The Lamp July 2012

The magazine of the NSW Nurses’ Association

volume 69 no.6 July 2012

AN ATTACK ON INJURED WORKERS Print Post Approved: PP241437/00033

First State Super the fund for all nurses We have a range of well-priced investments which are simple to understand.

First State Super has made super a whole lot easier for nurses If you work in either a public or private hospital (or perhaps both) you can use First State Super for all your super requirements. This could include your employer’s superannuation guarantee (SG) contributions if they provide choice of fund. You may need to complete a Standard Choice form – visit Publications & forms on our website for a copy.

And stay with us when you retire with a choice of two First State Super income streams.

More information Web:

www.firststatesuper.com.au

Phone: 1300 650 873 Email: enquiries@firststatesuper.com.au

Low fees | Simple | Open Consider the First State Super Product Disclosure Statement having regard to your own situation before deciding whether becoming a member or continuing your membership is right for you. A copy is available by calling us or visiting our website. The information contained in this document is current as at June 2012. Prepared by FSS Trustee Corporation ABN 11 118 202 672, AFSL 293340, the trustee of First State Superannuation Scheme ABN 53 226 460 365.

FSS NURSES LAM 0612

First State Super – take us with you wherever you work!

CONTENTS

The

CONTACTS

lamp

NSW Nurses’ Association For all membership enquiries and assistance, including 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@nswnurses.asn.au W www.nswnurses.asn.au

Volume 69 No.6 July 2012

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

COVER STORY

NSWNA Communications Manager Janaki Chellam-Rajendra T 8595 1258

12 | The meanest workers’ comp in Australia The conditions were atrocious, yet more than 9000 people across NSW rallied against the state government’s attack on workers’ compensation.

Anne-Margaret Jeppesen RN

5 6 8 11 21 35 37 38 42 43 47 49 50

Editorial Your letters News in brief What’s on Ask Judith Social media Nurse uncut Nursing research online Crossword Books Movies of the month Obituary Diary dates

TV ADVERTISING

27 | Eleanor explains ratios to the community

RATIOS

22 | Ratios positive for RPA nurses

Nurse-to-patient ratios have improved clinical care and work satisfaction for nurses at the Royal Prince Alfred Hospital.

CORRESPONDENCE

7 | Win a stay in Canberra

Editorial Committee • Brett Holmes, NSWNA General Secretary • Judith Kiejda, NSWNA Assistant General Secretary • Coral Levett, NSWNA President • Roz Norman, Tamworth Base Hospital • Elsie May Henson, Barraba Multi Purpose Service • Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital • Michelle Cashman, Long Jetty Continuing Care • Richard Noort, Justice Health Advertising Patricia Purcell T 8595 2139 or 0416 259 845 or F 9662 1414 E ppurcell@nswnurses.asn.au Records and Information Centre – Library To find old articles in The Lamp, or to borrow from the NSWNA nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnurses.asn.au

The Lamp ISSN: 0047-3936

29 | Brett Holmes replies to Jillian Skinner

Brett Holmes responds to Health Minister Jillian Skinner’s letter on nursing issues.

ADVERTISING COMPETITION

Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnurses.asn.au

COVER PHOTO BY SHARON HICKEY

REGULARS

FOR ALL EDITORIAL ENQUIRIES, LETTERS AND DIARY DATES: T 8595 1234 E lamp@nswnurses.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017

THE VOICE

30 | Prinnie nurses her dream Like nursing, singing is a vocation, says RN Nia Beaman, so she was well placed to support her daughter Prinnie in her bid to be The Voice.

General disclaimer The Lamp is the official magazine of the NSWNA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNA. 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 NSWNA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Privacy Privacy statement: The NSWNA 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 NSWNA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission.

Subscriptions for 2012 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $50.

Individuals $78, Institutions $130, Overseas $140.

T H E L A M P J U LY 2 0 1 2 | 3

DON’T PUT YOUR NSWNA MEMBERSHIP AT RISK! The State Government could at any time stop payroll deductions.

As a matter of urgency please convert to the Direct Debit or Credit method of paying your fees.

BE PREPARED. CHANGE TODA TODAY. ODAAY. Download, complete and return your Direct Debit form to the Association.

www.nswnurses.asn.au www .nswnurses.asn.au Alternatively call us on Metro 8595 1234 or Rural 1300 367 962 Authorised by B.Holmes, General Secretary Secretary,, NSWNA

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

An attack on the injured As The Lamp goes to print the state government’s changes to workers’ compensation have passed through parliament, reducing the New South Wales scheme to the meanest in the country.

“It will cause financial hardship for injured nurses.”

The government’s changes to the workers’ compensation scheme will disproportionately disadvantage nurses and midwives.

Nurses, midwives and assistants in nursing work in dangerous environments. The nature of the profession means that musculo-skeletal and psychological injuries are common.

Recovery from these sorts of injuries takes time, often months or even years.

Risk of harm is inherent in nursing environments such as mental health and corrective services.

Many of the government’s changes are disgraceful. The worst is the cap on medical and related treatment expenses. If a nurse does the right thing and returns to work as quickly as possible after an injury, but with the need for further treatment, she will not receive any payment for the cost of that treatment after a 12-month period from the date of injury, or within 12 months after weekly payments cease (whichever is the longer period). Should she require surgery a year later, directly related to the injury, the cost will no longer be covered by workers’ comp, unless there is a ‘30% whole of person impairment’.

We are talking here about injuries that have occurred in the course of a nurse conscientiously doing her job.

Many other changes are simply heartless.

Prior to this new legislation, the family of a worker killed at work was able to make a claim for nervous shock or trauma. That entitlement has been scrapped, unless the pain and shock in itself is work-related.

The changes make it very difficult to claim for heart attacks or strokes when work was a contributing factor, as was possible before.

It is much harder to prove employer negligence.

FINANCIAL HARDSHIP FOR INJURED NURSES These changes will undoubtedly lead to financial hardship for many injured nurses.

Often, nurses are the sole income earner for their families and have a number of dependents as well as financial commitments such as a mortgage.

A preliminary assessment by the NSWNA indicates that injured nurses and midwives could face a pay cut of at least 20% in the fourth month after their work injury if they have been unable to return to work.

For a fulltime experienced Registered Nurse in a public hospital that is nearly $300 per week less if they are injured for more than 13 weeks. For a fulltime Assistant in Nursing in an aged care facility, that is a pay cut of nearly $150 per week.

Workplace injuries inevitably leave psychological scars as well. Research has shown that many injured nurses suffer from anxiety about their future after an injury (see page 16). The labyrinthine workers’ comp processes they are put through often compound this.

A trauma that will undoubtedly be made worse by the government’s changes.

AN ARTIFICIAL CRISIS The government has manufactured a crisis in workers’ compensation. Really, they are masquerading their mean-spiritedness with dubious economic arguments.

This is merely the latest manoeuvre in a relentless attack on the public sector, which has been in play since the Liberal Party came to office.

Over the past year they have frozen public sector wages and cut 5000 public sector jobs.

In the recent state budget the government announced the axing of the equivalent of 10,000 public sector jobs.

They also have a proposal on the table to remove staffing arrangements from awards.

These cuts and policies are not driven by economics but by ideology.

T H E L A M P J U LY 2 0 1 2 | 5

LETTERS LETTERS

NSWNA – A MUST HAVE I would like to thank all at NSWNA for the support I have been given in my fight for justice, due to a fall at work five years ago.

The fall was accepted as a liability by the health service’s insurer, thus ending my career for hands on nursing. I returned to work and worked hard to retrain in administration. I was a late career getter so it was really hard to accept, not being able to pursue my much-enjoyed goal in life.

The NSWNA helped me to retain my nurse status, penalties and conditions so I can continue working in the industry. I urge all health professionals to get behind your union. No matter how long you have been at your employment they (the NSWNA) are the ones that will get behind you when you need them. It was thought that at 63, I would give up.

But age is no barrier.

We hear so much about our unions – mostly what they don’t do. Not enough praise is given when due.

Many thanks NSWNA Brenda King, ADM/EN Multi assignment contracts Our Local Health District (LHD) has started “multi assignment” contracts. For those who don’t know about this, it is where an employee who is part time takes up another part-time job in another area, or a full-timer reduces hours to take up part-time hours in another role.

Staff members have been informed that accumulated sick leave hours do NOT transfer to the second job. In effect, in the second “assignment” there is no sick leave entitlement for a year, and then you start accumulating

NSWNA responds The issue of Multiple Assignments is not new, although previously referred to as two or three permanent part-time positions, that may involve employment at multiple sites across an LHD or across more than one LHD or alternatively within a single hospital, health service or facility.These positions are not always at the same classification nor covered by the same award provisions.

For permanent part-time staff on multiple assignments, conditions generally remain unchanged. However, there were situations where certain staff members were obtaining entitlements to which they were not entitled.This issue is now being rectified through ongoing negotiation with the Ministry of Health.

LETTER OF THE MONTH

Angry about workers’ comp As I sit here writing this, recovering from surgery as a result of an assault at work, I feel very angry about the proposed changes to workers’ compensation legislation.

I was injured at work in February 2011. I was punched in the throat by an aggressive patient. I have endured two surgeries in an attempt to repair my vocal cords so that I can speak without deficit and fatigue, not to mention many hours of speech therapy, hours of psychological counselling and travel all over Sydney to do this.

Reduced working hours and reduced income. It places a massive strain on myself and my family and my relationships.

My workers’ compensation journey has been one of the most difficult things I have ever had to endure. It has affected every area of my life and, in short, my life and career will never be the same.

I am not sure what role I can play in opposing these changes as I am literally voiceless.

I am seeing all the advertising campaigns and hope that they will make a difference.

Bernadette Pringle, RN

from scratch (too bad if you have 1000 hours in your sick leave bank). Staff can only access their sick leave from the first “assignment” when they are supposed to be at work in the first assignment. If you are sick on second “assignment” days, then you only get LWOP (leave without pay) until you have accumulated sick leave in that “assignment”.

back-to-back in the same area). What it has meant so far for us is that nobody wants the second “assignment”. Why would you?

You do not get an ADO (accrued day off).

You are paid for 80 hours work, not 76.

This is one of the most ludicrous policies to have come from the Ministry of Health. It would be laughable if it weren’t so tragic. And it’s coming to an LHD near you.

Staff members are not entitled to overtime until they have done their 80 hours per fortnight in each “assignment” (unless it’s

In February 2012, a process was introduced whereby staff members were advised of the intention to review the application of award entitlements for multiple assigned staff. It is the Association view that all members who feel that they are not being treated appropriately under this review should contact the Association to receive assistance regarding their individual issue.

All employees, either full time and/or part time, are generally required to complete full-time employee hours, prior to being eligible for overtime payments, except where the award provides otherwise.

Sick leave is an annual entitlement and is aligned to the position per se, should any member be unfortunate enough to find themselves in the position referred to in the members’ correspondence, they are urged to contact the Association urgently.

Every letter published receives a $20 Coles Group & Myer gift card.

6 | T H E L A M P J U LY 2 0 1 2

So these positions are either left vacant, or have to be backfilled with regular staff. Then the holes created by backfilling are filled by regular staff doing overtime. So much for trying to reduce the overtime bill.

Mandy Short, NSWNA delegate However, each time a person commences a new employment situation, be it full time or part time, there is always a qualifying period for entitlements such as sick leave/annual leave etc.

Staff members who are working in a position for 40 hours per week and paid only 38 hours per week are entitled to an ADO.This is funded by the two hours per week that are held back each pay period.

Permanent part-time staff members generally work reduced hours in one or more positions, but do not regularly work 40 hours per week in any one single position, to enable the accrual of the extra two hours per week for the entitlement of an ADO. Each individual position for “multiple assignments” is often set at 19 hours per week, thus ensuring the employee only works a straight 38-hour week and is paid accordingly, resulting in no ADO entitlement.

Again, we would strongly encourage members who have concerns regarding their individual situation to contact the Association Information Services to discuss their specific issues.

COMPETITION

WIN A STAY IN CANBERRA AND SEE Testing for nurses I am writing to express my concern for a really wonderful nurse and what she has had to endure to get her registration as an Enrolled Nurse.

At the cost of $300 she sat her first IELTS (International English Language Testing System) and was told her result of 6.5 was not high enough; she needs overall 7. So at another cost of $300 she books in to sit another IELTS test and scores overall 7!

However, she is still ineligible because she has not scored 7 in all six categories of the test. She scored 7 in four and a 6.5 and a 5.5.

Can you believe it! So here she goes again at another $300 to book in and try to get that 7 in all categories.

I would like to say that this is a woman who is an excellent nurse, born and bred in rural NSW, who for 10 months has not been able to continue her career because she comes from an era where Year 12 was not the be all and end all, when getting into the work force was what sometimes had to be done and working raising a family was a priority and study and career aspiration and goals came later. Now, after all this study to be told that you don’t have enough English skills to register.

Thank you for letting me share my thoughts on this matter. Daily I see nurses who are talking about the pressures of nursing, leaving, looking for alternatives and is there any wonder that with all the barriers such as this that working in a supermarket, a coffee shop, a dress shop or even collecting eggs is more appealing?

Sue Lawler, Nurse Educator Lamp Retraction In the April 2012 issue of The Lamp we published an article entitled “Nurses knock down 60 needless hurdles”.

This News In Brief item on page eight of the issue, discussed the announcement by the Ministry of Health offering 60 scholarships to cover the cost of re-entry to nursing – an important issue to nurses and something the Association campaigned for.The quote by NSWNA General Secretary Brett Holmes in reference to the Australian Nurses and Midwifery Council’s (ANMAC) delay in approving online courses, which would facilitate the re-entry of nurses, has been disputed by ANMAC. In a letter to the Association, ANMAC states: “... delays (approval of online courses) that ANMAC had experienced in receiving information from the education provider concerned.This delay was not within the control of ANMAC and it is misleading to indicate otherwise.”

We would like to retract the statement about ANMAC being responsible for the delays, in light of the clarification provided to us by them.

LETTER OF THE MONTH The letter judged the best each month will be awarded a $50 Coles Myer voucher courtesy of Moore Equipment.

‘Clever carts to help clever nurses.’

For details on the range of clax carts please call (02) 9519 5540 or visit www.mooreequipment.com.au

SAYSOMETHING

Send your letters to: Editorial Enquiries email lamp@nswnurses.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.

NURSES

FROM ZULULAND T O A F G H A N I S TA N

Nurses: from Zululand to Afghanistan, a new exhibition at the Australian War Memorial, explores the personal stories of Australian military nurses, from the first known Australian nurse in the Zulu War of 1879 right up to the experiences of nurses serving in recent conflicts and peacekeeping operations.

It draws on the Memorial’s rich collection to tell the story of Australian military nursing. The exhibition is FREE and on display until 17 October 2012.

The Lamp is offering members a chance to stay in Canberra and see the exhibition. There are three prizes to be won!

Valued at $500, the major prize includes accommodation for two people at Forrest Hotel and Apartments for one night with complimentary breakfast and a bottle of wine; a tour of Nurses: from Zululand to Afghanistan exhibition with curator Robyn Siers; a signed copy of Stories of Love and War by author Rebecca Britt; and a nurses’ pack, which includes Wartime magazine, a bookmark, a copy of Places to Remember and Hall of Memory, compact mirrors, badges, poppies, and much more.

Quiet, convenient and tranquil, Forrest Hotel and Apartments is situated in the leafy suburb of Forrest, with views to parkland and beyond to Parliament House, just minutes from the Australian War Memorial. You will enjoy all the comforts of home complemented by outstanding service.

