to our novice and graduate nurses. Sue always had compassion and understanding for
38 | THE LAMP OCTOBER / NOVEMBER 2020
her patients and colleagues and was always one to ask “Are you okay?” when she sensed things were not as they should be. She taught and mentored with kindness and patience, never condescension. She was a respected member of the team and much loved by her colleagues, who found working with her a delight, privilege and pleasure. Susan cared about her patients and her colleagues. She always treated people so nicely, making new people feel so welcome and valued. Her s t r on g work e t h ic a nd professionalism provided a role model to other members of the team. Staff wanted to work with her; Susan had such compassion and kindness for people. We all miss her infectious laugh and quirky sense of humour, as well as her diligent work ethic. Never one to leave her work half done, she brought with her the ethos of days gone by when all work – especially the end-of-day cleaning – was done to an exemplary level, before leaving the workplace, regardless of what ungodly time that was. We all used to laugh and say “We’d better not stand still too long, or she will clean us too”. Susan succumbed to illness this year after a short fight. She is and always will be dearly missed by her colleagues.
NURSING RESEARCH AND PROFESSIONAL ISSUES The Australian Journal of Advanced Nursing (AJAN) is the peer-reviewed scholarly journal of the Australian Nursing and Midwifery Federation (ANMF). The mission of AJAN is to provide a forum to showcase and promote a wide variety of original research and scholarly work to inform and empower nurses, midwives and other healthcare professionals to improve the health and wellbeing of all communities and to be prepared for the future.
COVID-19 and residential aged care in Australia J. Ibrahim The COVID-19 pandemic continues to have far-reaching impacts on individuals, professionals, human services such as aged care and, society more broadly. In Australia we are proud of our success in limiting the direct impacts the virus has on mortality and morbidity. The reality is Australia’s success with the emergency response and management of COVID-19 pandemic are in a large part due to inherent underlying geographic and population factors. We live on an island continent with an extraordinary ability to control our borders. We have an extremely low population density and our population is widely dispersed. Also instrumental was our coordinated and prompt public health responses and community cooperation. As of 24 June 2020, nationally the total number of COVID-19 infections was 7521 with 103 deaths comprising 29 aged care residents. Internationally, Australia rates extraordinarily well on these metrics. What we must guard against are complacency and overconfidence. This is evident in efforts to thank aged care staff for working extremely hard. We conflate our words of gratitude with unsubstantiated statements about how well the whole aged care sector is operating. The absence of catastrophic impacts of the COVID-19 pandemic in aged care homes in Australia that occurred around the world are not evident of a highly functioning system. The virus has not washed away the systemic failures highlighted
in the interim report by the Royal Commission into Aged Care Quality and Safety. The COVID-19 pandemic exacerbates and highlights the existing primary failures in the provision of residential aged care in Australia. We require a prudent approach if we are to guard against the high COVID-19 case fatality rate of residents in aged care homes. This article is intended as a sober reflection at the structural domains of the aged care sector and the COVID-19 pandemic. https://www.ajan.com.au/index. php/AJAN/article/view/226/26
A national survey of nurses who care for people with intellectual and developmental disability Nathan J Wilson, et al The literature about Australian nurses who specialise in caring for people with intellectual and developmental disability (IDD) is limited in quantity and narrow in focus. This gap is historical, dating back to the commencement of the deinstitutionalisation era of the 1980s when the role of nurses in the day-to-day lives of people with IDD was gradually phased out. That is, these nurses were marginalised while more socially-inclusive models were developed that did not mandate the need for nursing skills. Decades later, these nursing skills are still required as many remain employed in the IDD sector. The disparate healthcare needs and outcomes of many people with IDD requires varying degrees and frequency of care from nurses with specialised skills across multiple settings. However, we know very little about these nurses’ roles, what
constitutes their nursing practice and the type of contexts within which they work. In light of the new and rapidly evolving National Disability Insurance Scheme (NDIS), which promotes individualised support needs in the community, a deeper insight about the role of nurses in the care of those with IDD is vital. https://www.ajan.com.au/index. php/AJAN/article/view/120/27
