Lamp September 2013

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 70 No.8 SEPTEMBER 2013

DEFENDING OUR PUBLIC HEALTH SYSTEM Print Post Approved: PP241437/00033

Our look has changed but our commitment to our members hasn’t First State Super is committed to the ongoing support of nurses and midwives. What makes us different is that we exist to grow our members’ wealth, not our own. We work with our members to help them build and secure their financial future.

If you would like to be a member of the super fund that puts its members first, call 1300 650 873 today.

This is general information only. Consider our product disclosure statement before making a decision

FSS Trustee Corporation ABN 11 118 202 672 ASFL 293340 is the trustee of the First State Superannuation Scheme ABN 53 226 460 365

CONTENTS

lamp THE

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

VOLUME 70 No.8 SEPTEMBER 2013

Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au Hunter Office 8-14 Telford Street, Newcastle East NSW 2300

COVER STORY

30 | When the cost of living is bankruptcy In the American documentary Sicko, by renowned filmmaker Michael Moore, Donna Smith told her incredible story of bankruptcy brought on by a family medical crisis.

Donna Smith

5 6 8 37 39 42 43 45 46 50

Editorial Your letters News in brief Ask Judith Social Media Nursing research online Crossword Books Movie of the month Diary dates

ANNUAL CONFERENCE

28 | A proud past, a fighting future.

ANNUAL CONFERENCE

18 | Minister announces more educators

The Health Minister’s announcement of more nurse educators was warmly received at Annual Conference.

ANNUAL CONFERENCE

20 | Building people power in the workplace

Association delegates are learning new ways of organising campaigns and spreading their message.

COMPETITION

10 | Win $200 book vouchers

FOR ALL EDITORIAL ENQUIRIES, LETTERS AND DIARY DATES: T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au

PHOTOGRAPH: SHARON HICKEY

REGULARS

NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258

PRIVATISATION

32 | Defending our public health system

The NSWNMA has produced a TV ad encouraging people to vote for the right to public healthcare.

Editorial Committee • Brett Holmes, NSWNMA General Secretary • Judith Kiejda, NSWNMA Assistant General Secretary • Coral Levett, NSWNMA 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@nswnma.asn.au Records and Information Centre – Library To find old articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnma.asn.au

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

Privacy Privacy statement: The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission.

Subscriptions for 2013 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $50.

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

THE LAMP SEPTEMBER 2013 | 3

and go in the draw to

r e b m e m w e n a it u r Rec

Get lost in Singapore

Are Are your workmates or friends members of the NSWNMA? Why Why not ask them. And, if not, invite them to sign up. up. Lik Likee you, they need the security of belonging to a strong and ddynamic ynamic union. Not only will you be building your union bbyy signing up new members, you and a friend could win this fabulous holiday to Singapor Singapore. e. The mor moree members you sign up up,, the mor moree cchances hances you ha have ve to win!

The prize includes rreturn eturn airfar airfares es for tw twoo from Sydney with Scoot Airlines; 5-nights accommodation at the Shang Shangri-La ri-La Hotel, Singapor Singapore; e; Attr Attractions actions Pass for 2; and taxi tr transfers ansfers from airport rreturn. eturn.

Remember ffor or every every new member you recruit/ha recruit/have ve recruited from 30 June 2013 to 30 June 2014 means you will ha have ve your name submitted to the dra draw. w.

RECRUITERS NO NOTE: TE: Nurses and midwives can now join online aatt www.nswnma.asn.au! www .nswnma.asn.au! .nswnma.asn.au If you refer a new member to join online, make sure you ask them to put your name and workplace on the online aapplication pplication form. form. You You will then be entitled to your vouchers and dra draw/s w/s in the NSWNMA Recruitment Incentive Scheme.

An ever ever-changing -changing city, city, Singapore Singapore offers offers a diverse mix of experiences ffor or you to enjoy this lush, modern and vibrant destina destination tion at at your own pace.

The recentl recently-opened y-opened Gardens bbyy the Bay Bay is a sight to behold. Home to a-quarter a-quarter-of-a-million -of-a-million rare plants and a plethora of buzzing activities, it promises an all-encompassing experience for for the whole famil family. y. After the sun sets, don’t miss the sky show of dazzling lights and sounds in the OCBC Garden Rhapsody, Rhapsody, which takes place nightl We’re certain sleep will be the last nightlyy amidst the Supertrees. We’re thing on your mind with all the new and exciting things that that are w..yoursinga coming your wa y. Go to www .yoursingapore.com/getlost way. www.yoursingapore.com/getlost Loca ri-La Hotel, Singapore Singapore is just ted in the heart of the city Located city,, Shang Shangri-La a short walk to the city’ city’ss main shopping, entertainment and dining district. The hotel is well situated Singapore’s extensive situated within Singapore’s network of buses and trains, and it is only only a 10-minute drive to the CBD and 30 minutes to Changi Changi International International Airport.

Contact www.shangri-la.com/singapore www.shangri-la.com/singapore Introducing Australia’s Australia’s newest low cost airline flying direct to Singa pore from Sydney Sydney and the Gold Coast. If you are looking Singapore ffor or the most cost ef fective way way to Asia, fly scoot and sa ve loot. effective save Book now aatt www .flyscoot.com www.flyscoot.com

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

We will not allow public hospitals to be privatised by stealth The privatisation of public hospital services is on the political agenda and we have made an intervention with a TV ad leading up to the federal election to ensure the public are aware of it.

“There is a lesson here for both the major parties that we will not sit on our hands and allow the privatisation of public health system services through the back door.”

As always our advertisement asks people to vote for the issue not the party. But I won’t hide from the fact that we are convinced that the Liberal National Coalition has this issue on its agenda, public policy or not. It is up to individuals how they vote but we want them to be informed about an important issue that has serious consequences for patients, nurses and midwives.

Both major political parties would probably prefer that it flew under the radar. We are not going to let that happen. On our watch privatisation will not happen by stealth.

We have been accused of running this ad merely on the basis of a quote by Peter Dutton, the Coalition’s federal health spokesperson and alternative Minister for Health.

That is not true. Our concerns about the privatisation of public hospitals are not theoretical. Privatisation is already the very clear agenda of the Liberal National parties in New South Wales, Queensland and Western Australia.

Mr Dutton has indicated he too sees a role for private operators in the running of our public hospitals. That is not just our interpretation of his statements. It is also an interpretation shared by conservative business media such as the Australian Financial Review and the Business Review Weekly.

Mr Dutton also says the Liberal Party welcomes a debate on this issue. Well, we have joined that debate, even if our contribution may not please him, sections of the media, or some of our members who cannot believe any political party would have such an agenda.

Our fear is that opening up the running of public hospitals to the private sector will lead to profits coming before patients.

It is totally reasonable for us to think that.

If there is a combination of conservative governments at the state and federal level, this will open the door to private operators to seize control of the billions of dollars in public money that is made available to maintain our public health system.

The facts on the ground reinforce that belief.

In recent months we have reported in The Lamp on the O’Farrell Government’s plans to privatise the new Northern Beaches hospital, as well as the privatisation agendas of the Queensland and Western Australian governments. We now know this is no one off event in NSW, with the announcement by the Minister for Mental Health and Lifestyles, Kevin Humphries, that two pilot mental health services would be put out to tender to private companies and the non government sector to deliver mental health, physical health and drug and alcohol support in their local communities at a cost of $1.8 million.

So, on the one hand, we have our state government starving our community health services of resources, and instead offering the money to private companies or NGOs to deliver the core business of our community health services.

In this edition of The Lamp (page 30) Donna Smith tells us what the shocking consequences can be for patients in the United States when profits come before patient care. It is a cautionary tale that we must be aware of and which we must share with the public.

At our Annual Conference she noted how privatisation usually occurs in a gradual way.

There is plenty of evidence of that modus operandi in the way public hospital services in Australia are currently being offered to private operators.

We call it as we see it. There is a lesson here for both the major parties that we will not sit on our hands and allow the privatisation of public health system services through the back door.

The new Northern Beaches hospital tells us that if governments think the community is disengaged, they will simply make the announcements as a fait accompli and no one will care. We do and so do our members.

THE LAMP SEPTEMBER 2013 | 5

YOUR LETTERS

LETTER OF THE MONTH

Resolute for safe patient care As nurses we must all stand together to achieve safe patient ratios for all nurses and their patients no matter where they work in New South Wales.

To accept any less is to compromise the hard-foughtfor position we have already achieved in some state hospitals.

We must not take a backward step at this critical time. We must be strong and resolute in our efforts to bring safe patient care to those in our hospitals and community.

Debbie Lang, Green Point

Refugees deserve better Great to see us nurses and midwives demonstrating for decent ratios and patient safety. Thanks for that front cover of some of the 3000 nurses at Sydney Olympic Park on 24 July. Bravo!

There are other demonstrations happening just about every weekend at Town Hall Square in Sydney. These are against the anti-asylum seeker policies that both major parties are hoping to be elected with.

Labor and Rudd’s “PNG Solution” is breathtaking in its cruelty, both to the asylum-seekers and the people of Papua New Guinea, which is being treated as a colony. The “solution” also breaches the 1951 UN Refugee Convention, yet again treating asylum seekers differently according to how they come here.

I am old enough to remember when we did not lock up asylum seekers, before 1992.

Locking them up was brought in by the Keating Labor government as an “interim measure”. It is an “interim measure” of 21 years standing: 21 years of pain and anguish for those fleeing persecution, but of great wealth to the security companies that run the camps at our expense. And, it must be said, it has been of great benefit to the political parties, which use the people coming here by boat as their political football.

I know there are other nurses at the Sydney Town Hall demonstrations. I have met them. But it would be great to see some NSWNMA banners to show where our heart is as an Association.

If these protests against these outrageous asylum seeker policies were endorsed, I would be happy to hold a NSWNMA banner, or one end of it.

It is great to see the CFMEU banners at the protests. Can we see some NSWNMA banners there too?

Refugees are welcome here!

Stephen Langford, Paddington

6 | THE LAMP SEPTEMBER 2013

The Lamp online?

I was recently online looking for an electronic version of The Lamp when I saw the link to “Check out our Lamp flipbook”. I was suitably impressed and was left wondering if the NSWNMA had plans to offer members the opportunity to receive their version of The Lamp electronically in the future, rather than printing and sending via post.