The second and third winner will receive a two-nights stay in a family room at Canberra City YHA. Canberra City YHA is located in the heart of Canberra, close to all attractions, distractions and activities.

To enter the competition, simply write your name, address and membership number on the back of an envelope and send to: Nurses: from Zululand to Afghanistan Competition 50 O’Dea Avenue, Waterloo, NSW, 2017 Competition closes 31 July 2012. Prize must be claimed before 17 October 2012.

NEWS IN BRIEF

Greece

Germany

?

Health care in free fall Prescription drugs are scarce and health care funding has been slashed as the Greek financial crisis intensifies.

Five straight years of recession have had a devastating effect on the Greek health system.

A shortage of medicines, made worse by panic among patients, has been one of the visible symptoms of the crisis according to the secretary general of the Panhellenic Pharmaceutical Association.

“Already we have cancer sufferers going from hospital to hospital to try and find drugs because no one can afford to stock them,” Dimitris Karageorgiou, told the Guardian newspaper. “120 pharmacies have closed in Athens alone because of pressures from delays in payments for prescriptions from social security funds.

There are about 300 medicines that are no longer readily available.

It’s tragic.”

The Greek government has cut healthcare spending by 13% over the past two years and instructed hospitals to tighten their belts dramatically.

At the same time, public health facilities have seen a 30% increase in demand, as middle class Greeks stop paying for private healthcare.

The Greek state only provides healthcare for people who are employed and making regular national insurance contributions, or if they are fully up to date with tax payments, the director of the charity Medicins Du Monde in Greece, Nikitas Kanakis, told the BBC.

8 | T H E L A M P J U LY 2 0 1 2

Doctors apologise for holocaust The German Medical Association has issued an unconditional apology for the role it played during the Holocaust in the mass murder, sterilization and medical experimentation done on Jewish people and others.

United States

Skills gap found after US veteran deaths A series of reviews by US Veteran Affairs (VA) of its hospitals, following a number of fatalities in cardiac monitoring units, has found a “startling gap” in nurses’ skills.

According to a 2011 VA report of one fatality in Manhattan, the nurses working in the unit didn’t understand how the monitors that tracked vital signs worked. None of the nurses interviewed could accurately explain what would happen if a patient became disconnected from a cardiac monitor, as allegedly occurred to the patient who died.

A review of 29 facilities by the VA Inspector General found only half had adequately documented that their nurses had the needed skills. Some nurses “did not demonstrate competency in one or more required skills” but there was no evidence of retraining, the report said. A US nursing expert who reviewed the reports for the independent news website ProPublica, said the fact that the lapses weren’t identified and corrected “signified much broader problems”.

The findings revealed “a lack of oversight and adherence to accepted clinical and regulatory standards” according to Jane Hirsch, a clinical professor emeritus at the University of California, San Francisco School of Nursing.

The apology, made at a German Medical Association congress in Nuremberg, was unanimously adopted.

The apology says that contrary to popular belief, doctors were not forced by political authorities to kill and experiment on prisoners but rather engaged in the Holocaust as leaders and enthusiastic Nazi supporters.

The apology says “outstanding representatives of renowned academic medical and research institutions were involved” in organising and carrying out the mass extermination of millions.

In the statement the German doctors said they “remember the living and deceased victims and their descendants and ask them for forgiveness.”

United States

Only 1 in 7 medical errors reported A report by the Director-General of US Department of Health and Human Services has found that only one out of seven errors, accidents and other events that harm patients while they are hospitalised is reported.

Even after hospitals investigate preventable injuries and infections that have been reported, they rarely change their practices to prevent repetition of the adverse events, according to the study.

“Despite the existence of incident reporting systems,” the Director-General Daniel Levinson said, “hospital staff did not report most events that harmed Medicare beneficiaries.”

Some of the most serious problems, including some that caused patients to die, were not reported.

Adverse events include medication errors, severe bedsores, infections that patients acquire in hospitals, delirium resulting from overuse of painkillers and excessive bleeding linked to improper use of blood thinners.

The inspector general estimated that more than 130,000 Medicare beneficiaries experienced one or more adverse events in hospitals in a single month.

95

Britain

%

SUPPORTED A GROWTH S T R AT E G Y TO C R E AT E J O B S

70

AGREED

%

WITH REDISTRIBUTING W E A LT H F RO M T H E RICHEST

73

%

BACKED SUPPORT FOR YOUNG PEOPLE TO GO TO COLLEGE

Public gives thumbs down to spending cuts With only 10% of its public sector spending cuts implemented, the British government’s policy of austerity is being challenged by popular opinion.

In a poll recently conducted by a new British trade union think tank – the Centre For Labour and Social Studies – more than two-thirds of people questioned said they were unaware that 90% of the government’s spending cuts had yet to take effect.

The poll revealed that people want an alternative to austerity politics: • 95% supported a growth strategy to create jobs and reduce unemployment • 70% agreed with redistributing wealth from the richest • 74% supported the creation of a national investment bank to lend to businesses for growth • 73% backed support for young people to go to college or university The centre’s chair, Steve Hart said: “The results from this survey show that the consensus behind austerity-focused economic policy has well and truly collapsed.

“Across Britain and Europe there is now an unmistakable demand for a radical economic alternative to austerity and British people are now searching for new and braver ideas from politicians.”

Choose Avondale for

postgraduate studies in Nursing!

MASTER OF NURSING (COURSEWORK) GRADUATE CERTIFICATE IN NURSING Students have a choice from four areas of study: UÊ V> Ê UÊ V> Ê/i>V } Ê Ê ÕÀà }ÊÊ Ê Ê Ê Ê UÊ i>`iÀà «Ê> `Ê > >}i i ÌÊÊ UÊ Ê}i iÀ VÊV ÕÀÃiÊÜ Ì ÕÌÊ>ÊëiV > ÌÞ Ê Ê Ê ÊÊ Ê Ê Ê Ê Ê Ê

Ài` ÌÊ« ÌÃÊ­V«Ã®\ Ê Ê Master of Nursing UÊnÊÕ ÌÃÊÌ Ì> }Ê{nÊV«ÃÊÊ Ê Ê Ê Ê Ê ÊÊ

Ê

Graduate Certificate in Nursing UÊ{ÊÕ ÌÃÊÌ Ì> }ÊÓ{ÊV«Ã Ê Ê Ê Ê Ê

`i\Ê ÃÌ> ViÊ `ÕV>Ì ÊÜ Ì Ê V> «ÕÃÊÃÕ«« ÀÌ° Ê Ê Ê Ê Ê

ÕÀÀi Ì ÞÊÌ iÊV ÕÀÃiÃÊ>ÀiÊ vviÀi`Ê Ê>Ê«>ÀÌ Ì iÊL>à ÃÊ Þ° Ê Ê Ê Ê Ê Ê Ê Ê Ê MARCH and AUGUST intakes µÕ À iÃ\ÊÊ >VÕ ÌÞÊ vÊ Ê Ê ÕÀà }Ê> `Ê i> Ì Ê Ê * i\Ê­äÓ®Ê {nÇÊ ÈÓÇÊ ÀÊ­äÓ®Ê {nÇÊ Èä Ê Ê Ê Ê Ê Ê Ê > \Ê > V °> `iÀà J>Û `> i°i`Õ°>Õ Ê

www.avondale.edu.au

T H E L A M P J U LY 2 0 1 2 | 9

NEWS IN BRIEF

Australia

Dentists take wing The Royal Flying Doctor Service is launching a program to provide dental services to remote communities in outback New South Wales. The $2.5 million program will conduct more than 250 clinics over the next year, more than half for children.

The program will run for the next three years and be funded by private sector donations. It is an add-on to existing Royal Flying Doctor dental services and those provided by the government.

One of the flying dentists, Hendrik Lai, told ABC Radio that levels of tooth decay and disease in the bush were worse than he’d seen in developing countries.

“Certainly the severe cases that we see in these rural and remote vulnerable communities in many cases are worse than what we see in developing nations like East Timor,” he said. “In certain areas people haven’t seen a dentist since the 90s.”

One beneficiary of the new scheme, Geoffrey Wallace, told the ABC that without the service he would need to drive several hundred kilometres to see a dentist.

“Too bloody far. We need a dentist here, now. It’s a necessity.”

“Without the service I would need to drive several hundred kilometres to see a dentist.”

Australia

Managing mental health and smoking The NSW Health and NSW Cancer Council have combined to provide training and practical tools for nurses and others involved in the care of people with mental illness.

The training, being delivered via the Addressing Smoking in Mental Health project, aims to give skills to manage nicotine dependence among mental health clients.

Anna Jones, a project manager working with the Cancer Council, says people with mental illness are more likely to smoke than others.

“This is a significant issue, bringing about both health consequences and premature death. It also entrenches the social disadvantage many people with mental illness face, as a regular to heavy smoker would spend on average between $70 to $100 a week on cigarettes.”

The training covers: • the relationship between smoking and mental illness.

• assessing nicotine dependence on admission.

• managing nicotine withdrawal in hospital.

• the impact of smoking cessation on medications.

Training will be offered through Local Health Districts. For more information, visit the NSW Health website: www.health.nsw.gov.au

1 0 | T H E L A M P J U LY 2 0 1 2

Brenden Stapleton, NSW nurse was one of the three Hesta Award winners on the night: from left to right, Glenda Entwhistle (DON), Brenden, Anita Sharma – ME Bank, Mark Ashby – HESTA.

Australia

HESTA and ME Bank working together to support nurses HESTA and ME Bank representatives visited the winners of the 2012 HESTA Australian Nursing Awards at their workplaces recently to host a series of celebratory morning teas.

It was a wonderful opportunity for the winners to share their achievements with their colleagues and reflect on the awards evening.

“The feedback from both the finalists and winners was they felt like movie stars at the Oscars during the night and were overwhelmed and appreciative of the whole experience. This is what makes it so special for me, as I am the lucky person who gets to contact the winners and arrange their prizes,” Kylie Whicher ME Bank National Partnership Manager said.

“ME Bank is a proud sponsor of the HESTA Australian Nursing Awards and we feel privileged to honour and recognise the extraordinary achievements of nurses. The prize money we provide goes directly to the winners to assist them to further their education, enhance their innovative initiative or treat themselves to a well deserved break,” Kylie added.

This could be you in 2013! Nominations for the 2013 HESTA Australian Nursing Awards open in September 2012. For more information visit hestaawards.com.

For more information on ME Bank visit mebank.com.au.

EDUCATION@NSWNA

Head of the Bahrain Nurses’ Association, Rula al Saffar, right, and Dr Fatima Haji, left, comfort each other after hearing the appeals court verdict.

Bahrain

Nurse freed but colleagues jailed An appeals court in Bahrain has convicted nine doctors for their alleged roles in the country’s pro-democracy protests, sentencing them to between one month and five years jail.

The court dismissed verdicts against nine other medical staff, including Rula al-Saffar, head of the Bahrain Nurses’ Association.

She had originally been sentenced to 15 years in prison.

All were originally convicted by a military court, on charges of attempting to overthrow the government. An Independent Commission of Inquiry found the medics were tortured while in custody.

Organisations such as Amnesty International and Physicians for Human Rights described the charges as a travesty of justice. They said the medics only “crime” was to treat wounded protestors and speak to the international media.

Bahrain Nurses’ Association leader Rula al-Saffar, formerly head of the emergency nursing program at the College of Health Sciences, said she was too sad to celebrate her release because “I am not free if my colleagues are not free.

“Over five months of detention, I was beaten, given electric shocks, and sexually harassed. Then I was convicted – just for doing my job.”

Rula al Saffar, who lived in the US for 18 years, criticised the Obama administration for remaining “mostly silent” about the abuses perpetrated by its ally, which hosts the US Fifth Fleet and is a major buyer of US weaponry.

WHAT’S ON JULY 2012

Computer Essentials for Nurses and Midwives – 1 day 4 July, Prince of Wales Hospital, Randwick Seminar is suitable for all nurses and midwives.

Members $85 Non-members $170

——— • ——— Legal and Professional Issues for Nurses and Midwives – ½ day 6 July, Albury, 13 July, Coffs Harbour, 27 July, Dubbo Topics covered include the Health Practitioner Regulation National Law, potential liability, importance of documentation, role of disciplinary tribunals and writing statements.

Members $40 Non-members $85

——— • ——— Are you meeting your CPD requirements – ½ day 20 July, Port Macquarie Seminar is suitable for all nurses and midwives to learn about CPD requirements and what’s involved in the process.

Members $40 Non-members $85

——— • ——— Aged Care Seminar Series – 1 day 20 July, Armidale Seminar is suitable for all RNs, ENs and AiNs. Members $75 Non-members $170

——— • ——— Practical, Positive Leadership – 3 days 24 July, 11 September, 23 October Penrith A workshop specifically designed to meet the leadership needs of nurses and midwives.

Members $250 Non-members $400

——— • ——— Mental Health and Drug and Alcohol, Nurses’ Forum – 1 day 27 July, Waterloo Members $30 Non-members $50

——— • ——— Basic Foot Care for RNs and ENs – 2 days 22 & 23 August, Newcastle Members $203 Non-members $350

“Over five months of detention, I was beaten, given electric shocks, and sexually harassed.

Then I was convicted – just for doing my job.”

——— • ——— To register or for more information go to www.nswnurses.asn.au/education or phone Carolyn Kulling on 1300 367 962

T H E L A M P J U LY 2 0 1 2 | 1 1

COVER STORY

The meanest workers’ comp in Australia

The conditions were atrocious — a cold day with driving rain — yet more than 9000 people across NSW rallied against the state government’s attack on workers’ compensation.

1 2 | T H E L A M P J U LY 2 0 1 2

CATASTROPHIC FOR NURSES Several workers, who will be badly prejudiced by the changes, addressed the rally, including RN Emily Orchard.

“I injured my back at work while assisting in the resuscitation of a patient. It started a journey to hell and back. Life has been incredibly difficult. Every day I have pain. At every step the insurer has resisted paying for treatment,” she said.

Emily said the proposed changes to workers’ comp would see all support withdrawn after two-and-a-half years.

“This is a frightening prospect.Will I end up on a disability pension or the financial burden placed on my family? That’s not fair when I was injured doing my job.

“The planned reform on workers’ compensation is going to be catastrophic for workers.”

NSWNA General Secretary Brett Holmes says the changes will bite particularly hard for nurses.

“Hundreds of nurses and midwives, in public and private hospitals and aged care facilities, suffer serious injuries each year.These are not always high-profile injuries, but the ‘sprain and strain’ injuries nurses and midwives often suffer can cost them thousands in lost income under the current system.

“The O’Farrell Government plan will make those losses even worse, because it is not uncommon for these types of injuries, especially if they involve the back, to go on for months.

A STRONG CONTINGENT OF NURSES RALLIED

outside NSW Parliament House on June 13 with more than 7000 other workers. In Newcastle, 2000 turned out and in numerous other centres across NSW rallies were held to protest the O’Farrell Government’s attack on workers’ compensation.

The rallies were held on the eve of the government introducing into parliament a bill that would: • reduce benefits after 13 weeks • stop benefits after 2 1/2 years for workers with partial capacity • stop medical payments after 1 year from the date a claim is made or weekly payments cease, whichever is larger • remove journey claims • limit access to lump sum payments At the rally in Macquarie Street, Sydney, Unions NSW Secretary Mark Lennon blasted the government for its narrow approach to reform.