Recognition for registered nurses supporting students on clinical placement: a grounded theory study Carina Anderson et al Across the globe, nursing standards state that when nursing students are on clinical placement, registered nurses (RNs) will be supportive of the students and provide them with learning opportunities. The leading body in global health care, the World Health Organization, declares that all RNs are required “to supervise and teach” nursing students. This Australian study examined RNs’ perspectives of being supportive of students and providing them with learning opportunities. The study aimed to examine RNs’ perspectives of being supportive of nursing students and providing them with learning opportunities when on clinical placements. The research question being examined was: what are RNs’ perspectives of being supportive of nursing students and providing them with learning opportunities when on clinical placements? https://www.ajan.com.au/index. php/AJAN/article/view/98/28
THE LAMP OCTOBER / NOVEMBER 2020 | 39
Favourites NSWNMA
Not only stylish and comfortable, but also affordable and sold at cost to members
Active Soft Shell Navy Jacket $55 Poly/spandex, micro polar fleece lining, breathable fabric
Red Hoodies $50 80% cotton/20% poly brushed fleece, kangaroo pocket with full lining hood Navy Hoodies
$50
Snowy Puffer Jacket $55 380T nylon outer, poly fill padding, two zippered pockets and elasticated cuffs NSWNMA Water Bottle
$15
NSWNMA Royal Blue or Red Cap
$15
FREE POSTAGE
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Spend $60 and over to receive
n ge f or orders u
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test your
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ACROSS 1. A potentially life-threatening condition caused by drinking too much water (5.12) 10. A type of brain wave pattern (5.6) 11. Any vaulted or archlike structure (5) 12. A margin, border, or edge (3) 13. Lights up (11) 15. Strange, unusual (3) 16. Face appearances determined by the physical or emotional state (11) 17. International normalised ratio (1.1.1) 18. Optical Local Oscillator (1.1.1) 19. The reaction of a muscle, nerve, gland, or other excitable tissue to a stimulus (8) 22. Fish eggs (3) 24. A curved line (3)
25. Bovine mammals (4) 27. The son your spouse by a former marriage (7) 29. Becoming less dense; thinning out (9) 31. Universal time (1.1) 32. Trespasses, exceeds (9) 33. Repetitive and persistent, demanding (9) 35. Inability to verbalise thoughts coherently (11) 36. Ocular tension (1.1) 37. A device that brings amplified sound to improve hearing (7.10)
DOWN 1. Parallel red sores in the stomach, frequently seen with cirrhosis of the liver (10.7) 2. A device or apparatus for retaining heat (11) 3. Willingness to learn something new (11) 4. A psychotic delusion of one's non-existence or of the non-existence of the world (8) 5. A cereal grass (3) 6. A drug that reduces the body’s natural immunity by suppressing the natural functioning of the immune system (17) 7. A point at the tip of the anterior nasal spine (9) 8. A tooth with a sharp edge adapted for cutting or gnawing (7) 9. A drug that provides temporary oral relief of common cold’s symptoms (5.12) 14. Death of individual muscle fibres (11) 19. Respiratory rate (1.1) 20. A type of legume native to Asia (3) 21. Continuance in life (9) 23. A sequence of DNA that interacts with a repressor of operon to control the expression of adjacent structural genes (8) 24. Before (4) 26. One of nursing qualification (1.1) 28. Unharness or unyoke (animals) (7) 30. The soft muscular tissue of the body (5) 34. Lice eggs (4)
THE LAMP OCTOBER / NOVEMBER 2020 | 41
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 42 |
IMPORTANT NOTE From 1 December 2018 the insurance benefits have changed as follows: • Journey Accident Insurance: the waiting period for benefits is now 14 days • Professional THE LAMP OCTOBER / NOVEMBER 2020 Indemnity Insurance: the limit per claim is now $5 million
REVIEWS
book club
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The Bushfire Book: How to Be Aware and Prepare
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All books can be ordered through the publisher or your local bookshop. Call 8595 1234 or 1300 367 962, or email library@ nswnma.asn.au for assistance with loans or research. Books are not independently reviewed or reviewed using information supplied by the publishers.
The Happiest Man on Earth Midnight Sun Eddie Jaku Pan Macmillan Australia: RRP $32.99: ISBN 9781760980085
Eddie Jaku always considered himself a German first, a Jew second. He was proud of his country. But all of that changed in November 1938, when he was beaten, arrested and taken to a concentration camp. Over the next seven years, Eddie faced unimaginable horrors every day, first in Buchenwald, then in Auschwitz, then on a Nazi death march. He lost family, friends, his country. He pays tribute to those who were lost by telling his story, sharing his wisdom and living his best possible life. Published as Eddie turns 100, this is a powerful, heartbreaking and ultimately hopeful memoir of how happiness can be found even in the darkest of times.