I for one would opt for the electronic version. In the future we may even see it come on the App Store Newsstand given the numbers of smartphone users in Australia.

Many thanks Pauline Dobson, Newcastle NSWNMA RESPONDS Thank you for the feedback Pauline and we’re glad you appreciate the digital flipbook version of the magazine, which is available on the NSWNMA website. We are looking into developing a Lamp app for smartphone use, but at the moment we intend to keep printing The Lamp and sending it to all members by post. We feel there are times – away from the computer or smartphone – when members and others enjoy the opportunity to thumb through a copy of The Lamp and read about our campaigns. We might consider offering an electronic-only version of the magazine in the future if there is enough interest from members.

letter of the

month The letter judged the best each month will be awarded a $50 Coles Myer voucher.

“Whatever your next purchase, remember Union Shopper. After all, who can think of a reason NOT to save.”

unionshopper.com.au • 1300 368 117

SAYSOMETHING Send your letters to: Editorial Enquiries email lamp@nswnma.asn.au fax 9662 1414 mail 50 O’Dea Avenue, Waterloo NSW 2017.

Please include a high resolution photo along with your name, address, phone and membership number.

Letters may be edited for clarity and space.

NO TIME

YOUR LETTERS

Penalties a vital incentive I currently work every weekend in community palliative care on a permanent part-time basis, and drive one hour each way from home to work. The service is based in a regional town and provides seven days a week palliative care to the community.

If weekend penalty rates were abolished I would resign from this post, as there would be no incentive for me to drive the extra kilometres each weekend, when I can pick up extra shifts, in the same speciality, in a town closer to where I live.

If I resigned from my weekend position it would leave that community without a weekend palliative care service and place greater pressure on the local district’s Emergency Department.

Leonie Gambrill,Taree

FOR CPD CPD? ?

CPD online saves you time

Disillusioned with paperwork Is it just me or do others of my vintage, some 41 years nursing, feel as disillusioned as I do? I work in the private sector, on night duty for some 30 years now, and am finding more and more that my time is taken up with the endless amount of paperwork and less time spent hands-on delivering care to my patients. I ask myself, what was the reason I became a nurse and it wasn’t to be a secretary and paper-pusher, but that is what I am becoming.

I can understand our accountability because we deal with patients’ lives, but sometimes taking time out to talk to a patient can answer a lot of questions. Do others find this or is it just me? I thank God each day that I am nearing the end of my career as I would be a very disillusioned new grad and I feel for those coming through the ranks to take my place.

Lyn Galvin, Liverpool

ADVERTISE IN

THE LAMP AND REACH OVER

58,800 NURSES &

*

MIDWIVES

Contact Patricia Purcell on 02 8595 2139 or 0416 259 845 or email ppurcell@nswnma.asn.au for more information. *Circulation Audit Board actual figures 58,846. 30/09/2012

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

Trial Topic...

Try e-Learning on HEALnet with our FREE trial course topic. Simply log on to healnet.edu.au and follow the link on our homepage.

HEALnet.edu.au HEALnet.edu.au is a pr product oduct of North North Coast Coast TAFE TA AFE

1300 730 121

NEWS IN BRIEF

Britain

GPs flee sinking NHS

Dr Clare Gerada

World

Think before you tweet Swedish and Canadian research suggests health professionals should be vigilant when using Twitter.

A study published in the British Medical Journal online examined 276 Twitter accounts held by doctors or medical students.

Of 13,780 tweets, researchers deemed 276 (1.9%) to be “unprofessional”. From these, 26 tweets (posted by 15 different users – representing 6.3% of all accounts analysed in the study) – included information that could violate patient privacy.

“Physicians and medical students need to understand that professionalism and sharing private information publicly are intertwined and to always think before you tweet,” said the researchers.

Similarly, a Canadian study that surveyed 682 medical students, about their use of Facebook, found that almost half had witnessed what they deemed to be unprofessional content being posted by a colleague. More than a quarter of respondents admitted to having posted such material themselves.

8 | THE LAMP SEPTEMBER 2013

“85%

OF GPs THINK THE PROFESSION IS IN CRISIS.”

A rise in the number of GPs leaving the NHS to practise overseas represents “a significant danger” to the profession, the British Medical Association has said.

Figures obtained by the GP magazine Pulse revealed that the number of family doctors who requested Certificates of Good Standing from the General Medical Council – required for registering to work abroad, and seen as a key indicator of how many doctors are leaving the country – has risen by more than a third since 2008, from 521 to 722.

Increased workloads and poorer wages had led to a brain drain, with GPs “fleeing the sinking ship” said one senior doctor, with most departing for Australia, New Zealand and Canada.

Dr Clare Gerada, chair of the Royal College of General Practitioners (RCGP), told the Independent newspaper that the government needed to urgently invest in general practice.

“It is a great shame but not surprising that such a high number of GPs are moving abroad when across the UK we are heaving under ever-increasing workloads and decreasing resources,” she said. “The RCGP’s own research has shown that GPs are making up to 60 patient contacts in a day and 85% of GPs think the profession is in crisis.”

Australia

Queensland government threatens QNU The Queensland Director-General of Health has threatened the Queensland Nurses Union with court action over what he called the unlawful use of a photo in anti-privatisation pamphlets, according to the Brisbane Times.

The union was told to remove the image – an artist’s impression Qld Health Minister of the Sunshine Coast University Hospital – and apologise for Lawrence Springborg breaching copyright laws.

QNU General Secretary Beth Mohle said the letter was an attempt to stop the union protesting against the privatisation of the state’s health sector.

“If they think this is going to stop our campaigning activity then they can be assured it won’t,” she said.

“We received the letter the same day Mr Springborg announced he is going to privatise Sunshine Coast University Hospital.”

Health Minister Lawrence Springborg denied his department was using bullying tactics to silence the union.

“All we’re seeking to do is to remind them that they can not publish this stuff without the express consent of Exemplar Health Ltd (which owns the image),” he told the ABC.

NEWS IN BRIEF

World

Governments failing workers: poll Two out of three people rate the current economic situation in their country as bad, according to a new global public opinion poll conducted for the International Trade Union Confederation (ITCU).

The poll was conducted in Belgium, Brazil, Canada, China, France, Germany, India, Japan, Russia, Spain, South Africa, the UK and the USA. It showed that people feel abandoned by their governments as they fail to tackle unemployment and prioritise business interests over worker interests: • 80% of voters said their government had failed to effectively tackle unemployment in their country.

• Only 13% of voters believed their government was focused on the interests of working families.

The poll also showed strong support for laws that protect rights for workers: • 64% thought current laws did not protect job security.

• 68% strongly supported a minimum wage.

• 91% supported the right to join a union.

Sharan Burrow, general secretary for the ITUC and a former president of the ACTU, said unemployment and inequality was poisoning the world’s economies and societies.

“Jobs, collective bargaining, a minimum wage on which people can live, social protection and essential services are the core elements of reducing inequality and unemployment,” she said.

64%

THOUGHT CURRENT LAWS DID NOT PROTECT JOB SECURITY.

: TH S UT EAL H

Expand your career opportunities UTS Master of Nursing and Master of Health Services Management have flexible and adaptive pathways to help you achieve your career goals.

INFO SESSIONS ON 1 & 2 OCTOBER Register at health.uts.edu.au/leadership and find out more about our immersive master classes, supported online learning and globally connected academics.

Phone: 1300 ASK UTS Email: health@uts.edu.au

68%

STRONGLY SUPPORTED A MINIMUM WAGE.

91%

SUPPORTED THE RIGHT TO JOIN A UNION.

UTS CRICOS PROVIDER CODE 00099F

EDUCATION@NSWNMA

COMPETITION

Win $200 Book Vouchers

WHAT’S ON SEPTEMBER 2013 Are you meeting your CPD requirements – ½ day 4 September Bathurst Seminar suitable for all nurses and midwives.

Members $40 Non-members $85 ——— • ———

Legal and Professional Issues for Nurses and Midwives – ½ day 5 September Orange 13 September Nowra Topics include the Health Practitioner Regulation National Law, potential liability, the importance of documentation, the role of disciplinary tribunals and writing statements.

Members $40 Non-members $85 ——— • ——— Check Checklists for Clinical Nursing Skills by Louise Sparkes, JJennifer Bassett and Elisabeth Jacob Publishing SSeptember 2013

Appropriate Workplace Behaviour – 1 day Smeltzer & Bare’s e’’ss Medical-Surgical al Nursing

by Maureen Farrell rell and Jennifer Dempsey ey Publishing November mber 2013 Fundamentals of Nursing and Midwifer Midwifery ryy by Jennifer Dempsey, Dempsey, Sharon Hillege and Robyn Hill. Publishing September 2013

19 September Penrith 7 November Newcastle Topics include why bullying occurs; antidiscrimination law and NSW Health policies; appropriate behaviour in the workplace; identifying unlawful harassment and bullying; what to do if subjected to unlawful harassment and bullying; how to use workplace grievance procedures; identifying, preventing and resolving bullying.

Members $85 Non-members $170 ——— • ———

To celebrate the arrival of three new editions of our bestselling nursing textbooks LWW are giving away 5 x $200 vouchers for our new book website www.LWWBooks.com.au

Basic Foot Care for AiNs – 1 day 20 September Wagga Wagga

Members $85 Non-members $150 ——— • ———

Computer Essentials for Nurses and Midwives – 1 day 25 September Prince of Wales Hospital, Randwick Seminar suitable for all nurses and midwives.

Members $85 Non-members $170

Browse the latest nursing drug books, references, study aides, models and charts!

Educators, get your inspection copy now!

Email CustomerServiceANZ@ wolterskluwer.com

——— • ———

Practical, Positive Actions in Managing Conflict and Disagreement – 1 day 1 October Penrith 9 October Gymea

Members $85 Non-members $170 ——— • ———

Basic Foot Care for RNs and ENs – 2 days 30 & 31 October Tamworth

Members $203 Non-members $350 ——— • ——— To register or for more information go to www.nswnma.asn.au/education or phone Matt West on 1300 367 962

NEWS IN BRIEF

Australia

Ireland

Super win for women

Limited legalisation of abortion

Australian women live longer than men but, on average, retire with substantially less superannuation. Now, an Australian firm has come up with a plan to redress this balance, according to the Sydney Morning Herald.

Abortion has become legal in Ireland, in limited circumstances. New legislation allows terminations when a mother’s life is at risk due to medical complications or the threat of suicide.