“When it comes to workers’ comp and reforming the system, the O’Farrell Government has one agenda – a free kick for employers. Forget better health outcomes for workers. Forget compelling employers to provide better return-to-work programs. Forget making insurance companies earn their money by better claims management. No, just once again, attack the worker,” he said.

“Where are the broader proposals that put additional responsibilities for improving

the scheme on employers, insurers and WorkCover?”

He contested the government’s assertion that there is a crisis within the workers’ compensation scheme and said the latest attack was consistent with an anti-worker agenda that the government had been driving since elected.

“In the past 15 months this government has announced privatisations, cuts to entitlements, job cuts and the removal of workplace rights.And more in yesterday’s budget: 10,000 more jobs cut and another $1.2 billion cut to entitlements.”

“A preliminary assessment of the O’Farrell Government plan, by the NSWNA, indicates that injured nurses and midwives could face, at least, a 20% pay cut in the fourth month after their work injury. For a fulltime, experienced Registered Nurse in a public hospital, that is a pay cut of nearly $300 per week.

“If they are injured for more than 13 weeks, for a fulltime Assistant in Nursing in an aged care facility, that is a pay cut of nearly $150 per week.”

“When it comes to workers’ comp and reforming the system, the O’Farrell Government has one agenda – a free kick for employers.”

— unions nsw secretary mark lennon

(pictured) T H E L A M P J U LY 2 0 1 2 | 1 3

COVER STORY

An attack on injured workers Like many nurses injured at work, Anne-Margaret Jeppesen, RN at Blacktown Hospital, will need a lifetime of treatments and medication.

How O’Farrell’s Workers’ Comp cuts will affect you Changes are retrospective According to a government briefing, the “changes to weekly benefits, medical costs and duration [of payments] are to apply as soon as possible to existing claims” and “changes to lump sum compensation are to apply to existing claims from the date of the legislation’s introduction”.

Most payments will cease after 2.5 years

“I WENT TO THE RALLY BECAUSE I BELIEVE THAT IF THINGS are not going right in the industry it’s important that people speak up. If something’s wrong you have to do something about it. If you sit on the fence nothing gets changed.

“I’ve been to hell and back several times with a number of back, shoulder and neck injuries starting from 1985. I had three femoral hernia repairs and femoral nerve damage, followed by a lumbar disk prolapse.

“When I first got injured there were no light duties for nurses then so you just had to keep going and make the best of it.

“I am now doing an admin job because I’m not fit for bedside nursing – I can’t work above shoulder height or lift more than five kilograms, for example.

“In my experience, once you are injured nobody looks after you at work – you are on your own.

However, I’ve been very happy with the backup from the Nurses’ Association. I used the Association solicitors a few times to resolve some workers’ comp problems.

“I’m now working full time so I no longer rely on workers’ compensation for income, but it still covers my treatments and medication. It’s not a lot of money but it’s a lot for me.

“The new legislation puts a one-year cap on payment of medical expenses so my financial situation will be worse, especially after I retire.”

1 4 | T H E L A M P J U LY 2 0 1 2

Most workers’ payments will cease after 2.5 years, unless there is total incapacity for work.

Payments will then cease for those with total incapacity after five years, unless there is 20% whole person impairment. Previously, payments continued until you could return to work – or until retirement.

Cover during travel retained in limited form Workers injured when travelling are only covered “if there is a real and substantial connection between the employment and the accident or incident out of which the personal injury arose”.

Cuts to medical expenses cover Medical and other expenses are only paid for maximum of one year from the date a claim is made, or weekly payments cease, whichever is longer.

Restrictions on cover for occupational disease Disease is only to be covered where employment is “the main contributing factor”, rather than previously where it could be one of a number of contributing factors

Partners’ claims for nervous shock abolished Currently the spouse, partner or direct relative of someone who has died in a workplace accident can access some cover if they are diagnosed as having nervous shock as a result, and, for example, are unable to work for a period of time.

This Bill abolishes that type of claim.

“The new legislation puts a one-year cap on payment of medical expenses so my financial situation will be worse, especially after I retire.�

T H E L A M P J U LY 2 0 1 2 | 1 5

COVER STORY

Injured workers face hostility For people on workers’ compensation, coping with injury or illness may be the least of their worries.

59% of survey respondents reported having contemplated suicide following their injury.

1 6 | T H E L A M P J U LY 2 0 1 2

DEALING WITH UNCARING AND

hostile employers and/or insurers is a far greater cause of stress to people on workers’ compensation than their injuries and/or illnesses.

This is revealed in a survey of NSW workers, presented to the state parliamentary committee that recommended drastic cuts to workers’ compensation benefits.

Carried out by the Injured Workers’ Support Network, the survey received detailed responses from more than 300 people who were either receiving workers’ compensation, in dispute over their claims, or back at work in a limited capacity.

Of those surveyed, 42% nominated dealing with their employer/insurer as the biggest cause of stress. A further 20% said dealing with the workers’ compensation system was the major stress factor. Only 16% named their injury or illness as the most stressful factor.

An alarming 59% of survey respondents reported having contemplated suicide following their injury.

Fifty-five per cent said their relationships had suffered significantly and 34% were now separated or divorced.

Convenor for the Injured Workers’ Support Network, Michelle Burgess, said the survey showed many injured workers experienced the claims management process as hostile and uncaring.

“Unnecessary and often inappropriate pressures are being placed on many injured workers, which do not assist their rehabilitation needs,” Michelle said. “In too many cases, injured workers report that employers do everything they can to stop them from returning to work and that insurers attempt to bully them and their treating doctors into treatment schedules that ignore medically accepted treatment standards.

“Insurers routinely deny and delay treatments and then fail to monitor and manage ongoing treatments when they are finally approved.”

Poor case management, by insurers who were poorly equipped to understand or appropriately manage many of the cases they receive, was also a major contributing factor to cost blowouts in the workers’ compensation system, Michelle said.

“Any attempt to reduce benefits will add further hardship on people who already consider current benefits to be both unfair and inadequate.”

Estimated Earning Pre-injury

6%

10% 11%

40% 33% <$10,000 $10,000 -$20,000 $20, 000- $30,000 $30,000 -$40,000 $40,000- $50,000 $50,000- $60,000 $60,000-$70,000 $70,000 or greater

Estimated Earning Post-injury

6% 52%

8% 13% 21%

<$10,000 $10,000 -$20,000 $20, 000- $30,000

“Every day I have pain.

At every step the insurer has resisted paying for treatment.”

— rn emily orchard

$30,000 -$40,000 $40,000- $50,000 $50,000- $60,000 $60,000-$70,000 $70,000 or greater Source: Submission to the NSW Parliamentary Enquiry into the Workers Compensation Scheme May 2012

T H E L A M P J U LY 2 0 1 2 | 1 7

COVER STORY

NINETEEN MONTHS AFTER BEING ATTACKED

and stabbed by a patient, and seeing a colleague fatally wounded, mental health nurse Emily Pritchard continues to rely on workers’ compensation support for her rehabilitation.

Ongoing psychological counselling has been essential in helping the 21-year-old Endorsed Enrolled Nurse return to work and cope with the trauma of the attack in Orange on January 2, 2011.

“I wouldn’t have been able to set foot in the workplace again without workers’ compensation continuing to pay for psychologist sessions, which have been extremely helpful,” she says.

“Continuing to see a psychologist once a month really helps me to be able to keep going back to work, and to work through the issues I have after the incident.”

Injured nurses may be about to lose such support, with the New South Wales government moving to put a cap on medical expenses, and a time limit on payments. The current scheme, which covers 100% of a worker’s wage for 26 weeks, will be replaced by a system of stepped-down benefits after 13 weeks.

“You can’t put a time limit on recovery.

Some people never fully recover.”

— emily pritchard een

1 8 | T H E L A M P J U LY 2 0 1 2

Time heals, at its own pace A young nurse injured in a harrowing workplace assault tells why ongoing workers’ compensation support – now under threat in New South Wales – can be vital to recovery.

Emily was in the second year of her nursing career when a patient attacked her with two steak knives, partially severing the little finger on her right hand. Her life was saved when a courageous fellow nurse, Bob Fenwick, came to her rescue and was himself stabbed in the chest. Mr Fenwick, 63, died the following day.

Mr Fenwick was posthumously awarded the Star of Courage earlier this year, having been nominated by the NSWNA Mid Western Mental Health branch.A patient also received a bravery medal for helping the two nurses during the attack.

Emily underwent an operation to reattach ligaments, arteries and nerves in her hand.

The surgery and physiotherapy succeeded in restoring movement but the nerves have not fully grown back, leaving her with only partial feeling down one side of her little finger.

In April 2011 she returned to work for three half-days a week, gradually building up to five days,“but only if I am up to doing it. I don’t sleep many nights so there are days when I can’t make it to work.

“Management has been very supportive with my return to work plan, and in paying my shifts even if I can’t come to work. I’m rostered as an extra on the ward so other staff are not put out if I’m not able to come in.”

Emily says having her wages and medical costs covered by workers’ compensation has been crucial, especially because she has an eight-month-old daughter to support.

“If nurses are no longer able to get their wages covered in full after an injury, then how are we meant to look after ourselves? How are we meant to survive, let alone pay for the cost of treatment and rehab?

“You can’t put a time limit on recovery.

Some people never fully recover and need ongoing support for the rest of their lives. If they don’t get it how are they ever meant to go back to work?”

NSW Nurses’ Association Assistant General Secretary, Judith Kiejda, said Bob Fenwick’s death was the first death of a nurse at work in NSW since Sandra Hoare was murdered at Walgett Hospital in 1994.

However a nurse at Blacktown Hospital’s psychiatric emergency care centre was brutally assaulted by a patient last October.

“Nurses, midwives and nursing assistants are particularly vulnerable to cuts to the workers’ compensation scheme because so many of them work in environments where there is an increased risk of injury,” Judith said.

“These include emergency departments, mental health units, facilities within the criminal justice system, aged care where many residents suffer from dementia, and community care where nurses are required to attend patients’ homes alone.”

Adding insult to injury Nursing is a physical job but nurses are vulnerable to psychological as well as musculo-skeletal injury.

WHEN A NURSE IS INJURED AT WORK IT

usually results in much more than physical pain and loss. It usually goes hand-in-hand with psychological injury and a sense of anxiety about the future.

Dr Maya Guest, of the School of Health Sciences at the University of Newcastle, has conducted comprehensive research with 674 injured nurses, looking at their rehabilitation.

The study involved nurses with a significant injury that had resulted in an absence of more than five days away from their usual work.

She said the research was driven by two key questions: why are so many nurses unable to return to pre-injury jobs? And why is it so difficult to find them suitable duties?

“Research shows that it is best to get workers back to the workplace as soon as possible but in suitable duties that don’t exacerbate the injury. If you do that it is more likely to get them back to pre-injury duties.

This wasn’t happening in an ideal manner,” she says.

Musculo-skeletal injuries are by far the most common injuries for nurses but the big, poorly acknowledged sleeper is the psychological injuries that can come with the injury, and from the difficulties and trauma found on the road to recovery.

“People were saying in the research ‘I have a musculo-skeletal injury but I also have a psychological injury’. They told us that the process was so difficult that they ended up with a psychological injury as well,’ says Dr Guest. “Psychological becomes important because 32% said that when they reported the injury they got a negative response from their supervisor or from HR. “If you report a psychological injury the chances of getting a negative response are high, which exacerbates the problem.”

FAILURE TO FIND SUITABLE DUTIES Maya Guest says the key impediment to rehabilitation is the failure to find suitable duties for nurses to allow them to return to work.

“Nursing is a physical job, especially for AiNs and ENs, but it is difficult to give them suitable duties, compared to specialist nurses who are easier to return to work.

“For 30 years I gave my patients the best available care but when I was a patient I didn’t get it. I had to wait for approval from the insurer.”

— from one of dr guest’s survey participants

“If you’re injured, the employer should be able to provide you with duties that avoid tasks that would worsen that injury.

Dr Guest says 87% of those nurses with musculo-skeletal injuries who participated in the research were provided with suitable duties. The 13% who weren’t, went on to develop a psychological impact.

Just more than half (51%) of participants had not been able to return to their pre-injury duties. This often left them worried about their long-term ability to work and earn a living. Lack of understanding from colleagues compounded the problem.

“If you are a nurse, employed on a ward, and another nurse can’t do manual handling but can do other tasks, and if she is not supernumerary, you have to cover for her. This is where some resentment comes from.

“This explains why nurses continue to work when they have an underlying injury, because they don’t want to be a burden on their team.

“They know they have a problem. They try to cope, they use up their leave and then, when they report the injury, it is going to be tough. She says older nurses especially are likely to do this.

“Ageing of the nurse workforce is a huge factor and will continue to be one. Older nurses struggle on through the injury and tend not to report it.”

Rural nurses trying to return to work also face particular obstacles to their rehabilitation.

Injury suffered by nurses Dr Guest’s research found that of the injuries suffered by nurses: • 86% were physical: the most common being musculo-skeletal.

• 62% resulted from the heavy nature of the work: — pushing/pulling injuries.

• 22.5% were from aggression: — bullying or mental stress.

The difficulties nurses face in returning to work • 63% took more than two weeks to return to work.

• 76% needed suitable duties.

• 64% needed to see a specialist and needed approval from an insurance company to do this.

“There is a bigger distance to work and also to treatment.The travel often undoes the good physio that is done. People can travel 50 kilometers on dirt roads to get to work. The car trip is a killer.”

Dr Guest quotes one particular nurse who she says captures the frustration of the process of rehabilitation: “For 30 years I gave my patients the best available care but when I was a patient I didn’t get it. I had to wait for approval from the insurer.” …continued page 20 T H E L A M P J U LY 2 0 1 2 | 1 9

COVER STORY

…from page 19

Dear Brett and members of the NSW Nurses’ Association, Here in Victoria, we fully suppor t your fight to retain a fair and just workers’ compensation system for your injured and ill nurses. We know that being injured at work can be devastating in its own right, without having to fight to maintain adequate levels of income in the process.

Injuries and illness caused by work affect not just nurses and midwives, but also everyone around them, including family members, friends, work colleagues and of course the wider community.

By stripping back the rights and entitlements of injured nurses and midwives, this would make an already extremely difficult time significantly worse.

Please convey our suppor t to your New South Wales members.

Yours in solidarity, Lisa Fitzpatrick Branch Secretary Australian Nursing Federation (Victorian Branch)

KURRI KURRI WORKERS’ COMP RALLY Members from the Kurri Kurri District Hospital held a rally to show their opposition to proposed changes to NSW Workers’ Compensation law. Local businesses, KFC, Kurri Seafood, Kurri Subway and The Bread Basket, showed their support for the hands off workers’ comp message, by providing lunch.

“Their support was very much appreciated as we used our lunch breaks to protest, so that the patients under our charge did not suffer,” Julia Morgan, CNS at the Kurri Kurri Hospital Emergency Department, told The Lamp.

2 0 | T H E L A M P J U LY 2 0 1 2

OTHER SECTORS TRY HARDER In contrast to health, employers in heavy industries will do anything to get their employees back to work because their premiums are based on the company’s claims history says Maya Guest.

“They will do anything to keep the premiums down. If the organisation is big enough they will always find a role because of the premium. In big multinationals it is often a KPI for the CEO. Unfortunately this doesn’t translate into the health sector.”

Dr Guest says the state government may well be right that the workers’ compensation scheme has high costs. But, she argues, there are other ways to fix the problem.