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Polly Marsden and Chris Nixon CI AL RRP $19.99 ISBN 9780734420077 IN T E Australia is a big country with all sorts of weather. And sometimes extreme weather that leads to bushfires. Bushfires can make a real mess of things. The air fills with smoke. The skies turn red. Ash falls. Precious things burn. But we don’t need to be scared; we just need to know all about bushfires and prepare for them. This book will help you understand what causes bushfires, introduce you to all the clever people who are keeping an eye on them, and teach you how to be prepared and not scared. A practical and reassuring book for children to help them understand bushfires and what action they can take to feel less anxious and be more prepared as Australia faces longer and more intense bushfire seasons. The Bushfire Book offers information based on national RFS guidelines in reassuring language to help reduce children’s anxiety.
When She Was Good Stephanie Mayer Little Brown and Company: RRP $45.00: ISBN 9780349003627
When Edward Cullen and Bella Swan met in Twilight, an iconic love story was born. But until now, fans have heard only Bella’s side of the story. At last, readers can experience Edward’s version in the long-awaited companion novel, Midnight Sun. This unforgettable tale as told through Edward’s eyes takes on a new and decidedly dark twist. Meeting Bella is both the most unnerving and intriguing event he has experienced in all his years as a vampire. As we learn more fascinating details about Edward’s past and the complexity of his inner thoughts, we understand why this is the defining struggle of his life.
Michael Robotham Hachette Australia: RRP $32.99: ISBN 9780733644849
Six years ago, Evie Cormac was found hiding in a secret room in the aftermath of a brutal murder. But nobody has ever discovered her real name or where she came from because everybody who tries to, ends up dead. Forensic psychologist Cyrus Haven believes the truth will set Evie free. Ignoring her warnings, he begins to dig into her past, only to disturb a hornet’s nest of corrupt and powerful people, who have been waiting to find Evie – the final witness they have been searching for.
THE LAMP OCTOBER / NOVEMBER 2020 | 43
LIONS NURSES’ SCHOLARSHIP Looking for funding to further your studies in 2021? THE LIONS NURSES’ SCHOLARSHIPS OPEN ON 1 AUGUST AND CLOSE ON 31 OCTOBER EACH YEAR The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships. Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT. You must currently be registered with the Nursing and Midwifery Board of Australia
and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last 12 months of which must have been spent in NSW or the ACT. Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and
application forms are available from: www.nswnma.asn.au/education Administration Liaison Lions Nurses’ Scholarship Foundation 50 O’Dea Avenue Waterloo NSW 2017 or contact Matt West on 1300 367 962 or education@nswnma.asn.au
COMPLETED APPLICATIONS MUST BE IN THE HANDS OF THE SECRETARY NO LATER THAN 31 OCTOBER
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REVIEWS
at the movies A
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Striking Out The complete series 1 & 2
Dead Still Season 1
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Dublin, 1880. Cameras are becoming cheaper and the country is flourishing with photographic studios. However, the practice of memorial portraiture - the portrait photography of the recently deceased – is on the wane. Renowned memorial photographer Brock Blennerhasset tries to revive his business after an accident, requiring the assistance of his estranged niece Nancy Vickers and his over enthusiastic new assistant Conall Molloy. After a rocky start, their working relationship begins to develop, but it appears someone more sinister is getting in on the death photography game. This charming Acorn Original drama follows Tara Rafferty (Amy Huberman), a successful Dublin lawyer. After she discovers her fiancé’s infidelity, she abandons her wedding plans and her job, striking out on her own by starting an unconventional private practice. Email The Lamp by 30 November to be in the draw to win one of five DVDs of Striking Out – The Complete Series 1 & 2 thanks to Acorn Media. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!
The investigations of Detective Frederick Regan of Dublin Castle suggest a killer may be cashing in on a developing taste for a different type of memorial imagery, in this case, pictures of people in their death throes. As the body count begins to escalate, Blennerhasset, Molloy and Nancy have to stop a murderer intent on ruining not just their business, but their lives. In stores October 7th. Email The Lamp by 30 November to be in the draw to win one of five DVDs of Dead Still Season 1 thanks to Acorn Media. Email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win! THE LAMP OCTOBER / NOVEMBER 2020 | 45
TRAVEL
Take a look at these fabulous holiday offers CONCIERGE SERVICE Save time and money when you book through members only Concierge Service. NSWNMA members have access to thousands of hotels across Australia and New Zealand. UBOOKDIRECT is giving members a $20 voucher to use on any already discounted member prices when booking through the Concierge. UBOOKDIRECT will beat any hotel you can find on Expedia by a minimum $20 (min 2-night stay).