Irish President Michael D. Higgins (pictured) signed the law after holding four hours of talks with a specially convened meeting of the Council of State – a body comprising, among others, former presidents and prime ministers.

The new law does not include those women seeking terminations because of rape or incest.

According to Irish Department of Health figures, about 4000 Irish women travelled to British hospitals and clinics to terminate their pregnancies last year. They included 124 women aged under 18.

Female staff at Rice Warner Actuaries will be paid a higher rate of superannuation than their male colleagues, in a move to stem the gap in retirement savings.

Rice Warner will pay their female staff an extra 2% superannuation, plus 18 weeks’ parental leave at full pay, with full super during parental leave, including unpaid leave, for up to 12 months. The package is believed to be the first such action by an Australian employer.

The Human Rights Commission has examined the plan and considers it a “special measure” designed to redress gender inequality, and therefore allowed under the Sex Discrimination Act.

RICE WARNER WILL PAY THEIR FEMALE STAFF AN EXTRA 2% SUPERANNUATION, PLUS 18 WEEKS’ PARENTAL LEAVE AT FULL PAY

The new Spaulding Rehabilitation Hospital

United States

Proofing hospitals against climate change According to Rice Warner, today’s 65-year-old women leave work with about $40,000 less superannuation than men of the same age, due to their smaller average pay packets and years spent out of the workforce, or in part-time work, raising children.

The super balances of women aged between 40 and 44 are, on average, $28,400 smaller than those of men in the same age group. The total gap between the super balances of men and women stands at $383 billion.

When Hurricane Sandy devastated the East Coast of the United States in October 2012, many hospitals were unprepared for the consequences.

It took 15 hours to evacuate 300 patients, including 20 babies from neonatal intensive care, at Langone Medical Centre, in Manhattan. At Coney Island Hospital the electrical room was inundated with water, forcing another evacuation.

According to the online blog Think Progress, a new hospital being built in Boston – the Spaulding Rehabilitation Hospital – is a new model aimed to “future proof ” against such climate change disasters.

Built near a bay, its ground floor is raised 30 inches above the current 500-year flood level and 42 inches above the 100-year flood level.

It has operable windows that, in the case of an air conditioning failure, can be opened so patients don’t overheat — an essential part of climate change preparation.

The hospital landscaping acts as a sort of reef, created to provide a certain level of protection from storm surge. And, importantly, its electrical equipment is on the roof, instead of in the basement, so it’s not susceptible to flooding.

These measures will add about 0.5% to the total cost of the building.

THE LAMP SEPTEMBER 2013 | 11

ANNUAL CONFERENCE

Blue army

12 | THE LAMP SEPTEMBER 2013

on the rise By undermining the NSW Industrial Relations Commission and unilaterally imposing its will on workers the O’Farrell Government has left us with no choice but to campaign in the political arena, NSWNMA General Secretary Brett Holmes told Annual Conference.

THE LAMP SEPTEMBER 2013 | 13

ANNUAL CONFERENCE

NSWNMA GENERAL SECRETARY BRETT Holmes paid tribute to the thousands of members who have participated in the “Ratios put safety first” campaign, in his address to the Association’s Annual Conference.

“Congratulations to all of our members and branch officials who have stepped up and taken a stand in the campaign so far,” he said.“I believe it has been one of the Association’s most prepared, researched and planned campaigns.”

Although the New South Wales government remains intransigent on the Association’s claim for improved and extended ratios, Brett assured delegates at the conference that the campaign would continue.

“It is clear that we remain on the right path, both for our members and their patients and ultimately the community of New South Wales.The international support and interest

14 | THE LAMP SEPTEMBER 2013

in our achievements and the ongoing campaign reinforces that conviction as well.”

Brett said a clear lesson from the campaign so far was the recognition that nurses and midwives had to engage with the political process.

“I believe that many members have made the shift from thinking politics and politicians were a no-go area, to a clear understanding that this campaign will be won or lost on the basis of what the local politicians, particularly those in government, will do for their communities and constituents.

“More members and branch officials have had direct interaction with their local members of parliament than ever before.

“Our message has to be clear to the state government that this campaign for safer patient care will continue up to the next state election in 2015, and beyond.”

Brett said some of the actions carried out by members to progress the campaign had been inspiring.

“Our ‘crash the conference’ at the New South Wales National Party conference in Bathurst was just one example of members doing something new and different to get the message to their politicians. I have a vision of a blue army of members prepared to show up at short notice to events where decision makers are appearing, to be a presence that cannot be ignored,” he said.

TAKING ON PRIVATISATION OF PUBLIC HOSPITALS Brett brought attention to an advertising campaign the Association is running against the privatisation of public hospital services, after federal coalition health spokesman Peter Dutton expressed his support for the drive

to privatise public hospital operations by the Queensland,West Australian and New South Wales state governments.

“As always our advertisement asks people to vote for the issue not the party so individuals can make up their own mind about how to cast their vote and be informed about an important issue that both major political parties would have probably preferred to go quiet on,” he said.

He said that the Association’s concern was heightened by a new state government announcement, just prior to conference, to privatise mental health services. This came hard on the heels of an announcement about the privatisation of public hospital services on the Northern Beaches of Sydney.

“Two pilot mental health services will be put out to tender to private companies and the non-government sector to deliver mental

health, physical health and drug and alcohol support in their local communities at a cost of $1.8 million.

“Our state government refuses to recognise the starvation of the community health services that are trying to deliver these services, and instead gives the money to private companies or NGOs to deliver the core business of our community health services.”

AGED CARE WIN UNDER THREAT Brett said another great win for nurses last year was the Aged Care Supplement legislation – the culmination of years of effort via the Because We Care campaign.

“For nurses in aged care it has the promise of the delivery of improved wages and conditions, providing employers agree to participate by enterprise bargaining or adhering to the requirements if they are small facilities.”

He cautioned that this significant win was under threat.

“The Federal Coalition has made employers very nervous that they may disallow the funding and withdraw the supplement in its current form, should they win government on September 7.

“The opposition shadow minister for ageing has made statements parliament on at least two occasions opposing the supplement, particularly the fact that it requires employers to bargain with employees, and deliver the money to workers, in order to access additional funding.

“Put simply a vote for an Abbot Government in either house of parliament could see the aged care money siphoned off or simply given to the providers to do with as they wish, which, going on history, is not to give it all to workers.”

THE LAMP SEPTEMBER 2013 | 15

ANNUAL CONFERENCE

International breakthrough for nurses In her Annual Conference report Assistant General Secretary Judith Kiejda told delegates about a global nurse action planned for September 17.

“Privatisation happens very subtly. No big announcements other than media releases that may or may not be picked up by journalists. Services just get chipped away and suddenly one day we wake up and realise that the essential quality public services – the measure of any decent society – are no longer.”

16 | THE LAMP SEPTEMBER 2013

FOURTEEN INTERNATIONAL NURSE unions gathered in San Francisco in June this year to form an international nurses union,Assistant General Secretary Judith Kiejda told members attending the Association’s Annual Conference.

“I couldn’t be more excited to announce the formation of the fledgling new Global Nurses United (GNU) at this conference,” she said.

Judith said the formation of the new organisation was timely “given the ravages of austerity and the continued worldwide resistance to mandated enforceable staffing arrangements for patient safety in all health sectors.

“GNU will meet electronically in the main and has a face-to-face meeting planned for September 2014, by which time we hope to have recruited even more nurses’ unions to the global union,” she said.

“In the meantime we will pursue coordinated global activities in pursuit of our agreed agenda of equitable access to quality public health services for all, and enforceable mandated staffing arrangements in all health care sectors.

“Our first global action will be on September 17.”

Judith also spoke about the work of Public Services International, to which the NSWNMA is affiliated.

“This global union federation has always had the protection and retention of quality public services as its prime objective, but more recently that objective has shifted up several notches as effects of austerity bite deep around the world.

“Even the International Monetary Fund has admitted that the austerity measures undertaken – particularly in southern Europe – have not worked and have ultimately wreaked havoc on the social fabric of countries such as Greece and Spain. The United States and UK have not escaped either. And of course here in Australia we are hearing similar rhetoric.”

Ultimately this rhetoric is code for privatisation, says Judith.

“Privatisation happens very subtly.

No big announcements other than media releases that may or may not be picked up by journalists. Services just get chipped away and suddenly one day we wake up and realise that the essential quality public services – the measure of any decent society – are no longer.”

Coalition will swing power to employers ACTU president Ged Kearney says Australian workers and families need to be informed about the truth of what a Coalition government would mean for them.

BUSINESS GROUPS HAVE AN AGENDA FOR Australia that poses enormous risks to workers’ conditions – and political parties must stand up to them, ACTU president Ged Kearney told the NSWNMA conference.

“We can see the plans employers have for Australia – cuts to important entitlements and conditions like penalty rates and more use of individual contracts that cut takehome pay. They will swing power back to employers and make it harder for workers to be represented at work,” she said.

“Political parties must stand up for the interests of ordinary Australians in the face of pressure from business to cut wages, reduce entitlements and erode job security.And that is why unions will be campaigning in force this federal election.”

Ged said that at this election unions would be talking to workers in their workplaces and in their communities about the choices they face at the ballot box: • Building a modern, globally-focused economy that offers real jobs growth – or leaving it to chance and the benevolence of big business.

• Investment or cuts to public services.

• Protecting or undermining work rights.

• Dignity in retirement or reliance on charity.

“The Your Rights At Work campaign proved that with the support of the Australian

community, the union movement is an unstoppable force.And that, of course, is why big business and the Tony Abbott-led Coalition are so determined to attack and weaken the union movement,” she said.

“They know that if unions are taken out of the equation there is nothing in the way to prevent them from implementing a radical agenda that would permanently take away the rights of Australian workers and slash their wages and conditions.”

Ged said the past five years had been a period of significant reform for working people, including initiatives such as: • The abolition of WorkChoices and establishment of the Fair Work Act; • The introduction of the paid parental leave scheme.

• Stronger protection of workers’ entitlements.

• The long-awaited increase to the Super Guarantee.

• A national bullying code.

• Tighter restraints on the heavily-rorted 457 visa system.

• And better, family-friendly work arrangements including the recently announced support for extended before and after school care.

“These outcomes for working people have occurred at the same time as good economic management through the Global

Financial Crisis saw Australia outperform the rest of the developed world and, most importantly, protected jobs.