“With what we have seen in our research, rehabilitation in some areas is not working well. So I am not surprised that the costs are high.There are structural issues with the process.

“We know nurses, with their health expertise, have a good knowledge of what is needed to get better. One problem for nurses is the process is not working for them or it is holding them up from getting the treatment they need.

“Get the process working better initially and you won’t have these long drawn out claims. The claims shouldn’t be taking this long.”

Q&A

ASK JUDITH Will workers’ comp changes affect me?

I have been reading in The Lamp about the changes proposed by the O’Farrell Government to workers’ compensation. As I am employed in a nursing home and am no longer covered by a State Award, would these changes affect me and my colleagues?

Yes, you and your colleagues will be affected by any changes to the legislation. The Workers’ Compensation Act and the Workplace Injury Management and Workers’ Compensation Act cover nurses employed in NSW, irrespective of whether they are working in aged care facilities, the private or public health sectors.

Employer won’t find me suitable work I am a registered nurse and was recently attacked by a patient in a mental health unit in a public hospital. While my injuries have resolved, I continue to suffer anxiety at the thought of returning to work in the same unit. My doctor has cleared me to return to work, with the restriction that I do not work in that area. Even though I also have experience working as a general nurse, the management says there is no work available for me. I have applied for a number of advertised positions with my employer, but to date have been unsuccessful. Is this fair?

The Workers’ compensation legislation is very clear in relation to the responsibilities of employers, insurers and injured workers.

Once the treating doctor deems an injured worker fit for suitable duties, and the worker has requested suitable work, the onus is on the employer to provide a graduated Return to Work Plan to assist the injured worker to return to their pre-injury duties.

If it becomes evident that you will not be able to return to your pre-injury duties and you have requested suitable work, Section 49 of the Workers’ Compensation and Injury Management Act 1998 places the onus on the employer to provide suitable work.

Further, section 3.2.1 of the Department of Health Policy Directive, Recruitment and Selection policy and Business Process – NSW Health Service 2011_032, requires an injured worker to be given priority status for a more suitable position.

However, management often misinterprets this requirement and the Association has experienced difficulties in getting the directive implemented. Therefore, in our submission to the government inquiry into workers’ compensation, the Association emphasised the fact that significant savings would be made in the workers’ compensation budget, if the responsibility of employers to provide suitable work to injured workers was enforced.

30 JUNE - 15 JULY 2012

When it comes to your rights and entitlements at work, NSWNA Assistant General Secretary JUDITH KIEJDA has the answers.

In your case, the employer should seek clarification from your treating doctor as to your prognosis and whether it is expected you will return to your pre-injury duties. Then the recruitment process for an identified position should be placed on hold while your priority status is established.

What if my benefits cease before I recover?

On reviewing the areas targeted by the government concerning workers’ compensation benefits, as an injured worker I am insulted by the suggestion in the issues paper that reducing or removing benefits will provide “incentives” for injured workers to return to work sooner! What will happen to injured workers if, as suggested, benefits are ceased but they are not fully recovered and back at work?

Unfortunately, although the government has not addressed it, it would appear that in this circumstance injured workers would have to rely on sickness, disability or unemployment benefits for income. If they still require ongoing medical treatment the cost would be shifted to Medicare. Further, if the injured worker requires surgical intervention, they would be placed on the public hospital waiting list or need to fund the surgery themselves.

Obviously, this will put greater pressure on public hospital waiting lists and any delay in injured workers accessing surgery would result in extending the recovery period and their ability to return to meaningful work. The nature of the work undertaken by clinically based nurses, and the resultant manual handling injuries they can sustain, are such that their recovery is often prolonged.

Will removing journey claims affect me?

I am currently unfit to work due to an accident on my way home from work. My understanding is that the government wants to remove journey claims from the workers’ compensation benefits. How will this affect my claim and can the changes be made retrospectively?

Information is scant concerning how this might be implemented and what type of incidents would or would not be covered. It is suggested that motor vehicle accidents should be covered by accident insurance and not workers’ compensation. However, it does not address what would be the case in relation to other types of journey incidents, for example trips and falls. Further, it is anticipated that all current claims would be affected by proposed changes to the introduction of the statutory rate of pay after 13 weeks, instead of the current 26 weeks, and the ceasing of all benefits possibly after two and half years of incapacity.

See an amazing Winter scene at Hunter Valley Gardens complete with snow and ice sculpture sculptures, s, have a go ice skating and take a toboggan ride! · 114cm High Polar Bear Ice Sculpture Sculpture · Winter Storytelling · 15m2 Skating Rink* · Make your own snowman or snow angel Tubing Toboggan To oboggan Race · Snow Tubing

· Snow Ball Thr owing Game Throwing · Winter Wonderland Wonderland o Treasure Hunt Treasure · Hunter Valley Va alley Gar dens T rain *Additional fee Gardens Train · Food and Beverage are fr ee after paid entry into the Gar dens · All activities are free Gardens

Make a night of it and stay in the Hunter Valley Wine Country at Harrigan’s Irish Pub & Accommodation just $204 per night midweek and $284 per night on weekends.

This includes accommodation, breakfast and garden entry for 2. Terms & conditions apply. Based on twin share.

Book Tickets online at www.hvg.com.au Phone 02 4998 4000 Broke Road Pokolbin

For bookings and inquiries please contact Harrigan’s on 02 4998 4300 T H E L A M P J U LY 2 0 1 2 | 2 1

RATIOS

Ratios positive for RPA nurses Nurse-to-patient ratios have improved clinical care and work satisfaction for nurses at the Royal Prince Alfred Hospital.

ON A GOOD DAY, IN THE BAD DAYS, ONLY

“The extra numbers meant I was able to implement a new model of care that saw the introduction of a flow nurse who helped with the admissions and discharges on the ward.”

2 2 | T H E L A M P M AY 2 0 1 2

seven nurses could be there to care for patients in Ward 7 East 2 at the Royal Prince Alfred Hospital (RPA). The Ward 7 East 2 surgical unit has a high patient turnover rate and is a multi-disciplinary ward specialising in, among others, urology, melanoma, gynaecology, gynae-oncology, radiation oncology and dermatology.

Aaron Jones, Nursing Unit Manager of this ward, remembers just how difficult it was before nurse-to-patient ratios were put in place.

“The staff were very stressed,” Aaron said. “They would often get so busy that they wouldn’t have time to just stop for a minute and regroup, and that would build up the stress.”

Only 30 beds are available to patients in the ward, with at least 12 discharges and admissions being made every day.

“Nurses would always say at the end of their shift that they felt that they didn’t have enough time to finish their work properly, or they didn’t get enough time to sit down and talk to the patients, or they felt that they were rushed,” Aaron told The Lamp. “On weekends, the nurses would report that they were very busy because there were only six of them on the ward and they felt that the workload was quite heavy.”

After ratios were implemented in August last year, the NUM noticed significant improvements in staff morale and the quality of clinical care.

“On a workplace satisfaction survey that we did late last year, after the new award provisions came in, we saw a significant improvement on the previous staff satisfaction survey results.

“What I’ve seen as a manager is staff who were really stressed and not particularly happy at times, to staff that are less stressed.

There will always be stress in this job, but now staff report to me that they have a lot more workplace satisfaction.”

New ratios have also allowed the ward to change its model of care, through the new staff they have taken on board. To add a much needed boost to the provision of care in the RPA ward, once the award provisions were put in place, Aaron spent a couple of months recruiting graduates, a flow nurse, supernumerary and extra night shift staff.

“The extra numbers meant I was able to implement a new model of care that saw the introduction of a flow nurse who helped with the admissions and discharges on the ward.

“We’ve taken on a lot of graduate nurses, which has been fantastic,” Aaron said. “We’re in a position where we’ve got quite a few graduate nurses coming through and in 12 months time, when we retain them, we’re going to have quite a nice, healthy robust nursing workforce.”

The hospital’s quality improvement program has also shown positive results. The Hand Hygiene Australia rating has risen from a 3.5 to a 5–star rating.

“RPA also has a clinical audit program.

Since August last year not only are the audits being completed by clinical staff, which is how it was designed, but our audit results are improving,” Aaron told The Lamp.

“Also what I’ve noticed is that staff are taking more interest in looking at extra stuff that they can do on the ward.

“It has been positive and I think it can only get better.”

Aaron Jones, Nursing Unit Manager with Emma Warren, RN. T H E L A M P J U LY 2 0 1 2 | 2 3

RATIOS

“You can definitely see the difference it has made.

The ward is a lot more relaxed.”

Lisa Bullock, RN

More attention for discharged patients Lisa Bullock has worked continuously in Ward 7E2 for 18 months, first with the old nurse numbers, through the implementation and now, for six months, with settled nurse-to-patient ratios.

She says an important benefit of ratios is the presence of a nurse who gives priority to discharges.

“We are a surgical ward with about 10 admissions and discharges every day. We have acute post-operative patients with acute surgeries such as cystoprostatectomies. They are complex surgeries. The patients come back in acute condition with a lot of things going on and at the same time you have others you are trying to discharge before 10 o’clock.

“Before, you wouldn’t have time to give the discharges information that they would benefit from. There is only so much you can do in one shift.

“Since we’ve had the ratios we have a supernumerary nurse who concentrates on discharges. They make sure they have their information, that they have a lift home, that they get their medications. So the patients are not waiting for hours and hours. The patients get out of here quicker.”

Lisa says she used to find it scary when there weren’t enough nurses on the ward but thankfully things have changed.

“You’d have this black cloud hanging over you that something serious could happen – especially when you are a new grad.You also suffered at home.You were so tired when you left. Often you didn’t get meal breaks.

“Yesterday a nurse said to me that she has more time and it is calmer with eight patients between two, rather than 10.

She was able to give them a bed bathing. It was more satisfying.”

Lisa Bullock, RN 2 4 | T H E L A M P J U LY 2 0 1 2

Emma Warren, RN

More time for mentoring RN Emma Warren has had two stints in RPA’s Ward 7E2, giving her an objective view on the value of nurse-to-patient ratios.

She did her new grad rotation in the ward before it had ratios, worked in another ward without ratios and then returned to 7E2 after ratios had been implemented.

“You can definitely see the difference it has made. Even having one less patient to look after makes a massive difference. The ward is a lot more relaxed.

“You are able to focus on one particular room with, say, four patients.You are not going in and out all the time. It’s better for patients – they always see a nurse within view so they are calmer. Nurses have a chance to be thorough.You don’t have to rush through everything, which gives more job satisfaction.”

Emma says a big plus of having more nurses on the ward is the increased opportunity for nurses to develop their skills.

“It encourages the senior staff to improve leadership. Ratios have brought in more graduate nurses. Now senior nurses have more time to help them. If you haven’t got the staff it can be a burden for senior staff, showing the younger ones.

“I’ve changed from being a new grad to having a leadership role.

I can’t imagine being able to do it with the previous workload. With more time you can provide that leadership to new grads.”

Emma says she was inspired to join the NSWNA campaign to implement ratios and hasn’t been disappointed.

“When I was a new grad I got involved in the rallies for ratios because I found the wards were very stressful. I was up for the ratios. I get satisfaction out of the fact that we won them.You know you can make a difference if you get involved.”

Emma Warren, RN

T H E L A M P J U LY 2 0 1 2 | 2 5

These people are caring, compassionate and leaders in their field.

Do you know them?

2012 Leadership in Nursing and Midwifery Awards PRESENTED BY – DEAKIN UNIVERSITY AND HEALTH SUPER

Enter or nominate now at healthsuper.com.au/nursingawards Applications close on Friday 7 September 2012

$20,000 MAJOR PRIZE

$6,000 PRIZES AWARDED TO 2 FINALISTS

Health Super is a division of the First State Superannuation Scheme ABN 53 226 460 365 of which FSS Trustee Corporation ABN 11 118 202 672 AFSL 293340 is the Trustee

TV ADVERTISING

Eleanor explains ratios to the community Nurse-to-patient ratios have been won – but with the state government holding a report recommending their removal, the NSWNA is using television to engage the public in understanding that ratios bring better patient care.

ROYAL PRINCE ALFRED (RPA) RN

Eleanor Romney, who stars in the Association’s new TV ad, says it is vital that we educate the public about the importance of ratios in ensuring the best patient care.

“I was very happy to be involved with the nurse-to-patient ratio ad, as I strongly believe that we need to raise community awareness about ratios. The public needs to know that better nurse-to-patient ratios means safer, more effective care. These are hard fought for changes to the public health system and the people of New South Wales should know how ratios improve the care they receive.”

Eleanor says we should not discount the possibility that the government could remove ratios from the award.

“I am worried about the O’Farrell Government’s plans for

ratios - there is the possibility that they may remove them. We want nurse-to-patient ratios rolled out more broadly in the New South Wales health system, not rolled back.

“I think this ad plays an important role in educating the public about how the new ratios benefit them, and what they could lose if the government goes ahead and rolls them back.”

She said making the ad was fun and interesting.

“I really enjoyed making the ad – a very different experience to ward work! It was amazing to see the number of people needed to produce a 45-second ad. I felt proud, if a little embarrassed, when I saw the ad for the first time. It captures the reality of what it is like to work now that the new ratios have been introduced.”

“I really enjoyed making the ad – a very different experience to ward work!”

T H E L A M P J U LY 2 0 1 2 | 2 7

CORRESPONDENCE

2 8 | T H E L A M P J U LY 2 0 1 2

N S W N U R S E S ’ A S S O C I AT I O N

Dear Mrs Skinner, I welcome your long awaited correspondence which arrived for the first time by email on 16 June. I know that you have been telling many members about this correspondence for some time beforehand saying we would not publish it. I have taken the extraordinary decision to publish in full and respond.

I appreciate your acknowledgement of the shortage of experienced nurses and hope that you and your Government will take that fact into consideration when bargaining with nurses and midwives around important wages and conditions, which are important factors in recruitm ent and retention.

The NSWNA welcomes your decision to increase the Re-Entry to Nursing initiative scholarship from $6,000 to $10,000 in response to a petition to Parliament initiated by NSWNA members which received many thousands of signatures from both the community and nurses. Of course there was also strong media attention to the plight of nurses who could not afford the Re-Entry to Practice courses at the College of Nursing prior to your decision. Unfortunately many nurses still face hurdles such as relocation for a minimum of four weeks to Sydney with associated costs of accommodation, travel and childcare.

We welcomed your agreement to write to the Nursing and Midwifer y Board of Australia (NMBA). We note that the policy released on the three month re-entry supervised practice now requires nurses to undertake that practice as student nurses, leaving it open for employers to require supervised nurses to work unpaid for the three month period. I hope that the Ministry of Health would provide guidance to Local Health Districts to employ these nurses as an Assistant in Nursing at the very least.

The NSWNA welcomes each and every one of those 2475 new nurses into the Public Health System. We understand that the number is a headcount and does not necessarily equate to full time equivalents. We welcome and applaud your Government’s commitment to employ more nurses and in particular additional Clinical Nurse Educators and Clinical Nurse Specialists.

We welcome and applaud the implementation of the Nursing Hours Per Patient Day (NHPPD) or Nurse to Patient Ratios, which will result in at least 1400 full time equivalent nursing positions being added to our Public Health System. As you know the NSWNA has made this clear with two television advertising campaigns since winning this outcome from the previous governm ent in 2011. We applaud your government’s commitment to honour your legal obligation under the Award and not to change legislation to do otherwise.