25% OFF
40% OFF
25% OFF 1/
Leisure Inn, Pokolbin Hill – Hunter Valley, NSW
Park Regis City Centre – Sydney, NSW
Leisure Inn Spires – Blue Mountains, NSW
Picturesque retreat, set on 25 acres of peaceful grounds in the heart of the Hunter Wine Country. Just a short three-hour drive from Sydney, guests are welcome to relax by the hotel’s outdoor swimming pool and play a game of tennis, or enjoy a BBQ in the undercover BBQ area. All apartments feature private patios looking out to the grounds, lake and vineyards. The perfect way to finish a great day of wine tasting and sightseeing sitting back on your veranda with a glass of wine or sink down and relax in your in-room spa tub.
Stay in the heart of Sydney from $110 per night! Opposite Hyde Park and a short stroll to Darling Harbour, Pitt Street Mall, Queen Victoria Building and Town Hall.
Set in 3 acres of hilly landscaped gardens just an hour from Sydney, this hotel offers peaceful accommodation close to attractions including the Three Sisters, Scenic Railway and Jenolan Caves.
Studio Spa Queen – 2 Nights $208* (2 ADULTS) • Free cancellations permitted outside 3 days of travel
CAN’T FIND WHAT YOU’RE LOOKING FOR? 46 | THE LAMP OCTOBER / NOVEMBER 2020
Superior King Room – 3 Nights $329* (2 ADULTS) • Bottle of wine on arrival • 12pm late checkout • Free Wi-Fi during stay * All travel deals are subject to availability. For black-out dates, high season and peak season surcharges and rates and full T&C’s go to unionshopper.ubookdirect.com • Leisure Inn Spires: Valid until 31 March 2021. Rate based on 2 adults and subject to availability • Park Regis City Centre: valid for travel until 26 December 2020. Rate based on 2 adults and subject to availability • Leisure Inn, Pokolbin Hill: valid for travel until 31 March 2021. Rate based on 2 adults and subject to availability.
Take a stroll into the charming village 3/ of Leura – full of boutiques, galleries,4/ restaurants, antique and book shops and quaint tea rooms.
One-bedroom apartment – 2 nights $299* (2 ADULTS) • Free cancellations permitted outside 3 days of travel
Contact the Member Concierge desk to discuss thousands of hotel deals on offer across Australia and New Zealand. To book one of these fantastic packages email bookings@ubookdirect.com.au or call 1300 959 550. 5/ For all other packages, head to unionshopper.ubookdirect.com
Recruit a new member and go into the draw to win A luxury
holiday in
Vanuatu Valued at over $5,000
The 2020 – 2021 NSWNMA Member Recruitment scheme prize Tamanu on the Beach Resort & Spa is a peaceful, private and secluded boutique resort located on its own private white-sand beach, just 20-minutes from Port Vila. Voted as Vanuatu’s luxury resort of the year, you will enjoy luxurious, ocean-facing villas and some of the best cuisine on the island. You and a friend will experience the following: • 7 nights’ accommodation in a beach-view villa at Tamanu on the Beach • Welcome fruit cocktail or chilled coconut on arrival • Daily a la carte breakfast for two adults • Free daily shuttle to Port Vila • Free in-house movies • Complimentary use of the resorts island facilities • Complimentary Wi-Fi. The NSWNMA will arrange return flights for two to Vanuatu Every member you sign up over the year gives you an entry in the draw!
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Prize drawn 1 July 20
RECRUITERS NOTE: Join online at www.nswnma.asn.au If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form, so you will be entered in the draw. Conditions apply. Prize must be redeemed by 30 June 2022 and is subject to room availability. Block out dates include 1 July - 30 September 2021 and 1 December 2021 - 31 January 2022. The prize will be drawn on 1 July 2021. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW Permit no: LTPM/20/05518.
Join the health fund that’s all about you.
Nurses & Midwives Health is dedicated to caring for the carers. We’re the only health fund exclusively for nurses, midwives and their families. When you’re a member, you’re part of our family. So that’s why your family members are also welcome to join us.
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 Authorised by B. Holmes, General Secretary, New NMH-NSWNMA-09/20 South Wales Nurses and Midwives’ Association, 50 O’Dea Ave, Waterloo NSW 2017