“You would never see anything like this from Tony Abbott – in fact he has worked relentlessly against each and every one of these initiatives.”

Ged said the ACTU had gone through the Coalitions’ policy document with a fine toothcomb and identified areas of real concern for every Australian worker, the first of these being cuts to penalty rates and award conditions.

This reflects the business wish list submitted to last year’s review of the Modern Award system, which received two dozen different submissions arguing that penalty rates should be reduced or scrapped completely in the retail, hospitality and tourism industries.

“The Business Council’s report last week also calls for Australia’s allegedly high minimum wage to be reviewed by the Productivity Commission,” she said. “You can bet that other employer groups will dust off their old submissions to abolish penalty rates and cut minimum wages.

“That is why Tony Abbott should be upfront with the Australian people and release the terms of reference for his Productivity Commission inquiry before the election – so we know exactly what is at risk.”

THE LAMP SEPTEMBER 2013 | 17

ANNUAL CONFERENCE

Minister announces more educators The Health Minister’s announcement of more nurse educators was warmly received at Annual Conference.

Delegates were less enthusiastic about the government’s intransigence on extending and improving ratios.

“This year we are allocating 60 new CSO positions which will be dedicated to community health and community mental health.”

18 | THE LAMP SEPTEMBER 2013

HEALTH MINISTER JILLIAN SKINNER USED the opportunity of her address to the NSWNMA Annual Conference to announce initiatives that will increase the number of Clinical Nurse Educators and Clinical Nurse Specialists in the public health system.

“I recognise that we need to be constantly seeking new ways to support, develop and grow our staff,” she said. “In that spirit I am extremely pleased to announce today some additional support for our nursing staff in rural hospitals, community health and community mental health.

“I am announcing an additional 40

Clinical Nurse Educators/Clinical Nurse Specialists will be funded this year, specifically targeted to supply our small-to-medium rural facilities (Peer Group C, D and F3 facilities).

This is in addition to the 80 positions already funded this year, and most importantly in addition to the 275 such positions we committed to over our first term.”

Mrs Skinner said she recognised “that rural hospitals do not always have the level of access to professional infrastructure and support that might be available in metropolitan and major regional centres”.

She also announced extra resources for the community health sector including 60 Clinical Support Officers “to help relieve the burden on community nursing staff from paper work and other non-clinical work.

“I am pleased to tell you that at least 45 of the 115 Clinical Nurse Educators/Clinical Nurse Specialists Grade 2 earmarked for 2014/15, as part of the government’s fouryear commitment, will be specifically allocated to community health and community mental health services.

“Recognising that community health and community mental health did not receive specific funding for these positions as part of the changes following the Garling Inquiry, this year we are allocating 60 new CSO positions which will be dedicated to community health and community mental health.”

The Minister said she agreed that patient safety was paramount in the public health system and appreciated the efforts of nurses and midwives.

“My priority as health minister is patient safety and I am pleased that you also share this priority for the patients of New South Wales. I am committed to putting the patient first in everything that we do.

“I am grateful every day for the hard work and dedication of those who work in our health system and ensure safety for our patients.”

Testy exchange over ratios claim When responding to questions from the floor, there were sharp differences of opinion between Minister Skinner and delegates with respect to the Association’s public health system pay and conditions claim.

Kerry Rodgers from Nepean asked when the government was going to negotiate in good faith around the improvement and extension of ratios.

Jillian Skinner: “I take exception to the claim that the ministry is not in negotiation with the union.”

Kerry Rodgers: “A discussion is not a negotiation.”

Jillian Skinner: “Well, I’m just trying to clarify this. There is a regular ongoing meeting between the union and the ministry to discuss this and all workforce matters. So that’s the answer to that.”

Brett Holmes: “Minister, I am happy to assure you that I have discussed with the delegates the fact that we are having what we call discussions.

“We haven’t had negotiations in this agreement because the government set the parameters around what it thought was negotiations i.e. ‘that’s the wage cost, that’s the wage outcome and nothing more can be done to extend anything beyond that unless nurses pay for it themselves’.

“So the discussions we’ve had have obviously been listened to by the Ministry of Health and I’m very glad to hear that a number of the things that were discussed with us have resulted in announcements today.

“But I think there is a very clear difference between being in real discussions or negotiations around award matters and having discussions that are outside the parameters of award negotiations.”

Kerry also took issue with the Minister’s public denials that ratios exist in New South Wales.

Kerry Rodgers: “If you would look at clause 53 of our award, the ratios and the Nursing Hours Per Patient Day can be expressed as an equivalent.

“I think you’re just prevaricating here, as you are over the issue of whether it’s a discussion or a negotiation. And I’m sorry, but a good faith negotiation does not commence with the government saying, ‘what are you going to give up so that we will give you something else?’.

Jillian Skinner: “You are quite right, the award says that Nursing Hours Per Patient Day can be expressed as an equivalent ratio. This was included in the award at the request of the Association in 2010 to provide a comparison only between Nursing Hours Per Patient Day and the equivalent ratio. The average number of hours can be expressed as an equivalent, but it is an average, not a fixed ratio for each shift.”

Some other questions asked of the Minister Luke Marks, Orange Base Hospital branch: Why won‘t you, Minister, agree to support guaranteed award-based staffing levels for emergency departments? This would go a long way in improving patient outcomes and safe patient care.

Minister Skinner: There is a mechanism to address the increased demand in emergency departments from a day-to-day, hour-to-hour, minute-by-minute arrangement [which] is better addressed by the more flexible workloads pattern arrangements that are made at the hospital level.

Fiona Deegan, Mona Vale Hospital branch: Can you, Minister, guarantee a private operator of your proposed new Northern Beaches Hospital will have the same nursing hours system applied in the same way as existing public hospitals of the same Peer Group and ward types, not for two to five years, but forever?

Minister Skinner: The outline of our commitment to staffing was made at the announcement of the expressions of interest request and that would be that we would require the new operator to offer employment to the existing staff on their current positions without interview for a period of five years with all award and salary provisions intact.

Karen Fernance, Bankstown Hospital branch: Ms Skinner, can you give us assurances that services that should be supplied by our government will not be privatised? And what happens to the local community when the private partners are just not interested, like at Bankstown wanting a cath lab?

Minister Skinner: Watch this space in relation to the cath lab because the cardiologist raised it with me personally and I have taken it up. In most of the cases where there has been private sector involvement in hospital services, and I am thinking particularly of the imaging services I discovered recently at Port Macquarie that’s being extended to the network of hospitals there, it’s providing a very high quality, much respected service. I can’t imagine they would pull back from that, but in the event they did, they would be picked up again by the public sector because it was such a critical issue to the wellbeing of patients. I understand that.

To read the full transcript of the Minister’s Q and As with delegates visit the NSWNMA website.

THE LAMP SEPTEMBER 2013 | 19

ANNUAL CONFERENCE

Building people power in Amelia Scott

Association delegates are learning new ways of organising WORKPLACE BRANCH OFFICIALS ARE THE vital link between the NSWNMA’s head office and nurses on the wards. Major campaigns, such as our current push to extend ratios, can place a heavy burden on the handful of active members who run most branches.

During last month’s Annual Conference branch officials looked at new ways of getting more members involved with the Association and the ratios campaign in particular.

Their immediate focus was on generating support for the signatures drive as it develops toward regional activities in the week starting September 9 and building to a day of action in Sydney on September 17.

The union called in ACTU campaign educator Kristyn Crossfield to run an education session on the theme “Building People Power to Win Campaigns.”

Kristyn said the session was based on two main ideas: learning more effective ways of asking members for commitment; and getting more people to do the asking.

“The more people you can get to ask others to make a commitment – to come to a meeting, get signatures on a petition, wear red for the day – the more likely you are to be able to build people power in your workplace to win your campaign,” Kristyn said.

“Instead of one delegate trying to speak to dozens of nurses about an issue, have five conversations with individuals who 20 | THE LAMP SEPTEMBER 2013

Diane Lohman

“It’s a simple way to spread the message.”

then commit to having five conversations, and so on.

“It’s the simple but powerful multiplier effect.”

She said branch officials should choose well-known and respected members as the first group to be asked to commit.

“It’s also important that once someone has made a commitment, the person doing the asking should go back and check they have done what they said they would do.

“By following them up you are letting them know you haven’t forgotten their commitment and that you are counting on them.

“We find that members who take the trouble to do that follow up get a really high percentage of people who carry out their commitments.”

What if you get a knock-back from someone who says they are too busy or too tired, thinks it’s a hopeless cause or is just anti-union?

Kristyn said the “LEAP” technique – Listen, Explore, Acknowledge, Propose – has a high rate of success.

“LEAP starts with asking questions to find out why someone is saying no, and listening to the answers to get an insight into where they are at on an issue.

“We often know a lot about an issue and want to tell people what’s good for them.

However it is more effective to build your argument from where the other person is at, rather than where you’re at.

NSW Nurses and Midwives’ Association gratefully acknowledges the sponsorship provided by the following companies for our Annual Conference held at Rosehill Gardens 7, 8 & 9 August 2013

the workplace campaigns and spreading their message.

“The next steps are to acknowledge that their feelings are legitimate, and suggest that if we really want to get a result and fix a problem we all need to get involved.

“You shouldn’t browbeat people and nor should you take no for an answer straight away, because the issue – ratios in this case – is so important and we need everyone on board.”

Delegates at the conference formed pairs to practice the LEAP approach.

“It was a very powerful session and it’s put me in a more positive frame of mind,“ said delegate Amelia Scott, a child and family health nurse at Fairfield community health centre.

“Union work tends to fall back on a small group of people and techniques like this should be very useful in broadening the circle.”

Dianne Lohman, delegate and branch secretary from Kempsey District Hospital, said it was valuable to learn a new organising approach that would give added impetus to the ratios campaign.

“The idea of each activist committing to talk to five people and asking each of them to commit to talk to another five, is a simple way to spread the message and gives everyone a clear task to do” Dianne said. “It puts less of a burden on individuals, which is important when people are so busy and shift work and travel distances make it difficult to coordinate our actions.”

Day of Action: September 17 The Association’s drive to collect signatures on a petition calling for nurse-to patient ratios in all hospitals will come to a head at a Day of Action in Sydney on September 17.

Global Nurses United, a new body of nurse unions from 14 countries including Australia, has made September 17 a day of international action. In NSW the focus will be on ratios.