We note the wage increases of 3.9%, 3% and 2.5% over three years negotiated with the previous government as a package which included the Nurse to Patient Ratios delivered by NHPPD. We also note that your government has determined that future pay rises are capped at 2.5% and that your government has removed nurses and midwives rights to have future pay increase s beyond 2.5% determined by the the independent umpire of the NSW Industrial Relations Commission.

Finally we acknowledge your commitment in writing that you have no plans to change the arrangements agreed in the last Award negotiation including NHPPD/Ratios as agreed.

I have published your letter in full so that every member of the NSWNA can see your commitments and look forward to future negotiations to improve our Public Health System for the benefit of the people of NSW and the Nurses and Midwives who work hard everyday delivering care within a system under enormou s pressure.

Yours faithfully,

Brett Holmes NSW Nurses’ Association 50 O’Dea Avenue, Waterloo NSW 2017 T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnurses.asn.au W www.nswnurses.asn.au

T H E L A M P J U LY 2 0 1 2 | 2 9

THE VOICE

Prinnie nurses her dream Like nursing, singing is a vocation, says RN Nia Beaman, so she was well placed to support her daughter Prinnie in her bid to be The Voice.

While working at Sydney Hospital for 26 years, RN Nia Beaman was also helping her daughter, Prinnie Stevens, realise her dream.

When Nia discovered that her children loved singing and dancing at a very young age, she enrolled Prinnie and her brother David in Sydney’s top performing art schools. But, Nia told The Lamp, it was never for fame or fortune.

“It wasn’t to support their career but to support them to become better human beings and hope that they get a better education and a better life,” Nia explained. “Musicians don’t get paid much and it’s a vocation, just like nurses, it’s something you’re born with,” Nia said. “It doesn’t mean fame and fortune, it’s a burning desire and a vocation.

“To be true to your profession and your vocation without much money – and they’ve been doing this since they were five or six – now that’s commitment.

And it’s not easy.”

Prinnie recently showed that commitment as a contestant on The Voice, where she battled it out every week for a spot on the popular Channel Nine TV show.

“We were very much aware that it’s up to the people who vote and there’s absolutely nothing you can do,” Nia told The Lamp.“It’s up to the mercy of the public and I suppose from a mother’s point of view, the worst thing that you want for your child is to be publicly scrutinised,” Nia said. “We all live in limbo and wait until ‘next Monday’ to see the result.”

3 0 | T H E L A M P J U LY 2 0 1 2

“When Prinnie did the battle with Jimmy Barnes’ daughter, that was the ultimate cruelty.”

— rn nia beaman, prinnie’s mother (pictured above)

After watching her daughter in singing and dancing competitions for more than two decades, Nia knows that “we’re only just touching the surface” when it comes to watching Prinnie perform on The Voice.

“It would be so sad for me if she gets voted out because we haven’t even seen the best of her yet,” Nia told The Lamp. “They [The Voice] want to cover all areas because it’s a show and it’s an advertisement for them.They’ve got to make their money and show people that they’ve got the full package,” Nia added. “You feel for her because she’s got no choice but to do her best with whatever she’s given.”

This was very much the case when The Voice coach, Joel Madden, pitted Prinnie against her best friend Mahalia Barnes, in a battle to decide who would stay in the competition.

“When Prinnie did the battle with Jimmy Barnes’ daughter, that was the ultimate cruelty,” Nia said.

“She did her best to show her ability.”

“She works so hard and it’s sad because I just think,‘Australia, give this girl a chance because she’s giving it her all’,” Nia said.

For the past decade, Prinnie has been slugging it out doing corporate and private gigs, while raising her six-year-old daughter with husband Ed Stevens, an American-Jamaican basketball coach. Last year she dubbed one of the roles in the upcoming Australian film The Sapphires, about four Aboriginal singers who entertained troops in Vietnam, and she was Christine

Anu’s understudy on the Baz Lurhmann film, Moulin Rouge.

“Prinnie’s very disciplined.

She doesn’t drink and she doesn’t smoke,” Nia said.

“It is hard. She’ll be doing a wedding or a corporate gig on Saturday or Sunday and you feel for them driving into the city or driving out to Liverpool at four o’clock in the morning. People don’t realise that it’s not all glamour. You do a wedding or you do a funeral for somebody and then you get in your car and you have to drive home,” Nia explained.“It’s lonely and it’s hard work.”

Even after all these years, Nia stays up after every gig until she knows that Prinnie is at home, safe and sound.

“I stay up. You can’t tell a mother to go to bed,” Nia said.

“Once she gets in, then I go to bed.”

Despite the ups and downs, Nia is proud of what her daughter has accomplished.

“I feel proud as a mother that she’s done her best and she’s delivered what people paid for,” Nia said.“From thereon in, the beauty is in the eye of the beholder and you don’t have any control over that. I just think it’s wonderful that people have remembered and thought of her.”

After reaching the final 12 contestants on The Voice, Prinnie was voted off in a show that saw eight contestants leave on one night.

T H E L A M P J U LY 2 0 1 2 | 3 1

advertisement

Australia's Carbon Price: What does it mean for my household?

0 01 1

Case Study C ase S tudy Middle-Income M iddle-Income Family F amily

E EXPECTED X P E C T ED P PRICE RICE R RISE ISE

+ + + + +

E lectricity Electricity Gas Food Other Fuel

0 02 2

$3.70 $0.60 $1.60 $6.10 $ 0.00 $0.00

Case S Case Study tudy Single S ingle Parent Parent

+ + + + +

Gas Food Other Fuel

0 03 3

$2.90 $0.40 $1.00 $4.00

Gas Food Other Fuel

Most middle-income M ost m iddle-income ffamilies amilies can expect some c an e xpect tto o rreceive eceive s ome government assistance, ssistance, iincluding ncluding g overnment a cuts, help cover price ttax ax c uts, tto oh elp c over tthe he p rice couple with kids aged rrises. ises. A c ouple w ith ttwo wo k ids a ged and and combined tthree hree a nd tten en a nd a c ombined annual off a around $110,000 a nnual iincome ncome o round $ 110,000 will approximately w ill rreceive eceive a pproximately $13.05 $ 13.05 extra extra per per week. week. =

FINANCIAL F Ia NrAnNiC ASSISTANCE A SS I SxT TA Earning E nIgA La approximately p p ro iAmNaCtEely assistance help cover iincreased ncreased a ssistance tto oh elp c over price single mum with tthe he p rice rrises. ises. A s ingle m um w ith ttwo wo k kids ids a aged ged ffour our a and nd six six a and nd a an n around annual income of ar ound $60,000 will around w ill rreceive eceive a round $10.15 $10.15 extra extra per week cuts and p er w eek tthrough hrough ttax ax c uts a nd government payments. g over nment p ayments.

=

3 2 | T H E L A M P J U LY 2 0 1 2

SUPPORT SUPPOR T

$11.90 $11.90 wk wk

COSTS

$1.15 $ 1.15 wk wk

GAIN G AIN

$1.70 $0.30 $0.50 $2.50

$60,000 year $ 60,000 a y ear $10. $10.15 15 wk

SUPPORT SUPPOR T

$8.30 wk

COSTS

$ $1.85 1.85 w wk k

GAIN G AIN

Earning E arning a approximately pproximately $50,000 $50,000 a year year F FINANCIAL INANCIAL A ASSISTANCE S S I S TA N C E from Many singles will beneďŹ t fr om tax cuts and other assistance. nder tthe he a ge o 5 with with Singles under age off 6 65 S ingles u ncome o round an a na annual nnual iincome off a around ear c an e xpect tto o $50,000 $ 50,000 a y year can expect round $ 5.80 p er w eek, rreceive eceive a around $5.80 per week, which should fully of fset the offset costs of the carbon price.

$ 0.00 $0.00

(Fuel not af affected fffected fec by carbon price) The Climate C limate Institute

$13.05 wk

50/50 5 0an/y5ssingle 0iniin income sp split, pilllilitt, ki kids ds Many M gnlecparents poam renetss will w rreceive e, c2eivk eiid

$ 0.00 $0.00

E EXPECTED X P E C T ED P PRICE RICE R RISE ISE

+ + + + +

F FINANCIAL INANCIAL A ASSISTANCE S S I S TA N C E

B Based ased o on n2k kids ids

Case C ase S Study tudy Single S ingle Person Person Under U nder 6 65 5

E Electricity lectricity

5 50/50 0/50 iincome ncome s split, plit, 2 k kids ids

E Earning arning a approximately pproximately $ $60,000 60,000 a y year ear

E EXPECTED X P E C T ED P PRICE RICE R RISE ISE E Electricity lectricity

E Earning arning a approximately pproximately $ $110,000 110,000 a y year ear

IN PARTNERSHIP WITH

=

$5.80 wk

SUPPORT SUPPOR T

$5.00 wk

COSTS

$0.80 $ 0 . 8 0 wk wk

GAIN G AIN

For more more information visit

y yourcarbonprice.com.au ourcarbonprice.com.au Cost Cost a and nd a assistance ssist anc e data d at a based b ase d on o n independent ind ep en d en t analysis ana l ysis by

by CSIRO CSIRO and and A AECOM. ECOM. E Energy nergy ssavings avings d data ata ffrom rom tthe he S Sustainability ustainability A Advice dvice T Team and eam a nd Pitt&Sherry Pitt&Sherry for for tthe he C Clean lean E Energy nergy C Council. ouncil.

NSWNA BRANCHES

Warning!

84 workplaces without local representation 84 NSWNA WORKPLACE BRANCHES listed here are no longer operating because they did not hold or complete their 2012 elections.

While members of these former Branches may apply to the Council of the Association to join another Branch, without a Branch at your workplace your local representation and powers are limited.

A Branch gives you a voice at work. It gives you authority to meet, discuss and negotiate with your management under the umbrella of, and with the full backing of, the NSW Nurses’ Association.

A Branch is your source of collective power for tackling large issues such as inadequate staffing, hospital closures, occupational health and safety issues.

Branches also take up individual issues for members and are a source of advice and support close at hand.

Importantly, Branches give every individual member a chance to influence state action at the bi-monthly Committee of Delegates, and set Association policy at the Annual Conference.

Don’t go without – you may not have a problem today but there’s always tomorrow and you need to be organised.

Management is well organised with human resources departments, employer associations, and in the public sector, NSW Health, ready to step in. Not to mention the bevy of solicitors they can drum up at a moment’s notice.

THE

ADHC Metro North

Kenmore Hospital

Alexander Nursing Home

Kingscliffe Gardens Residential Centre

Alma Place Aged Care Facility

Legacy Aged Care Wyoming

Australian Red Cross Blood Service Sydney

Lithgow Gaol Clinic

Bankstown/Lidcombe Community Health

Lutheran Aged Care Albury

Baringa Private Hospital Beaumont Terrace Tuncurry Beecroft Nursing Home Belmont Hospital

1 2 3

Macquarie Care Centre Magnolia Manor Aged Care Kanwal Medibank Health Solutions Nepean Private Hospital

Berala on the Park

Nexus Child and Adolescent Mental Health Unit

Bupa Banora Point

Nowra Private Hospital

Bupa Mosman

Orana Gardens High Care

Caritas – St Vincent’s Hospital Darlinghurst

Our Lady of Consolation Home

Cedar Place Aged Care Facility Cedars Nursing Home (The) Cessnock District Hospital Chamberlain Gardens Aged Care Chatswood Community Nursing Home Coffs Harbour Legacy Nursing Home College of Nursing Commonwealth Department of Health and Ageing Community Health Centre Hunter Street Cooinda Nursing Home Coonabarabran Corowa Health Service

THE BOTTOM LINE You have three choices: Talk to nurses in your workplace and get support for your local Branch to be reformed. Then contact the NSWNA for help with the process; Write to the Council of the Association and request a transfer to another Branch.

This is possible but does not give you as much influence in your own workplace; or Do nothing and hope you never need the support of your colleagues in taking a united stand. Remember, you are stronger when you speak with the voice of a determined group of nurses and midwives!

Liverpool Mental Health

Daintree Aged Care Denman Multi Purpose Service Dorrigo Hospital Dubbo Nursing Home Forest View Nursing Home Glen Innes District Hospital Gosford Blood Bank Griffith Nursing Home Gulgong District Hospital Harbison Memorial Retirement Village Holy Spirit Dubbo Jemalong Village Nursing Home Junee District Hospital

THE CHOICE IS YOURS BUT THINK CAREFULLY, IS THERE REALLY A CHOICE?

Justice Health Forensic Hospital

Contact your NSWNA organiser to re-form your Branch – 8595 1234 (metro) and 1300 367 962 (non-metro).

Kareena Private Hospital

Justice Health Goulburn Justice Health Parramatta

Palm Grove Nursing Home Peninsula Retirement Village – Umina Prince of Wales Private Hospital Regis – The Gardens Royal Far West Russell Lea Nursing Home Shoalhaven Community Nurses Sir Joseph Banks Nursing Home St Andrews Nursing Home Ballina St Catherine’s Nursing Home St Luke’s Aged Care – Lulworth House St Mary’s Gardens St Vincent’s Private Hospital Bathurst Stanmore Nursing Home Sydney Private Hospital Sydney West Nurse Managers Sydney West Western Cluster Branch Taree Aged Care Assessment Team The Bay Nursing Home Turramurra House Nursing Home Tweed Heads Residential Aged Care Facility Walcha District Hospital Wauchope District Memorial Hospital Wontama Nursing Home Woodport Nursing Home Woy Woy Community Nursing Home Wyoming Nursing Home Wyong Nursing Home Yagoona Nursing Home

T H E L A M P J U LY 2 0 1 2 | 3 3

OPEN YOUR WORLD TO NURSING OPEN DAY SYDNEY NURSING SCHOOL 25 AUGUST 2012, 9.30AM–4PM

When you make the decision to become a nurse you are making the first step into the wonderful, varied and rewarding world of health care.

At Open Day you’ll discover a world where where you can make a real difference to people’s lives.

Learn about Sydney Nursing School’s new Bachelor of Nursing (Advanced Studies), combined degrees and Master of Nursing graduate entry program. Meet our academic staff, current students and graduate registered nurses. Explore our state-of-the-art clinical simulation facilities and have fun with a free health check.

sydney.edu.au/nursing

CRICOS 00026A

For more information, head to

SOCIAL MEDIA

nurses are on the frontline of health care and at the cutting edge online! See what the NSWNA and nurses throughout the state are up to via our Facebook, Twitter and YouTube pages.

WHAT YOU LIKED ON FACEBOOK Nurses at the ACTU Congress NSWNA blogged live on Facebook from the ACTU Congress in Sydney in mid-May, and the announcement that aged care activist and member Linda Hardman was recognised by PM Julia Gillard at the congress was extremely popular:

How proud we are of Linda, who has done so much to get a voice for aged care.

Very proud to have you as our delegate Linda, you have done yourself, workplace and union proud and have given our aged care sector a muchneeded voice. Come on fellow workers, stand behind your delegates and make the voices louder.

You are an amazing woman Linda, don’t ever forget that.

You are an inspiration to all aged care delegates.

Linda Hardman

Friends with patients?

Linking to an article on social media netiquette for nurses, we asked whether a patient had ever asked to be Facebook friends with you. The answer was a resounding “no”!

No. I can’t believe a nurse could be that insecure as to accept/encourage patients as Facebook friends.

No. UNPROFESSIONAL. WHY would a nurse even want to be FB friends with a patient?

Aged care picnic Our Hyde Park picnic in support of aged care nurses, on May 18, was the central focus of the Time to Act for Better Pay FB page, including an album of photos from the picnic.