The Sydney Day of Action is being held in co-ordination with activities by other member unions of Global Nurses United.

NSWNMA branches from outside Sydney will hold regional activities in the lead-up to the Day of Action, during the week beginning September 9.

Get members on board Hold a meeting of activists to set targets for petition signing and numbers attending your regional day of action.

Each activist asks 5 members to commit to gathering signatures and attending the action. Each of these 5 members then gets commitments from another 5.

Every person follows up on the commitments they received and feeds the information back to whoever contacted them.

First State Super HESTA Super Fund Health Industry Plan ME Bank Mercure Sydney Chifley Financial Services Fuji Xerox Gillen Motors Offset Alpine Printing Scott and Broad/Clark Pacific

The Association also thanks the following companies for their contribution and assistance Bio Oil DB Health Galderma Australia Heritage Brand Lippincott Wilkins & Williams Nivea No Time to Lose Phytocare Precision Printers Polyflor Mints Silicea Products

THE LAMP SEPTEMBER 2013 | 21

ANNUAL CONFERENCE

DELEGATES HAVE THEIR SAY

“Privatisation is an issue very close to my heart because the state government will close Manly Hospital and relocate services to a new Northern Beaches Hospital, which will be built and operated by a private business.

Manly staff got a flyer saying we may retain our positions if similar positions can be found in the new hospital. If they do take us on we will keep our conditions for five years – but after that, who knows? I’m sure the private owner will want to streamline costs.

We already have the experience of the failed privatisation of Port Macquarie hospital. It turned into a big debacle.

The government spent bucket loads of money to sort out the mess and buy the hospital back off the private owners.

“PEOPLE ARE JUST NOT AWARE WHAT PRIVATISATION WILL MEAN, ESPECIALLY FOR THE LONG-TERM CHRONICALLY ILL.” I think people are just not aware what privatisation will mean, especially for long-term chronically ill people, because there is no money to be made out of them. The money is in quick turnovers for surgery. I work in aged care mental health and we take a lot of dementia clients who can stay for months waiting for guardianship and to find a place in a nursing home. Where’s the money in that?

Privatisation of health care is a major issue in America and it looks like Australia is heading the same way.”

Stephanie Cummings CNS Manly Hospital

22 | THE LAMP SEPTEMBER 2013

“I’ve been at Wagga Base for almost 20 years and this is my first union conference. It’s been fabulous. My role here is to be a bit of a voice for Wagga nurses.

Also, to learn what’s going on up here and take it back to the branch members so they know what’s happening and can tell the community what’s going on.

Sometimes members think the union isn’t doing anything when in fact they are trying to get better conditions, better safety and improved care for the patients.

“MY WHOLE CAREER I’VE FACED THE ISSUE OF BEING IN A COUNTRY HOSPITAL THAT DOESN’T GET THE SAME LEVEL OF RESOURCES AS A CITY HOSPITAL.” My whole career I’ve faced the issue of being in a country hospital that doesn’t get the same level of resources as a city hospital might. Getting nurse-topatient ratios is definitely our priority, especially for our high dependency and paediatric units.

Generally the Wagga Base nurses feel it’s good the union is going for the ratios. However some are reluctant to get involved in the campaign. They say: ‘That’s good if you get it but I just want to be left alone to do my job.’ We need more nurses to get involved.”

Sylvia Moon RN Wagga Wagga Base Hospital transport unit

THE LAMP SEPTEMBER 2013 | 23

ANNUAL CONFERENCE

DELEGATES HAVE THEIR SAY

“The danger of hospital privatisation has been raised at this conference and we have heard first hand about the American system. It’s ludicrous to think Americans can be paying $2000 per month insurance and still not be covered for all their hospital expenses and certain treatments.

The federal election campaign is a good time for the union to raise the privatisation issue in TV advertising because there is the possibility of a new government. The public needs to know where the parties stand on the issue and who will put people first and put patient safety first.

“THE FEDERAL ELECTION CAMPAIGN IS A GOOD TIME FOR THE UNION TO RAISE THE PRIVATISATION ISSUE.” This is my first conference and it’s a great chance to advocate for St George Hospital, to hear new ideas, to show our support for each other and plan our future campaigns.

The evidence shows the ratios we won in 2010 are working so there is no reason not to expand them to other areas that still suffer from inadequate staff levels.

For example our ED is as bad as 1-to-5 on night shifts. How can you be expected to look after five patients while taking care of all the admission paperwork and starting to plan their care?”

Ian Press RN St George Hospital intensive care unit 24 | THE LAMP SEPTEMBER 2013

“The conference guest speaker from the USA, Donna Smith [See story page 30] was fabulous. We already knew that the American health system had a lot of flaws and wasn’t equitable, but Donna explained how, even with private health insurance, many people still go bankrupt because of the cost of health care. Her speech was a massive eye opener.

I don’t want to see privatisation degrade our health system. It would take us down the American path.

That would be doing a huge disservice to everyone.

I believe we have a right as citizens in a democratic country to expect a level of excellence in our health care and we need to provide for our patients.

“I DON’T WANT TO SEE PRIVATISATION DEGRADE OUR HEALTH SYSTEM.” Privatisation would also take away some of our legitimacy within the system because it is doctor run, and nurses would have less say. The system would be controlled by accountants for the benefit of shareholders.

Chris Hele RN Maitland hospital medical assessment unit

THE LAMP SEPTEMBER 2013 | 25

ANNUAL CONFERENCE

DELEGATES HAVE THEIR SAY

“Gosford is a large training hospital so we don’t have to fight for staff as much as some of the smaller rural hospitals, but I’m here at conference to fight for ratios that other hospitals don’t have.

I work in intensive care on a 1:1 ratio but it is not actually mandated in our award. If the government wanted to, they could take that ratio away. It is important that it gets put into our award and made solid so we can’t ever lose it.

I worry that a new federal government could attempt to remove penalty rates or at least decrease them as they tried to do with WorkChoices. It’s the single biggest issue for me in this federal election.

Penalty rates are a very important issue for me being a young person. Working on the weekends really wrecks your social life.

If they didn’t have penalty rates any more I would just go back to university and find a new job. I think the system would lose a lot of young nurses.

Nursing is a tough and stressful job and the penalty rates make it a bit better to work on the weekends and after hours.”

Jessica Gray RN Gosford Hospital intensive care unit

“PENALTY RATES ARE A VERY IMPORTANT ISSUE FOR ME BEING A YOUNG PERSON. IF THEY DIDN’T HAVE PENALTY RATES ANY MORE I WOULD JUST GO BACK TO UNIVERSITY AND FIND A NEW JOB.”

26 | THE LAMP SEPTEMBER 2013

“For me the most important thing at conference is to have the opportunity to consider where we are with our campaign and how we keep it going. Conference gives us the ability to network and find out where everybody is at – in Sydney, regional areas and further out in the country.

Conference shows us we all have a common cause and a common focus. We can share some of the strategies we have put in place to deal with things.

We don’t want to allow a culture to develop of city versus country or big hospital versus small hospital. We need to see that we have shared issues, understand what others are going through and support each other.

As an Association we also need to be encouraging members to speak up more. I feel that nurses who worry about their workload and patient safety are sometimes pressured into thinking that the problem lies with them as an individual, rather than the hospital accepting that the system is the issue.

“WE NEED TO SEE THAT WE HAVE SHARED ISSUES …

AND SUPPORT EACH OTHER.” The people who are brave enough to speak up should be getting a pat on the back because they are saying the situation is not safe for patients and it is not safe for staff.”

Jill Telfer CNS Tamworth Hospital renal unit

THE LAMP SEPTEMBER 2013 | 27

ANNUAL CONFERENCE DINNER

A proud past, a fighting future.

28 | THE LAMP SEPTEMBER 2013

THE LAMP SEPTEMBER 2013 | 29

COVER STORY

When the cost of living is bankruptcy In the American documentary Sicko, by renowned filmmaker Michael Moore, Donna Smith told her incredible story of bankruptcy brought on by a family medical crisis. At the NSWNMA Annual Conference Donna warned of the perils of following the US model of privatised healthcare.

A FEW HOURS AFTER DONNA SMITH arrived in Sydney, and only 15 minutes after leaving her hotel, she had a terrible fall and suffered extensive bruising.

When “two, lovely, Australian women” came to her aid and wanted to call an ambulance, her first instinct was to say no, so fearful was she of the cost of medical treatment.

“That’s because I’m an American. How sad is that and what a commentary on the American healthcare system,” she said.

“Later I went to the doctor. The entire cost of everything – doctors, x-ray, medications and an ice pack – was less than $200.

In the US you would be talking $10002000.”

PERSONAL HEALTH CRISIS LED TO BANKRUPTCY Donna’s story is one of a mainstream, middle-class American family financially devastated by a broken healthcare system.

“My husband Larry and I have been married for 38 years. We have six children and 15 grandchildren. We had worked very hard all our lives, owned our own home, put our kids through college and we always had health insurance.

“My husband is a tall, slender man who developed a really serious artery disease – his family had a history of that – and had three open heart surgeries. He had a hard time.

“He had long-term chronic health issues, which were a strain, but we did what most middle class families do – we found a way to get by. We went out a little less, we bought 30 | THE LAMP SEPTEMBER 2013

fewer things for the grandkids. We did what we could do to be responsible but it wasn’t enough. I was diagnosed with cancer and we were hit with this double whammy.”

Donna and Larry wracked up an enormous amount of debt for medical expenses that they just couldn’t pay.

“We ended up being a part of Michael Moore’s film not because we were unique – just the opposite. We represented so many Americans who, when they get sick or hurt, eventually end up declaring bankruptcy and that’s what happened to us.

“It hurt and it was a shameful thing. I’ll never forget the day when we declared bankruptcy in South Dakota, a bankruptcy trustee looked at my husband and said ‘how did you get yourself into such a mess’.

“I saw this hard-working man, shoulders slumped, take the weight of what someone said to him, accusing him of failure when actually it wasn’t his failure it was the failure of the system.”

DYSFUNCTIONAL AND BROKEN According to a Harvard University study, so far this year 410,434 people in the United States have gone bankrupt due to a medical crisis, even though the majority of them had insurance at the time their illness or injury occurred.

A 2013 study in the Journal of Internal Medicine found that about 25% of all American senior citizens declare bankruptcy due to medical expenses, and 43% are forced to mortgage or sell their primary residence.