By far the most popular link on all social media last month was this: Aged care AiNs earn less than shop assistants.

Something’s got to change.

As one aged care nurse remarked:

All staff are very keen to see wage parity. Once wage parity comes into the sector we may be able to hang on to staff. Morale is low because staff feel undervalued.

Another nurse had a good idea for protecting her online identity from patients and work colleagues: Extremely wary of having colleagues [as FB friends]. And no way would I have patients as Facebook friends. I also use a different surname on Facebook to that which I’m registered under. http://socialmediablog.theshannoncompany.co.nz/2012/05/social-media-and-nursing-andsome-general-tips-for-any-profession/

Join us online New South Wales Nurses’ Association www.facebook.com/nswnursesassoc Aged Care Nurses: Time to Act for Better Pay www.facebook.com/timetoact4betterpay One2four the way to safe patient care www.facebook.com/safepatientcare

Tweet us NSW Nurses @nswnurses Watch us on YouTube NSW Nurses T H E L A M P J U LY 2 0 1 2 | 3 5

his win t y s o NA me te c t NSW rcha r e nd G in is

e

New ayered Ve ests

New

$40 40

Navy Bonded Polar Fleece Vests

$25

in S, M, L, nd XXXL

New

available in S, M, L, XL, XXL and XXXL

Red Heron Jackets â&#x20AC;&#x201C; also available in Navy

$40

available in S, M, L, XL (Red) and M, L, XL, XXXL (Navy)

T The he lat latest est NSWNA merchandise is not only stylish and comfor comfortable, table, it is affordable and sold at cost to members.

Bonded Polar Fleece Zip Front Jackets

TTo o order, orderr, fax the order o form to Glen Ginty Ginty, y, (02) 9662 1 1414 414 or post to: N NSWNA, SWNA, Ave NA, 50 Oâ&#x20AC;&#x2122;Dea A v ve NSW NSW 2017.

2017.

$30

available in S, M, L, XL, XXL and XXXL

ORDER FORM

www w..nswnurses.asn.au Merchandise order forms also available on www.nswnurses.asn.au

Navy Bonded Polar Fleece Vests $25.. Quantity: Size: S M L XL XXL XXXL Red Heron Jackets $40. Quantity: Size: S M L XL

Address Postcod Postcode Phone (h)

Navy Heron Jackets $40.. Quantity: Size: M L XL XXXL Navy Layered Vests $40. Quantity: Size: S M L XL XXL

Name

(w)

Method of payment

XXXL

Bonded Polar Fleece Zip Front Jacket $30.. Quantity: Size: S M L XL XXL XXXL cost of or der $ Total o Please include postage and handling of $5 per order.

(mob) Cheque Bankcard

Name of card holder Card number

Expir y date

/

Signature

Mastercard Money Order

Visa

NURSE UNCUT

what’s hot on nurse uncut?

Did you know that AiNs caring for the aged earn less than shop assistants? See a video interview with Rashmi, an AiN who works in aged care, and also hear from a nurse who shares her story on workers’ comp.

Check out the new NSWNA scrubs and read about how to get safe staffing. All at www.nurseuncut.com.au

HOTTOPICS And the International Nurses’ Day winners are…

Rashmi — an AiN in aged care

www.nurseuncut.com.au/and-the-ind-winners-are/

Nurses at the Blue Hills Manor aged care facility in Prestons, southwest Sydney, won our International Nurses’ Day photo contest with a snap of their truly global celebration. Staff members dressed up in costumes, brought in food from their country of origin and shared a wonderful meal [wish we’d been there!]. “We are proud of our heritage and honour the cultural diversity of our staff,” they told us. Congratulations to all the staff for helping create the photo. Now, in the spirit of international co-operation, two lucky staff members will be chosen to enjoy a two-night stay at Harrigan’s Irish Pub (www.harrigansirishpub.com.au) in the lovely village of Pokolbin in the Hunter Valley. Also included is admission to the magical Hunter Valley Gardens.

A nurse shares her story on workers’ compensation www.nurseuncut.com.au/video-a-nurses-story-about-workers-compensation/

The trade union movement’s campaign to protect workers’ compensation ramped up a notch, with the launch of TV and radio advertisements and the announcement of a major rally. The creative animation ad will air on major commercial TV networks for the next five weeks. As part of the campaign, nurse Emily Orchard, (who featured on the cover of our June issue), spoke to Channel 7 about how her life has been affected by an injury at work. Watch the video at Nurse Uncut.

AiNs earn less than shop assistants www.nurseuncut.com.au/ains-caring-for-the-frail-aged-earn-less-than-shop-assistants/

Thousands of nurses at for-profit aged care facilities are demanding that employers improve their wages and career opportunities, especially after the federal government’s recent decision to make $1.2 billion available from 2013 for better wages, working conditions, career and training opportunities. At current rates, an Assistant in Nursing, caring for the frail aged in the for-profit sector, is paid $18.94, less than many shop assistants. For example, a retail assistant working at Coles earns $19.05 an hour. Is this fair? Share your thoughts at Nurse Uncut.

New scrubs! www.nurseuncut.com.au/come-out-in-force-in-these-new-scrubs/

New scrub uniforms for NSWNA members are here and it’s time to scrub up! Show a united front at work and during rally and conference times in this new range designed to ensure a comfortable fit. The size range is from XS-5XL to ensure various body shapes and sizes are catered for. The scrub top and pants are $20 each, including GST, and you can order yours at Nurse Uncut.

www.nurseuncut.com.au/rashmi-an-ain-in-aged-care/

At a picnic in support of aged care nurses on Friday 18 May, in Hyde Park in central Sydney, Rashmi, a young AiN originally from Nepal, gave a strong voice to the reasons for the picnic. Watch her video interview at Nurse Uncut.

How to get safe staffing www.nurseuncut.com.au/how-to-get-safe-staffing/

What can union branches of community health services do to guarantee safe staffing? Several things: public campaigns, limiting client numbers, refusing non-urgent referrals and asking management to prioritise. Check out the full blog with all the tips at Nurse Uncut.

WHAT NURSES SAY

on the ‘i support nurses’ facebook page

www.facebook.com/NurseUncutAustralia

Shop assistants or AiNs – who should be paid more?

“It’s a disgrace what nurses get paid in the private aged care sector!”

As a matter of urgency, Australia must build a nursing workforce for the future, to replace current nursing staff who will retire in the next 15 to 20 years.

“That’s me in the retiring group.”

“How about making some scholarships available for AiNs who want to upgrade their qualifications and make the EN courses more accessible and cheaper.”

“I am an AiN –Cert III acute care ... I can’t find any work in hospitals! I’ve applied for an EN course but its $18,000 if I pass the exams.”

T H E L A M P J U LY 2 0 1 2 | 3 7

NURSING RESEARCH ONLINE

Australian Policy Online (www.apo.org.au) is a partnership of the Australian National Institute for Public Policy and the Swinburne Institute for Social Research. APO monitors more than 500 sources each week, including academic research centres and institutes, government departments, think tanks, NGOs and other media and information networks, to select and catalogue high quality open access research on public interest issues in Australia.

Smart technologies for older people – a systematic literature review of smart technologies that promote health and wellbeing of older people living at home Meg Morris, PhD Chair Physiotherapy, The University of Melbourne; Elizabeth Ozanne, PhD Associate Professor, Social Work, The University of Melbourne; Kim Miller, PhD Senior Lecturer Physiotherapy, The University of Melbourne; Nick Santamaria, PhD Chair Translational Nursing, The University of Melbourne; Alan Pearce, PhD Senior Research Fellow, Deakin University; Catherine Said, PhD Research Fellow Physiotherapy, The University of Melbourne; Brooke Adair, B.Phys Research Assistant, The University of Melbourne.

The Smart Technologies for Older People report surveys the current literature on the use of smart technologies to support ageing across the globe, adding a valuable resource to the policy debate. Findings from the report note the changing demographics of older Australians. The “new aged” such as the baby boomers, will have better financial resources and higher levels of education than previous generations. They will possess large purchasing power, be strong advocates as consumers and as patients, and will want to be fit, active, mobile, safe, connected and self reliant. Smart technologies can support older people by promoting independence, quality of life and wellbeing. Smart technologies support delivery of a range of products and services over devices such as tablets, phones, computers, TVs, virtual reality “gaming” systems, and sensor networks. Additionally, smart technologies allow for 3 8 | T H E L A M P J U LY 2 0 1 2

the delivery of telemedicine services to older people, prolonging the period they can remain living at home. The roll out of the National Broadband Network offers a unique opportunity to link Australians with state-of-the-art technologies with the potential to improve health, wellbeing and quality of life. www.apo.org.au/node/29534

Catholic Health Australia-National Centre for Social and Economic Modelling: Second Report on Health Inequalities: The cost of inaction on the social determinants of health

Parental involvement in preventing and responding to cyber bullying Elly Robinson, Australian Institute of Family Studies

This paper outlines definitions and statistics related to cyber bullying, differences between cyber bullying and offline bullying, and parental roles in preventing and responding to cyber bullying incidents. The aim of the paper is to inform practitioners and other professionals of ways to help parents clarify their roles, and provide them with the tools to help their teenage children engage in responsible online behaviour. www.aifs.gov.au/cfca/pubs/papers/04/cfca04.pdf

Laurie Brown, Linc Thurecht, Binod Nepal, National Centre for Social and Economic Modelling

The findings of the report confirm that the cost of government inaction on the social determinants of health, leading to health inequalities for the most disadvantaged Australians of working age, is substantial. This was measured in terms not only of the number of people affected but also their overall wellbeing, their ability to participate in the workforce, their earnings from paid work, their reliance on government income support and their use of health services. Improving the health profile of Australians of working age in the most socio-economically disadvantaged groups would lead to major social and economic gains with savings to the government and to individuals. apo.org.au/node/29676

Mothers with a history of childhood sexual abuse: key issues for child protection practice and policy Cindy Tarczon, Australian Institute of Family Studies

This publication reviews the literature examining the impacts of a history of maternal childhood sexual abuse on parenting capacities and the impacts on children. It specifically examines the domains of mental health, intimate partner violence, substance abuse and homelessness and the overlap with a history of maternal childhood sexual abuse, highlighting the difficulties faced by these women when engaging with statutory and welfare agencies. apo.org.au/node/29623

Enrolled Nurse State Conference 2012 The Enrolled Nurse Professional Association NSW are pleased to invite you to the 19th Enrolled Nurse state conference being held in Sydney at the Mercure Hotel. The conference is organized by ENPA enabling delegates to discuss and disseminate information to other nurses, forge friendships and networking with colleagues.

HIGHLIGHTS

43210/4.0-,

,%$#"! " $ 1,$ "#$1 1- $ 1! 1 %" ! 1, ! ! " 14! 10$ 1 " " 1 1 ! 1 1 134+ 210//.1-,+*1)/-('&1%10($$#1"! 1 /&( $/ 21 ,+-/.. +'!$ 1/-- /' 1 /,.+'!$1 /, / 1 1 !#.

21 / ! /1 /!, ' 1 !,/. 1 ,+ /, # 1 ! !$1 ! '.1"!

21 /,&(/1%1 ! /1)/ (,'.1121"! 1 $!'' '

!/$1"+&&1 0 10" 10"

&! 1 " $1 1 1 3 " $14! +(' !' .1!'&1)/ 1"! 1 /' .

1 1 ' ! 1 /'(/ 1 ',1 +, !1)+!& 1 /. 1)#&/1 1

â&#x20AC;˘ What is there for ENâ&#x20AC;&#x2122;s in the Future? â&#x20AC;˘ Surgical Nursing â&#x20AC;˘ Mental Health â&#x20AC;˘ Working with an Injury

Accounting and Taxation Spe Specialists ecialists cialists for Health Professionals

WHEN & WHERE

Come to us in Kogarah or our mobile bile sservice ervice rvice ccan

20th â&#x20AC;&#x201C;21st September, 08.00â&#x20AC;&#x201C;09.00am for registration Mercure Hotel, 818â&#x20AC;&#x201C;820 George Street, Sydney Members $220 for both days. Non Members $250.

Dinner $45 per person.

We understand the needs of health professionalss in particular, particular pa ticularr, nurse nurses. nu sees. es innformation ormation so s you Tax with Integrity provides current and relevantt tax information can minimise your tax now and in the future.

Let us provide you with the most effec effective ve outcom outco outcomes

ENQUIRIES & REGISTRATION

â&#x20AC;&#x2DC;Make an appointmentâ&#x20AC;&#x2122; online ne at www.taxwithintegrity.com/health-care m/hea th care m/health-care or call Gerard on 0481 215 686 orr 9587 2225

Please direct all enquiries and registrations to: Enrolled Nurse Professional Association PO Box 775 , Kingswood NSW 2747 , Tel: 1300 554 249 Rebecca â&#x20AC;&#x201C; rjroseby@gmail.com Employers requiring an invoice contact Roz â&#x20AC;&#x201C; garozn@optusnet.com.au

NURSING POSITIONS

AVAILABLE CANBERRAâ&#x20AC;&#x2122;S LEADING NURSING AGENCY HAS OPENED IN THE RIVERINA AREA OF NEW SOUTH WALES. s Are you a Registered, Endorsed, Enrolled or Assistant Nurse? s Are you looking for a Quality driven organisation to work for? s Would you like the flexibility of choosing where and when you work? s Would you like to receive above award wages?

0/3,+-3*)/ (0'&/

Like us on www.facebook.com/taxwithintegrity m/taxw withintegrity thintegrity Tax with Integrity et, Suite 5/40-42 Montgomery Street, Kogarah NSW 2217

REACH OVER

,000 55 NURSES AND

MIDWIVES BY ADVERTISING IN

THE LAMP HE007_Lamp_240512_HE007_Lamp_240512 24/05/12 8:34 PM Page 1

EXHIBITION The magazine of the NSW Nursesâ&#x20AC;&#x2122; Association

The Professional Nursing Agency is committed to providing the Canberra community and now the Riverina with High Quality Care and Professionally Qualified staff to meet the clientâ&#x20AC;&#x2122;s needs 24 hours a day.

We are looking for Nurses at all levels in the Riverina with a similar commitment to the Health Industry to us to meet our clients requirements.

Please contact Val Hoskinson on 0418 867440 or through our website www.professionalnursing.com.au

â&#x20AC;Ťďą&#x2DC;ďą&#x17E;ďą&#x2DC;â&#x20AC;Ź madang, new guinea, c.1945.

Group portrait of Nurses, left to right: Sisters Witcombe, McNamara, Furey, Senior Sister Doherty, Sisters Scholes, Rodda, Fewkes, in their tropical uniforms at no. 1 Medical Receiving Station RAAF.

volume 69 no.5 June 2012

Photographed by John Thomas Harrison.

Photo courtesy of the Australian War Memorial. image id og3354.

NURSES

FIGHTING FOR MY FUTURE Print Post Approved: PP241437/00033

FROM ZULULAND TO AFGHANISTAN

24 | THE LAMP JUNE 2012

Nurses: from Zululand to Afghanistan, a new exhibition at the Australian War Memorial, explores the personal stories of Australian military nurses, from the first known Australian nurse in the Zulu War of 1879 right up to the experiences of nurses serving in recent conflicts and peacekeeping operations.

The exhibition draws on the Memorialâ&#x20AC;&#x2122;s rich collection to tell the story of Australian military nursing. The iconic veil and cape worn by early nurses together with the technologically advanced equipment used today, speak of the changing role and place of nurses in Australian military operations.