The US spends $2.8 trillion on healthcare, nearly $US8000 per person, or 17.4%

of GDP, compared with $3445 per person or 8.7% of GDP in Australia.

These numbers are enormous and numbing, but there is one number that worries Donna the most: 123.

“In the United States 123 people die per day because they can’t access healthcare.That is 45,000 people every year. It’s like a jet liner going down every day and no one’s talking about it. It’s tragic,” she says.

“The US is spending a staggering amount on healthcare – almost twice that of any other industrialised nation.Yet our outcomes are poor. We should throw out what we are doing, study what others are doing and emulate it.”

THE SCOURGE OF PRIVATISATION Donna says that at the heart of the US healthcare crisis is a fragmented and privatised system that lets enormous numbers of people fall through the cracks.

“Forty million people in the US are uninsured or underinsured – that is twice the population of Australia. If you privatise more and more of your healthcare, money will drive it more and more. They cut back on nurses and ancillary staff but they never cut back on profits.”

The costs to families and the economy, whether you are sick or not, are enormous, Donna says.

“My insurance cover now costs over $800 a month. I have a friend who pays $2100 a month for her family.

“The ripple out into the economy is huge. Bankruptcy due to medical crisis and debt doesn’t just impact access to health

“In the United States 123 people die per day because they can’t access healthcare.That is 45,000 people every year.”

services. It also makes it difficult for those who have gone bankrupt to fully participate in the economic activity of their communities and nation.

“Buying homes or cars, securing housing and even getting a new job with good health insurance benefits can be made much more difficult.Those losses are felt by everyone in the wider community.”

LOBBYISTS FOR THE PEOPLE Donna says nurses have a pivotal role to play in defending public health from privatisation.

“Private operators have their tentacles so deep into government. Nurses have to counter that and be lobbyists for the people.

It is important to be heard above the clinking of the money. The pushback has to be mighty and it has to come from you – nurses and midwives.

“People trust nurses because they believe nursing is a helping, human profession.

People listen when you say it is not the way to go.You’ll be trusted more than a politician.”

She says, for all its faults, the Australian public health system is a good system, worth fighting for.

“You do not allow 123 of your people to die daily simply because it wouldn’t be profitable to care for them. [Your health system] is not forcing people into bankruptcy.

“Your system is superior to ours. Protect that.Teach us. Do not import the things we do less well than you do. Export to us the compassion and common sense that first drove you to create something better.”

THE LAMP SEPTEMBER 2013 | 31

PRIVATISATION

“IT’S WELL KNOWN THAT PEOPLE HAVE TO MORTGAGE THEIR HOME OR TAKE OUT LOANS TO PAY FOR THEIR MEDICAL BILLS, EVEN WHEN THEY ARE INSURED.” BRITTA HOUSER, ED NURSE, AMERICA

Vote for your right

Defending our pu The NSWNMA has produced a TV ad to public healthcare. The Lamp talks

Britta Houser is an ER nurse from Kaiser Hospital in Oakland, California. She has been a nurse for five years.

Britta says that in the United States patients often wait before they come into hospital, because of their anxiety about the cost, meaning that, generally, they come in a lot sicker.

“People come in with serious medical problems and the first question they ask is ‘how much is this going to cost?’ or ‘how is it covered?’ ‘where is the bill

be calm in the face of pain and going to be sent?’ – those sort chaos. What we’re not equipped of questions; when they have to deal with is to see the very serious medical problems,” systems fail our patients. she said. “It’s a big burden and the fear of that expense is what “It places a lot of stress on nurses keeps a lot of people from when you go home and think coming in [sooner]. Even just one ER visit can affect their life about patients who didn’t get all even though they are well when they needed or were discharged before they should have been. they leave.

“Nurses worry about those sort She says working in this environment can be difficult for of folk. And we see them come back. In fact sometimes we are nurses. lucky if they come back and we don’t just read about them.”

“It’s a heart wrenching part of being a nurse. We’re trained to

32 | THE LAMP SEPTEMBER 2013

“I WAS DEVASTATED WHEN I HEARD PRIVATISATION WAS GOING TO OCCUR AT MY HOSPITAL.” LYN HOPPER, ICU NUM, NSW

to public healthcare.

blic health system encouraging people to vote for the right to the two nurses who starred in the ads.

Lyn Hopper is an ICU NUM at Manly Hospital on Sydney’s northern beaches. She says privatisation is a genuine threat to the public health system “Queensland has a lot of public hospitals going private at the moment. There is a big one on the Sunshine Coast. Western Australia has a couple built and operating. New South Wales tried a while ago at Port Macquarie and failed miserably.

Currently they are having a go with a new hospital at Frenchs Forest. They are building a private hospital with public beds leased out. They’ll give it

back to the public sector in 20 years. The private sector will build and operate it.

“Private hospitals have a role to play in the complete package of a health system but there should be an absolute fundamental right to free healthcare.”

Patient care and conditions for nurses will be at risk, she believes, under a privatised health system.

“Nursing ratios are higher in the public sector. They have higher standards of allied health support. The cohort of patients

“I was devastated when I heard privatisation was going to occur at my hospital. The private system will not work for the public sector. At the end of the day the bottom line counts.”

is of a different mix – the elderly and the chronically ill who need extra care. They require input from social workers, occupational therapy, they need 24-hour medical insite services and much higher nursing ratios.

“In the public sector there are standards that have to be adhered to that don’t have to be upheld in the private sector. At the new Northern Beaches hospital, public hospital nurses coming from Manly and Mona Vale will be made to work under the private hospitals award.

THE LAMP SEPTEMBER 2013 | 33

PRIVATISATION

Patients before profits: taking our message to the community Nearly 200 people showed up at Harbord Diggers for a community meeting about the privatisation of the Northern Beaches hospital.

THE AUDIENCE WAS ADDRESSED BY A LEADING US advocate for affordable universal healthcare, Donna Smith, health union leaders, nurses and community activists.

State health minister Jillian Skinner and Treasurer Bruce Baird, plus representatives of the private contractors, were invited to speak to the community but didn’t front up for the meeting.

Donna Smith says Australia needs to learn from the American experience of privatised health care.

“Privatisation is something you should be very worried about in Australia. Australia performs better in every measure of your health care sector than the US does – in health economy, health efficiency and health outcomes.

“Wouldn’t you prefer to keep a system that is performing better? Our healthcare system is not one that you should follow.”

Donna said governments were crafty about the way they privatised health services.

“Privatisation did not happen in one swoop in the US. They chip away bit by bit by bit.”

NSWNMA General Secretary Brett Holmes said public hospital privatisation was once again an emerging issue in New South Wales, with the state Liberals and Nationals resurrecting the failed Greiner-Fahey government policy of asking private companies to run public hospitals.

“They have started with the new

34 | THE LAMP SEPTEMBER 2013

The Illawarra says no to privatisation Another community meeting held in Wollongong heard there was enormous resistance to privatisation, particularly of health services in the region.

In a survey commissioned by the Save Our Ports Committee, 83% of respondents thought privatisation of public assets and services was a bad idea. Only 10% thought it was a good idea.

Resistance to the privatisation of health services was even more marked: 92% thought Wollongong Hospital should stay in public hands, while 91% said they thought that, in general, health services and hospitals were better run by government.

Northern Beaches hospital, which will largely replace the Manly and Mona Vale public hospitals,” he said. “The state government hopes no one else around the state will notice what they have done. The same applies to the federal Liberals and Nationals who are also trying to hide their support for this dangerous policy.”

Brett said the Association had launched its Patients before Profits campaign last week to ensure that the community was fully aware of what the Liberal-Nationals were doing.

“The NSWNMA is currently running television advertisements on the issue and has also started holding public information meetings, such as the one at Harbord tonight,” he said.

“The decision to privatise the new Northern Beaches hospital is just the first step down the road of privatisation of our public hospital and community healthcare system. Words like contestability and outsourcing don’t fool anyone. The idea that it is only new hospitals being privatised doesn’t fool anyone either.

“We all know how this works.They start off slowly to get the idea established, and once they have a few hospitals privatised they then start running arguments about how it is now silly to keep all the rest in government hands. We’ve seen it all before, in other privatisation experiments.

“And having both a state and federal government in power that supports the idea

Donna Smith being interviewed by Channel 7

“Privatisation is something you should be very worried about in Australia.”

— Donna Smith

Lyn Hopper during Q & A

“Our parents and grandparents worked hard, against powerful private and vested interests, to build us a good-quality, free public hospital system and an affordable overall health system.”

— Brett Holmes

will undoubtedly see the rate of hospital privatisation accelerate.That would be a disaster for patients and hospital staff as private companies and NGOs either cut back services, pay and staffing levels, to run a profit, or eventually start demanding the right to charge hospital fees.

“Our parents and grandparents worked hard, against powerful private and vested interests, to build us a good-quality, free public hospital system and an affordable overall health system.Will we leave our children and grandchildren the same – or will we leave them a costly privatised mess?” Brett said.

NSWNMA Assistant General Secretary Judith Kiejda says the Association has taken a lot of flak for highlighting the privatisation issue during an election campaign, but it has a responsibility to inform the public about what is going on.

“We must always be vigilant,” she said.

“We know these threats exist and we must always be ready to confront them head-on if we are to maintain public hospital services.

“Our critics have claimed that in speaking up for public hospitals we are dishonest.Well, let’s just consider what has already happened and what is happening right now.

“We know that the O’Farrell Government has called for expressions of interest from private operators to design, construct, operate and maintain the new Northern Beaches Hospital.

“They also announced last week they are seeking expressions of interest for piloting a privatised mental health initiative in New South Wales.

“In Western Australia the Barnett Government has privatised, or is looking to privatise, services at the Peel Health Campus, Joondalup Health Campus, the Fiona Stanley Hospital and the Midland Health Campus.

“In Queensland, the full privatisation of the planned Sunshine Coast University Hospital is on the table as is the operation of the new Queensland Children’s Hospital.

The public day oncology services at the Mater Hospital in Brisbane have already been privatised to form a new Mater Cancer Care Service.

“This is what public hospital privatisation looks like today in Australia. It may be incremental and it may be occurring by stealth but it is happening right now.

“And it happens under Liberal/Coalition governments. They are philosophically opposed to universal insurance in health – always have been and always will be.”

According to NSW Health’s Annual Report 2011-12, the Northern Sydney Local Health District already has the highest share of private beds in Sydney – 45.4% of all beds compared to a state average of 22.0%.

THE LAMP SEPTEMBER 2013 | 35

NSWNMA announces a hot new pr product! oduct!

Hoodies!

You’ll o be seeing your yo colleagues who attended our recent Annual Conference wearing these out and about.

Show you are a proud NSWNMA member and order your hoodie.

These hoodies are snug and warm and only $30. Avvailable in red or navy. 89% cotton.

Sizes: Ladies 10, 12, 14, 16 and Unisex S, M, L, XL, XXL and XXXL. NSWNMA merchandise is not only stylish and comfortable, it is affordable and sold at cost to members. order form to To orderr, fax the o Glen Ginty, (02) 9662 1414 or post to: NSWNMA, 50 O’Dea Avenue, v Wa aterloo NSW 2017 Merchandise order forms also available on www.nswnma.asn.au

ORDER FORM

Keep warm this season in NSWNMA merchandise

Navy Hoodies $30. Quantity: Size: 10 12 14 16 S M L XL XL XXL

XXXL

Red Hoodies $30. Quantity: Size: 10 12 14 16 S M L XL XL XXL

XXXL

Navy Bonded Polar Fleece Vests $25.

Quantity: Size: S M L XL XXL

XXXL

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

Bonded Polar Fleece Zip Front Jackets

$30

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

XXXL

Bonded Polar Fleece Zip Front Jacket $30.

Quantity: Size: S M L XL XXL XXXL Tootal cost of order $ Please include postage and handling of $5 per order.

Name Address Postcode

on

$40

N Navy Layered Vests

Navy Bon Polar Flee Vests

$40 $25 available in S, M, L, XL, XXL and XXXL

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

(w)

Phone (h) (mob)

METHOD OF PAYYMENT Cheque Visa Bankcard Money Order Name of card holder Card number

Expiry date

/

Signature

Mastercard

ASK JUDITH Underpaid and out of patience I work in a public health facility and have had on going pay issues in which I have been underpaid for overtime shifts and weekend penalties. I have made a number of phone calls to my manager and Health Share, who tell me the matter will be rectified in the next pay period. However, two pays on, the issue continues. What can I do to get paid without further delay?

I suggest that you write to your pay office with a chronology of what has transpired, provide copies of any affected pay slips and rosters etc and request payment within three working days.

Clause 27, Payment and Particulars of Salaries, sub-clause (v) (a) of the Public Health System Nurses and Midwives’ (State) Award 2011 states in part: Underpayment: If the amount paid is equal to or greater than one day’s gross base pay the Underpayment will be rectified within three working days; If the amount is less than one day’s gross base pay it will be rectified by no later than the next normal pay.

However if the employee can demonstrate that rectification in this manner would result in undue hardship every effort will be made by the employer to rectify the underpayment within three working days.

If you don’t receive payment or a satisfactory response contact the Association and ask to speak to an Information Officer.

Study leave for training?

I am an RN working in a public hospital. Are we entitled to study leave if attending mandatory training?

You do not need to apply to take study leave to attend mandatory training because while completing mandatory

training you are considered to be on duty. This is set out in subclause (i) of clause 55, Learning and Development Leave, of the Public Health System Nurses’ and Midwives’ (State) Award, which says in part: Leave is not required for the following types of employersupported learning activities that are undertaken by employees on a routine basis, and at which employees are considered to be ‘on duty’: • In-house courses or activities.

• Mandatory training and education.

Unable to give injections?

I am an EEN with a Certificate IV working in community health. My colleagues have told me that I am unable to give intravenous and subcutaneous medications in my new workplace, i.e. while home visiting patients, as I need to work under the supervision of an RN. Is this correct?

When the issue of supervision is raised it is generally in terms of DIRECT or INDIRECT. According to the Nurses and Midwives Board, Medication endorsement for Enrolled Nurses guideline: The extent and closeness of supervision is decided by the registered nurse or registered midwife who is responsible for directing and supervising an enrolled nurse.

This means that if you have established competency accreditation in your new workplace you should be able to continue to work within your professional scope of practice. Also refer to your local policy on medication administration. Effectively it is up to your employer to determine scope of practice and competency for each employee; policies should be developed and implemented as a way of directing staff, and the policy should clearly state what method (direct or indirect) of supervision is required.

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

If your employer has a policy that prohibits you from giving intravenous and or subcutaneous injections, then this means it is not within your scope of practice and you should not give these injections. If however, they have provided you with a duty statement and they have a corresponding policy directive authorising you, as an EEN, to give one or both types of injections you have identified, and the method of supervision required, then you are able to give them. However, whenever giving any drugs the proper checking processes should be in place and strictly adhered to. In respect to Schedule 4 and 8 drugs, policies need to take account of the requirements within the Poisons and Therapeutic Goods Act.

Long service leave for casuals I currently work as a casual nurse in the public health system and have done so for nearly 10 years. Am I entitled to long service leave after I reach 10 years service?

As a casual employee within the public health system your entitlement to long service leave comes under the Long Service Leave Act, 1955 and not the Public Health System Nurse and Midwives’ (State) Award. Under the provisions of the Act, once you have worked for 10 years on a continuous basis with the public health system, you will have two months Long Service Leave (LSL) in credit. In determining “continuous service” the casual employee must not have a break of greater than a month during any calendar year. Periods of greater than a month per calendar year would constitute a break in service and would make you ineligible for LSL under the Act. The taking of up to four weeks off per calendar year should not be seen to have broken the continuous service.

THE LAMP SEPTEMBER 2013 | 37

It’s time Order your NSWNMA campaign scrub uniforms for conference and rally times, and make an impression!

Over the past few months, NSWNMA and Total Image Group have been working together to create a new fit for purpose scrubs range. The new campaign uniform range endorses a modern appearance and offers both comfort and durable features, while still embracing NSWNMA image.

SCRUB TOP

The new range consists of a Unisex Scrub Top and Unisex Classic Pant. Both made from 65% polyester,

With With every purchase purchase op, you of a Scrub TTop, o y rreceive e eceive this campaign cam TT-Shirt --Shirt for

FREE!

35% cotton. This fabric blend is durable and of superior quality. The scrub campaign uniform also has number of functional features, including jet pockets, pen partition, drawstring front on pants and brushed fabric coating for added comfort.

Sizes range from XS-5XL to ensure various body shapes and sizes are catered. Most importantly,

Size (cm)

XS

S

M

L

XL

2XL

3XL

4XL

5XL

Half Chest Circumference

53

56

59

62

66

69

73

77

81

Half Hem Circumference

54

74

78

82

General Guide for Female 8/10 SCRUB PPANTS ANTS A

to scrub up for 2013!

57

60

63

67

70

10/12

12/14

14/16

16/18

18/20

20/22 22/24 24/26

Half Waist (Relaxed)

29

33

37

40.5

43.5

46.5

50.5

54.5

58.5

Half Waist (Stretched)

47

51

55

58.5

61.5

64.5

68.5

72.5

76.5

Half Hip

55

59

63

66

69

72

76

80

84

Out Seam Length

103

105

107

109

111

112

113

114

115

the range has been designed to ensure a comfortable fit every time.

Scrub top and pant are $20 each incl GST. You can place your order by the following methods: 2

Shop online, online, by registering as a user on www.totalimagegrouponline.com/nswnurses on our tailored NSWNMA online store. catalogue, 2 Browse through the customised catalogue complete the order form and send back to Total Image by: email sales@totalimagegroup.com.au Fax: 9569 6200 or Post PO Box 199, Westgate NSW 2048 Total Image accepts credit card payment

by Visa, MasterCard, and AMEX (3.5% surcharge on AMEX) or cheque/money order.

Delivery by Australia Post within 10-14 working days and charged at $5 incl GST.

For more information please contact TTotal otal Image on (02) 9569 6233 or email uniforms@totalimagegroup.com.au

WHAT’S

SOCIAL MEDIA

HOT

NURSE UNCUT

THIS MONTH

A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES www.nurseuncut.com.au

@nurseuncut

Sign up for the weekly email that alerts you to new posts.

Nurse Uncut is also on Facebook: www.facebook.com/NurseUncutAustralia. And on Twitter @nurseuncut

Mistreatment in aged care www.nurseuncut.com.au/mistreatment-in-aged-care/

Nurses respond to an ABC Lateline program revealing terrible abuses and failings in aged care.

Nursing student wins prestigious TAFE award www.nurseuncut.com.au/nursing-student-wins-prestigious-tafe-award/

EN student Shingi Chando from Zimbabwe won the prestigious 2013 Sydney Institute Medal.

Ten good reasons nurses went on strike www.nurseuncut.com.au/ten-good-reasons-nsw-nurses-and-midwives-are-striking-next-week/

Reason number 4: We are sick of worrying about “near misses” that happen because of short staffing.

Nurse solidarity group in Korea seeks pen-pals www.nurseuncut.com.au/nurse-solidarity-group-in-korea-seeks-pen-pals/

An English study group of nurses in Seoul wrote to Nurse Uncut asking to exchange letters with Australian nurses.

Sleeping rough www.nurseuncut.com.au/sleeping-rough/

A team of trade union leaders, including NSWNMA’s Brett Holmes, took part in the CEO Sleepout, raising money and awareness of homelessness and workplace issues.

Penalty rates under threat www.nurseuncut.com.au/election-issue-penalty-rates-under-threat/

Women’s refuge worker Leah talks about the value of penalty rates to her work – an election conversation starter for all shift workers.

NEW! Support Nurses on YouTube Strike day highlights 24 July 2013 Clips from the 18 meetings held around the state. youtu.be/wMf4g4Ptdw8

See Red Day 1 July 2013 You wore red t-shirts, red shoes, red lipstick and even red bandages to get the message across! youtu.be/gcK2g3l-pv0

Follow us on Twitter >> NSWNurses & Midwives @nswnma Watch us on YouTube >> SupportNurses Connect with us on Facebook New South Wales Nurses and Midwives’ Association >> www.facebook.com/nswnma Aged Care Nurses >> www.facebook.com/agedcarenurses Ratios put patient safety first >> www.facebook.com/safepatientcare

NEW! Share photos with us on Instagram @nswnma THE LAMP SEPTEMBER 2013 | 39

Being a member of the NSWNMA suddenly got easier!

Introducing the do-it-yourself membership online portal Now you can change your personal details, pay your fees and even join online using membership online.