Photographs, diaries and personal objects, such as the doll hand-stitched by Nellie Constance Morrice, reveal a much more personal story.

THE LAMP JUNE 2012 | 25

Contact Patricia Purcell on 02 8595 2139 or 0416 259 845 or email ppurcell@nswnurses.asn.au for more information.

T H E L A M P J U LY 2 0 1 2 | 3 9

The Edith Cavell Trust

Scholarships for the academic year 2013 Applications for the Edith Cavell Trust Scholarships are now being accepted for 2013. Members or Associate Members of the NSW Nursesâ&#x20AC;&#x2122; Association or the Australian Nursing Federation (NSW Branch) are invited to apply.

Applicants should meet one of the following criteria: 1. Student nurses undertaking full-time courses leading to initial registration as a nurse or midwife.

2. Registered or enrolled nurses who wish to attend:

an accredited clinical nursing education course of six months or less, either full-time or part-time; an accredited nursing conference or seminar relevant to applicantâ&#x20AC;&#x2122;s clinical practice.

3. Properly constituted nursing organisations, faculties or schools of nursing or registered or enrolled nurses wishing to: attend full-time, relevant postbasic studies at an approved institution for a period or periods of more than six months;

undertake an academically approved research program in the theory and practice of nursing work; conduct or fund a relevant professional or clinical nursing educational program.

Applicants must be currently

Applications close 5pm on 31 July 2012

PS SCHOLARSHIIP

4 0 | T H E L A M P J U LY 2 0 1 2

Applicants must use the ofďŹ cial Edith Cavell Trust application form. Details of the Edith Cavell Trust Rules are available on request and will also be supplied with the application form.

For further information or forms, contact: The Secretary â&#x20AC;&#x201C; The Edith Cavell Trust 50 Oâ&#x20AC;&#x2122;Dea Ave, Waterloo, NSW 2017 T Mrs Glen Ginty on 1300 367 962 E gginty@nswnurses.asn.au W www.nswnurses.asn.au â&#x20AC;&#x201C; click on â&#x20AC;&#x2DC;Educationâ&#x20AC;&#x2122;

I F E RY IDWIF NG & MID NURSIIN

RCNA R CNA

registered with the Nurses and Midwives Board of Australia.

freecall fr eecall 1800 117 262 cna.org.au scholarships@rcna.org.au scholarships@r www.rcna.org.au w ww.rcna.org.au

Get a an n application ap p ation from: pplica frro om: www.rcna.org.au freecall 1800 w ww.rcna.org.au | fr eecall 1 800 117 117 262 262 Nursing Allied Health N ursing aand nd A llied H ealth SScholarship cholarship aand nd SSupport upport SScheme cheme overnment.

Government. ((NAHSSS) NAHSSS) iiss funded funded by by the the Australian Australian G eak p rofessional n ursing o rganisation, RCNA, peak professional nursing organisation, R CNA, Australiaâ&#x20AC;&#x2122;s Australiaâ&#x20AC;&#x2122;s p iiss p roud tto op artner tthe he A ustralian G overnment aass tthe he proud partner Australian Government ffund und administrator administrator for for this this program. program.

15th NSW Rural Mental Health Conference 29-31 August 2012 Mount Panorama, Bathurst The Conference Organising Committee would like to invite you to join us for the 15th NSW Rural Mental Health Conference at Mount Panorama in Bathurst.

The theme, Race to Recovery: Hold’en on / Moving For’d, reminds us to hold on to our aspirations as we strive for clinical excellence in rural and remote mental health care in the face of ongoing change. It also encourages us to continue to search for innovative ways to move forward as we implement new service models and ways of thinking in our endeavours to serve those in our communities experiencing mental health issues.

This year’s conference will focus around the following themes: • Service development initiatives / innovative models of care • Integrated care / partnership models • Meeting the needs of those with complex needs such as physical healthcare or drug & alcohol co-morbidities • Mental health promotion, prevention and early intervention • Rethinking the rural mental health workforce: workforce development and training initiatives Register at http://conventionhouse.com.au/NSWRURAL12/

Race to Recovery Hold’en On

Moving For’d

Other forthcoming events in 2012 …

Dementia + Recreation National Conference October 24 + 25, Melbourne

‘Australia’s prem premier mier health & aged care exp expo’ po’ for CEOs, Managers, Health & other Professionals, staff …

Sydney CAREX 2012

August 8 & 9, Rosehill Racecourse Free Attendees - F ree admission, register online www.totalagedservices.com.au now at www .totalagedservices.com.au

Sydney CAREX sponsored by:

BOOKINGS NOW OPEN

2 for 1

EARL LY BIRD SPECIAL EARLY

A ged Care Nurse Managers Conference Aged November 21 & 22, Melbourne All enquiries re exhibiting or attending, contact: o Aged Services Wayne Woff, Manager, Total P: 03 9571 5606 / 0422 484 209 F: 03 9571 9708 E: office@totalagedservices.com.au www.totalagedservices.com.au

CAREX EX X supported by:

T H E L A M P J U LY 2 0 1 2 | 4 1

CROSSWORD

test your

knowledge 2

1

3

4

5

6

7

11

10

8

9

12 11 14

13

15 16 19

18 21 22

20

17 19

23

21

23

25

26

24 29

25

26 27 28

Across

Down

1. Discharge of air, vapor, or sweat through the skin (13) 8. Symbol for rhenium (2) 10. Secretion and discharge of tears (11) 12. Medical intensive care unit (1.1.1.1) 13. The ability to distinguish object as being different from oneself (7.9) 15. Instruments used in cutting off enlarged tonsils (11) 16. Test of purity, trial (5) 18. Not in a state of crisis or emergency (11) 21. Rib (5) 22. The main supportive protein of cartilage, connective tissue, tendon, skin, and bone (8) 24. Laxative (8) 25. Affecting more members of the same family than can be accounted for by chance (8) 26. An unnaturally deep sleep (5) 27. Sexual or reproductive organs (8) 28. The beginning of female breasts development (9)

1. Producing immunological tolerance (11) 2. A narrowing or stricture of a canal (9) 3. S-shaped (9) 4. The major immunoglobulin of secretions (3) 5. Addiction severity index (1.1.1) 6. Situated inside; inward (5) 7. Loss of feeling or sensation (8) 9. To distribute and suspend small globules of fat in water (8) 11. Conservativist (14) 14. An intermediary product in the metabolism of alcohol (12) 17. An organism capable of synthesizing its own food from inorganic substances (9) 19. Involving or resulting from calcification (8) 20. Relating to the groin (8) 21. A crossing of two tracts, such as tendons (7) 23. Eggs (3) 25. Suffix meaning flight (4)

4 2 | T H E L A M P J U LY 2 0 1 2

BOOKS

BOOK ME Demystifying Qualitative Research in Pregnancy and Childbirth

Contemporary Treatment of Adult Male Sex Offenders

By Mark S. Carich and Martin C. Calder. Crown House Publishing Co (available through Footprint Books)

By Tina Lavender, Grace Edwards and Zarko Alfirevic. Quay Books

RRP $52.95 j ISBN 9781935810049 j footprint.com.au Contemporary Treatment of Adult Male Sex Offenders identifies the key components of sex offender treatment, exploring the key elements of each component while making practical suggestions on how to approach each of them. The contents include an introduction to sex offender treatment; assessment considerations; group work; relapse prevention approaches; aftercare and risk assessment, and more.

Transitions in Nursing: Preparing for Professional Practice (3rd ed.)

By Professor Esther Chang and Professor John Daly. Churchill Livingstone (available through Elsevier Australia)

RRP $79.95 j ISBN 9780729540827 j www.elsevier.com.au Transitions in Nursing offers a discussion of topics and issues that are of great relevance for students of nursing preparing to enter the world of clinical practice. This text addresses topics critical to nursing professionalism such as becoming a competent, confident practitioner.

This 3rd edition is divided into three sections: from student to graduate nurse; skills for dealing with the world of work; and organisational environment. This edition also includes two new chapters in the area of clinical leadership and continuing competence for practice.

RRP £25.99 j ISBN 1856422593 j www.quaybooks.co.uk/ Demystifying Qualitative Research in Pregnancy and Childbirth aims to guide readers through all the stages of the research process, enlightening them about the purpose of quality research, and informing them of considerations they should make before commencing. The text outlines the theoretical underpinning of the approach, highlights important ethical issues, discusses different methods of data collection, explores the process of analysis and suggests ways of assessing qualitative research. It also demonstrates how to integrate qualitative and quantitative research and provides examples of how to explore the views of those who are hard to reach.

Nursing Leadership: A Concise Encyclopedia (2nd ed.)

Editor in Chief Harriet R. Feldman. Associate Editors G. Rumay Alexander, Angela Barron McBride, Martha J. Greenberg, Margaret L. McClure, Marilyn Jaffe-Ruiz and Thomas D. Smith. Springer Publishing

SPECIAL INTEREST

RRP $125.00 j ISBN 9780826121769 j springerpub.com This second edition of Nursing Leadership has been expanded to encompass 80 new entries and revisions as well as updates to all original entries. It provides an extensive overview of current leadership issues including theories, characteristics, and the skills required of nurse leaders in today’s complex health care system. This new edition contains both alphabetic and thematic indexes, extensive crossreferencing, and print and web references for each entry.

Jarvis’ Physical Examination & Health Assessment (Australia and New Zealand Edition)

When Chicken Soup Isn’t Enough: Stories of Nurses Standing Up for Themselves, Their Patients, and Their Profession.

Edited by Suzanne Gordon. Cornell University Press (available through Footprint Books)

By Carolyn Jarvis. Australian Adapting Editors Helen Forbes and Elizabeth Watt. WB Saunders Co (available through Elsevier Australia)

j RRP $35.95 j ISBN 9780801448942

RRP $139.95 j ISBN 9780729539739 j www.elsevierhealth.com.au

When Chicken Soup Isn’t Enough brings together compelling personal narratives from a wide range of nurses from across the globe. We meet RNs working at the bedside, providing home care, managing hospital departments, teaching and doing research, lobbying for quality patient care, and campaigning for health care reform. Their stories are funny, sad, deeply moving, inspiring, and always revealing of the different ways that nurses make their voices heard in the service of their profession. The risks and rewards, joys and sorrows, of nursing have rarely been captured in such vivid, first-person accounts.

The Australia and New Zealand edition of Jarvis’s Physical Examination and Health Assessment has been fully revised and structured to enhance learning for undergraduate and postgraduate students and clinicians.

Each chapter begins with an overview highlighting the importance and relevance of given topics to nursing practice. An introductory chapter describes the purpose of health assessment in nursing practice and how it contributes to a multidisciplinary patient assessment. All spelling, terminology, measurements, cultural and social considerations, clinical procedures and best practice reflect the Australian and New Zealand context.

j footprint.com.au

All books can be ordered through the publisher or your local bookshop. NSWNA members can borrow the books featured here, and many more, from our records and information centre (RIC).

Contact Jeannette Bromfield gensec@nswnurses.asn.au or Cathy Matias 8595 2121 cmatias@nswnurses.asn.au. All reviews by NSWNA RIC coordinator Jeannette Bromfield. Some books are reviewed using information supplied and have not been independently reviewed.

T H E L A M P J U LY 2 0 1 2 | 4 3

ON

Australiaâ&#x20AC;&#x2122;s #1 Nursing

SUPERSTORE

Low 24hr Low Order Pr Processing ocessing

P Postage ostage Rates

LINE SHO P

100% Return Return Policy Policy

Delivering Australia wide

lik likee us on fac facebook ebook

Nursing Shoes

Nursing Scrubs

Nursing Books

Equipment / Accessories

IguanaM IguanaMed ed Scrubs Stealth Stealth pock pockets, ets, hidden pen slots, tagless labels and a double brushed anti wrinkle fabric!

We We dare dare you you to try them on!

Shop online or gi give us a call.

Visit : enurse.c Visit: enurse.com.au/eShop enurse com.au/e om au/eeShop 1300 130 0 886 814

Flexible Online Learning

“As a full-time paediatric nurse, I needed my studies to fit around my ever changing shift work. Studying online was so convenient and flexible, it helped balance work and study in a way that suited me”

Nursing career opportunities exist now with Ageing Disability and Home Care (ADHC) to provide services to people with an intellectual disability.

Ageing Disability and Home Care have vacancies in Newcastle, Lake Macquarie, Central Coast, North Ryde, Western Sydney and Western New South Wales.

Expand your nursing knowledge and take up an exciting nursing opportunity in disability nursing.

Our large residential and specialist supported living facilities have full time, part time and casual positions available now for: • Registered Nurses (Salary package up to $78685) • Medically Endorsed Enrolled Nurses (Salary package up to $56525)

Successful applicants can expect to be provided a paid comprehensive work place induction. Learning and development staff provide ongoing education and support to large residence and specialist supported living staff.

Vacancies and other details can be confirmed by contacting the nurse managers below: NEWCASTLE/LAKE MACQUARIE Helen Winning 02 4928 0844 CENTRAL COAST Ray Garner 02 4394 3702 WESTERN SYDNEY Sing Ting 02 9842 2314 ORANGE Michael Herbertson 02 6362 7153

• Enrolled Nurses (Salary package up to $53780)

SUMMER HILL Yvonne Turiano 02 9798 1100

• Assistant in Nursing (Salary package up to $44128)

NORTH RYDE Stephen Jankovic 02 9857 8002

Interested in finding out more about Careers in Nursing with Ageing, Disability and Home Care (ADHC) visit www.adhc.nsw. gov.au/careers/discover_career_paths/career_in_nursing

4 6 | T H E L A M P J U LY 2 0 1 2

DESIGNED FOR LIFE

Penny – Master of Nursing (Advanced Practice)

Large residences and specialist supported living facilities exist across the state of New South Wales. These facilities provide supported accommodation and specialist services to people who have an intellectual disability.

MOVIES

movies of the month HYSTERIA

In 1880 London, young Dr Mortimer Granville (Hugh Dancy), a believer in modern medical theories, lands a position as the assistant to society doctor Robert Dalrymple (Jonathan Pryce). Dalrymple specialises in the treatment of the female ailment “hysteria” – a catch-all diagnosis for all that seems to ail the women of the day.

Treatment involves a hands-on “pelvic massage” and demand becomes so great that Dalrymple and Mortimer can’t keep up with “curing” women. To keep Mortimer working, Dalrymple promises him his business and marriage to his beautiful, young daughter.

But when Mortimer falls for Dalrymple’s older and unconventional daughter Charlotte (Maggie Gyllenhaal), his future looks doubtful.

In desperation, he invents a machine that will at least solve his medical challenges – the world’s first vibrator.

Based on true events, Hysteria takes a remarkable story and turns it into a gentle, warm-hearted comedy.

IN CINEMAS JULY 12

MEMBERS GIVEAWAY the lamp has 20 in-season double passes to give away to Hysteria, thanks to hopscotch films. the first 20 members to email their name, membership number, address and telephone number to lamp@nswnurses.asn.au will win.

NOT SUITABLE FOR CHILDREN

What happens when a man’s biological clock starts ticking? Former Australian soapie star and True Blood hottie Ryan Kwanten finds out in Not Suitable For Children. Kwanten plays 20-something party boy Jonah who discovers he has testicular cancer and has an epiphany about fatherhood. He goes on a mission to find a suitable mating partner before losing his fertility. Not Suitable For Children is the first feature length film to be directed by Peter Templeman, who received an Oscar nomination for his short film, The Saviour in 2007.

IN CINEMAS JULY 12.

MEMBERSGIVEAWAY the lamp has 15 in-season double passes to give away to Not Suitable For Children thanks to icon film distribution. the first 15 members to email their name, membership number, address and telephone number to lamp@nswnurses.asn.au will win.

T H E L A M P J U LY 2 0 1 2 | 4 7

OBITUARY

Michael Longhurst activist for the me ntally ill 1956 — 2012

[e\ ON NEW YEARS’ DAY 2012, THE mental health nursing community lost an individual who had been an activist for mentally ill people since his youth. Someone who had a lifelong commitment to the disenfranchised in society. Michael Longhurst, 55, was a dedicated, highly skilled nurse, who spent his life enhancing services for the mentally ill.

Michael was an active member of the Endeavour Clubhouse Committee and of the St Vincent de Paul Society in Port Macquarie, prior to falling ill with cancer in 2010.

Born in 1956 to Pat and Joan Longhurst, Michael grew up in Goulburn, New South Wales. He trained as a mental health nurse at Kenmore Hospital Goulburn, and as an aged care nurse, and a learning disabilities nurse, in the 1970s and early 80s. Michael later completed a PO (Program Officers) course. He assisted in establishing the first community group home for adults with an intellectual disability in Goulburn in 1984.

Moving to Sydney in the mid 80s, Michael took a particular interest in mental health rehabilitation. At that time he wrote the proposal that led to the first Community Mental Health Extended Hours Team in Australia. Its aim was to support people who live in the community with long term psychiatric disabilities — Michael argued that this cannot be done only between the hours of 9 to 5!

Michael then commenced work at Ryde in Sydney, contributing to the Burdekin Report, a national inquiry into the human rights of people living with mental illness, produced by Brian Burdekin, former Australian Federal Human Rights Commissioner.

Michael’s contribution was published in Burdekin’s final report in October 1993 and the report remains relevant to this day.

Michael went on to become Deputy Director of Ryde Hospital and

4 8 | T H E L A M P J U LY 2 0 1 2

Community Mental Health Service, where he wrote a submission that created the highly successful Cornucopia project. This was, and is, a groundbreaking employment and rehabilitation scheme for people with a mental illness, through which they are paid award wages, helping to normalise their lives.

Cornucopia challenged the concept of sheltered workshops for the mentally ill. Michael saw these as stagnant and not providing much in terms of future hope. Instead, Cornucopia provided three businesses – a cafe, a function centre, and gardening/ nursery. Jobs included property maintenance, cleaning, hospitality, retail, and horticulture. Cornucopia’s workers are union members so their jobs are secure. In 2010, the NSW state government attempted to close down Cornucopia but failed after a public outcry, with Christina Keneally, then Premier, intervening to keep it in the public sector.The project continues to hold together the lives of many people who would not otherwise have work, providing them with dignity, job skills and a purpose to their day.

Michael received a Premier’s Award from Bob Carr for the success of Cornucopia, though he was always more proud of the certificate presented to him by the Ryde Mental Health Consumers Network, recognising the value of Cornucopia.

Prior to moving to the Mid-North Coast for a sea change, Michael became CEO of Real Jobs Work Pty Ltd, one of the top performing job network companies in Northern Sydney. There he continued to find jobs for the long-term unemployed and for disabled people.

Michael always thought outside the square and at times challenged bureaucracy. He just did things and sorted out the red tape later! He was a great humanitarian, stood for social justice and believed in Liberation Theology.

He was patient, fair and stood up for those who couldn’t stand up for themselves. He invited people from all walks of life to join him at his dinner table.

He had few material interests in life – family, friends, politics, swimming, camping, good food and red wine were what brought him joy. He was generous to all of those that he loved.

Michael’s final nursing position was as a Credentialed Mental Health nurse with the Hastings Macleay GP Network in Port Macquarie.There, he was able to work with severely disenfranchised mentally ill clients and use his vast experience in rehabilitating this client group.

Michael would be pleased that instead of flowers his family requested donations be made to Endeavour Clubhouse, a program that bears similarities to Cornucopia.

Michael leaves behind his wife Susan, his three beautiful daughters Vida, Emily and Louella, and his stepdaughter Andrea as well as many loved family and friends.

— Wendy Hall and Susan Longhurst

S P I IP H S R A L O H C S G N IN I S R U N E AGED CAR

DEVELOP DEVELOP AND AND SHAPE SHAPE YOUR YOUR AGED AGED CARE CARE CAREER C AREER AGED CARE NURSING SCHOLARSHIPS ARE AVAILABLE FOR AC TIVITIES AND COURSES IN THE FOLLOWING AREAS: U UNDERGRADUATE NDERGRADUATE

EVELOPMENT C CONTINUING ONTINUING P PROFESSIONAL ROFESSIONAL D DEVELOPMENT

For those with a demonstrated commitment to aged care

For registered and enrolled nurses working in aged care erence wishing to attend a short course, workshop or confe relating to the care of older people.

wanting to become a registered nurse.

P POSTGRADUATE OSTGRADUATE

For registered nurses working in aged care wishing to further their studies.

NURSE NURSE R REď&#x161;şENTRY E ď&#x161;ş E N T RY

For fo ormerly registered or enrolled nurses whose registration has lapsed wishing to re-enter the nursing proffession e with a fo ocus on a aged care.

N NURSE URSE P PRACTITIONER RAC TITIONER

For registered nurses working in aged care wishing to undertake studies leading to endorsement as a nurse practitioner.

F For or more more information inffo ormation on eligibility eligibility or ho how w tto o apply ffor o or a scholarship: scholars

RCNA R CNA

freecall fr eecall 1800 11 66 96 scholarships@rcna.org.au scholarships@r cna.org.au www.rcna.org.au w ww.rcna.org.au

APPLY FOR A SCHOLARSHIP TODAY Aged Aged Care Carre Nursing Nurs Scholarships Scholarships ((ACNS) ACNS) are arre funded b th A byy the Australian Government. ustralian G overnment.

RCNA, peak RCNA, Australiaâ&#x20AC;&#x2122;s Austrralia a â&#x20AC;&#x2122;s p eak professional professional nursing nursing organisation, orrganisation, g is proud prroud o to to par tner the D epartment of Health and A geing partner Department Ageing as the fund administr ministrra ator for this pr ogrra am. administrator program.

T H E L A M P J U LY 2 0 1 2 | 4 9

DIARY DATES

conferences, seminars, meetings SYDNEY, HUNTER & ILLAWARRA Mountains to the Sea midwifery conference 6 July 2012 Wollongong Kerry Duggan 4253 4267 Whitlam Orthopaedic Research Centre Symposium 10 August 2012 Liverpool Hospital maria.lingam@sswahs.nsw.gov.au Lynette McEvoy 02 8738 3886 lynette.mcevoy@sswahs.nsw.gov.au NSW GENCA Conference – Gastroenterological Nurses 18 August 2012 Sydney 1300 788 155 www.Genca.org 21st Annual Spinal Injury Conference www.sina.org.au 23-24 August 2012 Sydney jhebblewhite@bigpond.com Day Surgery Nurses’ Association Conference: Embracing Change 25 August 2012 Sydney DSNA Secretariat 9799 1632 nswadmin@adsna.info 40th Annual Meeting of International Society of Paediatric Neurosurgery 10 September 2012 Sydney Tracey Frawley 0412 174 090 info@ispn2012sydney.org www.ispn2012sydney.org/Nursesymposium Spring with the Kids Paediatric Perioperative Seminar 15 September 2012 Parramatta Claudia Watson 9845 2112 claudia.watson@health.nsw.edu.au Annual Enrolled Nurse Conference 20-21 September 2012 Sydney ENPA members $220, non-members $250 1300 554 249 rjroseby@gmail.com Bones on the Beach orthopaedic conference 13 October 2012 Wollongong Karin Tarne (02) 4222 5811 karin.tarne@sesiahs.health.nsw.gov.au

National Spina Bifida Conference 19-20 October 2012 Sydney Olympic Park Julie Dicker 9845 2802 Julie.dicker@health.nsw.gov.au www.nswspinabifidacollab.org.au Australasian Society for Ultrasound in Medicine 42nd Annual Scientific Meeting 26-28 October 2012 Sydney 03 9645 6311 congress@asum.com.au www.asumcongress.com.au/

REGIONAL It’s a Knock Out! Anaesthetic Cocktails and PACU Pick-me-ups 27 October Terrigal Teresa Farrell 4389 9419 farrellt@ramsayhealth.com.au Nicole Field 4389 9449 12th Rural Critical Care Conference 24-25 August 2012 Dubbo info@eastcoastconferences.com.au www.ruralcriticalcare.asn.au Australian Women’s Health Nurses’ Association (AWHNA) Annual Professional Update 27-28 August 2012 Canberra Sue Green (02) 6298 9233 Sue.green@gsahs.health.nsw.gov.au Gundagai District Hospital Dinner Dance 27 September 2012 Gundagai Farewell Gundagai District Hospital and welcome new Gundagai Multi Purpose Service Brunch and Hospital Tours 30 September Gundagai Health Service 02 6944 1022 gundagai.hospitalgsahs.health.nsw.gov.au

INTERSTATE & OVERSEAS Mental Health Services 22nd Annual Conference: Recovering Citizenship 21-24 August 2012 Cairns Tel 02 9810 8700 Fax 02 9810 8733 info@themhs.org www.themhs.org

Hospital in the Home Society of Australasia 5th Annual Scientific Conference 2012 22-23 November 2012 Melbourne 0458 291 166 www.hithsociety.org.au/conference; Megan.Chinzani@ashm.org.au 3rd International Conference on Violence in the Health Sector October 2012 Vancouver Canada www.oudconsultancy.nl/MAILING /vancouver/ Union of Risk Management for Preventive Medicine (URMPM) World Congress 2012 8-9 September 2012 London head.office@urmpm.com www.urmpm.org/UWC2012/

REUNIONS RAHC March 1973 PTS reunion 17 March 2013 Bronwyn Exley bronwyn.exley@bigpond.com Jenny Elliott jenelliot@bigpond.com Sherran Alexander (Peck) sherran.j.alexander@gmail.com

NOTICES Nurses: from Zululand to Afghanistan exhibition Australian War Memorial, Canberra Until 17 October, free www.awm.gov.au

NSWNA Events Check venue location with Lyn Stevens 02 8595 1234 Free call 1300 367 962.

EDUCATION DATES For more information on NSWNA Education Courses, contact Carolyn Kulling (02) 8595 1234 Free call 1300 367 962 www.nswnurses.asn.au/topics/2761.html

R A R A C T E A T U I O O N

N S P R I R L I L L L A C P A O L L A V C F A M I L U F G E N I T E C 5 0 | T H E L A M P J U LY 2 0 1 2

P I R A T G S M A T I O R T Y A W A D C O T I N E T T I T I C A N O L G E N D U A P E I A L H Y N I D A L S L T H E

I O N R N U N M I C E B R E N E S E S S A S S A L U C O S T H O P I E N T A R S O P O M P L A R C H

for for NSW NSW Nurses

12 Lead Lead ECG ECG A d dvanced Analysis Analysis Advanced and Interpretation Interprretation and 03 03 - 04 August August

10.5 10.5 CPD

extend This prro ogram aims to ex your knowledge of the rationale underpinning complex carrd diac rhythms.

It includes their presentation on ECG.

Alcohol and Alcohol and Ot Other her Drugs 23 - 2 24 4A August ugust

10.5 10.5 CPD

This program is designed to increase the knowledge of all nurses who are working with people dependent on alcohol and/or other legal and illegal drugs.

off tthe Seriously Case o he Se riously orr Injur Injured Child Ill o red e C Child 23 - 2 24 4A August ugust

10 10.5 .5 CPD

Designed especially for general nurses who need to enhance their knowledge of the care of seriously ill children.

Diabe Diabetes etes Refresher Refrre esher Seminar

Crossword solution T O L E R O G E N I C

August A ugust 2012 2012 CPD Programs Pr ogrra ams

E M U L S I F Y

2 7 - 28 A ugust 27 August

Come along to this highly evaluated seminar and update your knowledge about modern nursing care of those with diabetes.

Caring ffor or tthe he Deteriorating De eteriora ating Patient 30 - 31 A August ugust

A

R E

10.5 CPD 10.5

10.5 10.5 CPD

A program designed for nurses working in acute care settings. This program will update your knowledge about the clinical features of deterioration including what to do when it occurs.

Register: To R egister: ausmed.com.au/lamp ausmed.c com..au/lamp a ph: (03) (03) 9326 9326 8101 8101

My Wellness Our Strength PROFESSIONAL DAY 8 AUGUST 2012

REGISTER NOW TO ATTEND ON WEDNESDAY 8 AUGUST 2012 For more information or to register please contact the NSWNA on 8595 2181 (metro) or 1300 367 962 (rural) or go to www.nswnurses.asn.au/education

Scan the code to join the NSWNA online

CELEBRATE THE NEW FINANCIAL YEAR WITH

A NEW NISSAN! Micra ST

X-Trail ST

Navara ST

6 airbags, ABS and ESP, Bluetooth, front power windows, 3 year road side assistance, Plus more!

6 airbags, ABS and ESP, 6 stack CD, 17” alloy wheels, Bluetooth, Plus more!

6 airbags, Bluetooth, cruise control, climate control air con, 17” alloy wheels.

370Z

Murano ST

Dualis ST

Limited Edition Black Label

6 airbags, ABS and ESP, cruise control, 16” alloy wheels, power windows.

Plus more!

3.5L V6 engine, 18” alloys, Xenon headlights, Bose audio, leather trim, push start button.

Bose system, Bluetooth, sports leather seats, sat nav.

EXCLUSIVE LAMP OFFER $1000 WORTH OF FREE GENUINE NISSAN

ACCESSORIES ON ALL SUV, COMMERCIAL & SPORTS CARS# CELEBRATE THE NEW FINANCIAL YEAR WITH

A NEW KIA Rio S 3 Door

Car of the Year* 6 airbags, Bluetooth, iPod connectivity, ABS and ESP, 5 year unlimited km warranty.

FROM AS LOW AS

$15,990 DRIVE AWAY

5 YEAR UNLIMITED KM FACTORY WARRANTY ON ALL KIAS

Cerato S Hatch

Sportage Si

Grand Carnival S

Powerful 2L engine, 6 airbags, ABS and ESP, USB and iPod connectivity.

Bluetooth, reverse camera, alloy wheels, climate control, ABS & ESP, iPod connectivity.

Central locking, 6 airbags, ESP, Bluetooth, iPod connectivity, cruise control, 8 seater.

EXCLUSIVE LAMP OFFER $500 WORTH OF FREE GENUINE KIA ACCESSORIES WITH ANY NEW CAR PURCHASED THIS MONTH^ *Awarded to Kia Rio Si model. #$1000 FREE accessories valid with every new Nissan sold between 1st & 31st July, 2012. Offer not redeemable for cash. This ad must be presented at time of purchase. ^$500 FREE accessories valid with every new Kia sold between 1st & 31st July, 2012. Offer not redeemable for cash. This ad must be presented at time of purchase. Vehicles are available at time of printing. Cannot be used in conjunction with any other offer or promotion. Offer ends 31.7.12. MD20305 YPA3939

NISSAN & KIA 02 8014 4487 | 37 Blacktown Road | Blacktown www.landernissan.com.au

www.landerkia.com.au

Part of Australia’s Largest Motoring Group

www.ahg.com.au

ONLY 4 MINS FROM PROSPECT HWY TURN OFF ON THE M4