It’s easy. Simply register with your membership number, name and email address and create your own password.

From then on, use your member number and password to log in directly to the Members login area on the website.

You can now change your details at any time – address, workplace, credit card number, mobile number, etc.

You can pay fees online, print a tax statement or request a reprint of your membership card – it’s simple.

There are dedicated areas for branch officials.

Membership online via www.nswnma.asn.au

SOCIAL MEDIA Keep me logged in

WHAT

Forgot your Password?

NURSES & MIDWIVES SAID & LIKED on facebook

www.facebook.com/nswnma

Are you serious?

In a television news story about our July 24 strike, Health Minister Jillian Skinner said that NUMs in high-care wards could always call on nurses with “less serious” patients in other wards to help. Members were incredulous.

Gobsmacked!

Sure you can call on nurses from another ward that has less critical patients but you now have an extra nurse whose skill set is based on their employed ward’s needs. Let’s put an Oncology nurse into an ICU, now that’s going to help.

Wake up and smell the UTI! Take from one sinking ship to staff the ship that’s already gone down!

Nurses are already deployed to other areas to meet sick leave requirements instead of replacing with casual or agency staff. This pulls staff from areas such as ICU into areas like ED and even labour wards, where specialist nursing is required for safe patient care.

To the highest bidder!

When Premier Barry O’Farrell took a stroll in Burwood, NSWNMA members in blue scrubs followed him.

Privatisation is mental NSW mental health services are to be tendered to a private company

Aged care troubles ABC’s Lateline eported on abuses in aged care

So who looks after my patients when I’m called away to help someone with their “sicker” patients?

Californian nurses did it to Arnie, so NSW nurses will do likewise to Barry! Then we will put him up for sale on eBay and Gumtree!

This has been happening for some time, the NGOs getting more and more of the funding, essentially privatising mental health. Then you have more and more positions going to “care support” personnel rather than qualified clinicians.

I’m a palliative care nurse specialist who went into aged care to make a difference but was met with obstacles left, right and centre because it is not about providing a high standard of care. I arrived with good intentions and was cut off at the knees while dying residents screamed in pain. Try to introduce best practice and you’ll be booted out the front door so fast your head will spin.

We have poor staff ratios, often one RN to over 100 residents. Care workers who have eight weeks of training and then expected to go out and work with our elderly. You can get more for scanning groceries. This is just the tip of the iceberg.

How do you fight when even your own profession doesn’t see aged care as real nursing!

It does not matter how long a child remains in hospital they are not called bed-blockers!

Unless as a society we are prepared to invest in older people then we should not throw stones at one industry.

The AiNs are pushed to the limit, stressed and run down. It’s about time the government looked into this situation and introduced mandatory nurse-to-patient ratios, otherwise nothing is going to change; it is only going to get worse.

Where I work I don’t know one carer, EN or RN, who doesn’t put the residents first.

What a dynamic speaker. We must fight to keep our public hospitals!

YouTube star Annual Conference speaker Donna Smith’s YouTube interview was admired.

Health care is a human right and should not be negotiable. Giving a select few a leg up to profit off health provision is unconscionable. A well-balanced health system will benefit everyone.

THE LAMP SEPTEMBER 2013 | 41

NURSING RESEARCH ONLINE

In Need of a New Hip, but Priced Out of the US

Australia is seeing the incremental privatisation of health services, starting in Queensland, Western Australia and on the Northern Beaches of Sydney in New South Wales. This month The Lamp looks at a series published in the New York Times, “Paying till it hurts”, which explores why health in a largely privatised market is so expensive.

More instalments will be published by NYTimes.com The $2.7 Trillion Medical Bill Colonoscopies Explain Why US Leads the World in Health Expenditure Elisabeth Rosenthal, June 1 2013 Deirdre Yapalater’s recent colonoscopy at a surgical centre near her home on Long Island went smoothly: she was whisked from pre-op to an operating room where a gastroenterologist, assisted by an anesthesiologist and a nurse, performed the routine cancer screening procedure in less than an hour. The test, which found nothing worrisome, racked up what is likely her most expensive medical bill of the year: $6385.

That is fairly typical: in Keene, New Hampshire, Matt Meyer’s colonoscopy was billed at $7563.56.

Maggie Christ of Chappaqua, New York, received $9142.84 in bills for the procedure. In Durham, North Carolina, the charges for Curtiss Devereux came to $19,438, which included a polyp removal.

While their insurers negotiated down the price, the final tab for each test was more than $3500.

“Could that be right?” said Ms Yapalater, stunned by charges on her statement. Although her insurer covered the procedure, and she paid nothing, her health care costs still bite: Her premium payments jumped 10% last year, and rising co-payments and deductibles are straining the finances of her middle-class family, with its mission-style house in the suburbs and two SUVs parked outside.

“You keep thinking it’s free,” she said. “We call it free, but of course it’s not.”

In many other developed countries a basic colonoscopy costs just a few hundred dollars and certainly well under $1000. That chasm in price helps explain why the United States is far and away the world leader in medical spending, even though numerous studies have concluded that Americans do not get better care.

Whether directly, from their wallets, or through insurance policies, Americans pay more for almost every interaction with the medical system. www.nytimes.com/2013/06/02/health/colonosco pies-explain-why-us-leads-the-world-in-healthexpenditures.html

42 | THE LAMP SEPTEMBER 2013

American Way of Birth: Costliest in the world Elisabeth Rosenthal, June 30 2013 Seven months pregnant, at a time when most expectant couples are stockpiling diapers and choosing car seats, Renée Martin was struggling with bigger purchases.

At a prenatal class in March she was told about epidural anesthesia and was given the option of using a birthing tub during labor. To each offer she had one gnawing question: “How much is that going to cost?”

Though Ms Martin, 31, and her husband, Mark Willett, are both professionals with health insurance, her current policy does not cover maternity care. So the couple had to approach the nine months that led to the birth of their daughter like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors.

When she became pregnant, Ms. Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4000 to $45,000.

“It was unreal,” Ms Martin said. “I was like, ‘How could you not know this?’ You’re a hospital.” www.nytimes.com/2013/07/01/health/americanway-of-birth-costliest-in-the-world.html

Elisabeth Rosenthal, August 3 2013 Michael Shopenn’s artificial hip was made by a company based in the remote American town of Warsaw, Indiana, a global centre of joint manufacturing. But he had to fly to Europe to have it installed.

Mr. Shopenn, 67, an architectural photographer and avid snowboarder, had been in such pain from arthritis that he could not stand long enough to make coffee, let alone work.

He had health insurance, but it would not cover a joint replacement because his degenerative disease was related to an old sports injury, thus considered a pre-existing condition.

Desperate to find an affordable solution he reached out to a sailing buddy with friends at a medical device manufacturer, which arranged to provide his local hospital with an implant at what was described as the “list price” of $13,000, with no markup.

But when the hospital’s finance office estimated that the hospital charges would run to another $65,000, not including the surgeon’s fee, he knew he had to think outside the box, and outside the country.

“That was a third of my savings at the time,” Mr Shopenn said recently from the living room of his condo in Boulder, Colo. “It wasn’t happening.”

“Very leery” of going to a developing country like India or Thailand, which both draw so-called medical tourists, he ultimately chose to have his hip replaced in 2007 at a private hospital outside Brussels in Belgium for $13,660. That price included not only a hip joint, made by Warsawbased Zimmer Holdings, but also all doctors’ fees, operating room charges, crutches, medicine, a hospital room for five days, a week in rehab and a round-trip ticket from America.

“We have the most expensive health care in the world, but it doesn’t necessarily mean it’s the best,” Mr Shopenn said. “I’m kind of the poster child for that.”

As the United States struggles to rein in its growing $2.7 trillion health care bill, the cost of medical devices like joint implants, pacemakers and artificial urinary valves offer a cautionary tale. Like many medical products or procedures, they cost far more in the United States than in many other developed countries.

While Mr Shopenn was offered an implant in the United States for $13,000, many privately insured patients are billed two to nearly three times that amount.

An artificial hip, however, costs only about $350 to manufacture in the United States, according to Dr Blair Rhode, an orthopedist and entrepreneur whose company is developing generic implants. www.nytimes.com/2013/08/04/health/formedical-tourists-simple-math.html

test your

knowledge 1

2

3

4

5

8

7

9

10

12

11

13

12

16

15

20

14

16 17

19

6

17

18 17

18

21

22 22 24

23 27

25

26

26 28

28 29

30

31 32

Across 1. The inability to recognise tastes (9.7) 7. Marked with pits (12) 10. Toxic epidermal necrolysis (1.1.1) 12. The lower end of the suture between the nasal bones (7) 13. Characterised by the ability to survive only in a particular set of environmental conditions (8) 15. Amputate, cut off (6.3) 17. The middle point of the frontonasal suture (6) 19. Veins that carry blood to an organ (8.5)

22. Ultraviolet (1.1) 23. Breast-shaped (7) 24. Rickets (8) 28. Tibia (4.4) 29. Palatine tonsils (9) 31. Forming lime (8) 32. Any of the tendons at the rear hollow of the human knee (9)

Down 1. Spasmodic contraction of the stomach walls (11) 2. Any creeping or serpiginous eruption (7) 3. Walking slowly (7) 4. Viral hemorrhagic fever (6.5) 5. Born, formerly known as (3) 6. Inactive (5) 8. Joined together; united (9) 9. A lesion formed by a dilated capillary or terminal artery, most commonly on the skin (14) 11. Discharges or excretes from the body (6) 14. One of nurse classifications used in NSW awards (1.1.1)

16. Take or consume (3) 18. Eyes (5) 20. A small bundle or cluster, especially of nerve, tendon, or muscle fibres (8) 21. Resembling the shape of an oblique equilateral parallelogram (8) 25. Cauda (4) 26. Painful (4) 27. To make an involuntary effort to vomit (5) 28. Suffering from disease (4) 30. Advance Beneficiary Notice (1.1.1)

THE LAMP SEPTEMBER 2013 | 43

Working in health care you’ll know it’s important to have an eye on the future.

That’s why Sydney Nursing School is introducing a new primary health care program in 2014.

From graduate certificate to master’s level, the Primary Health Care degrees have been designed to give registered nurses the knowledge and skills to care for people with complex health needs and practise effectively within a variety of community and hospitalbased settings, now and in the future.

PRIMARY HEALTH CARE

You can find out more about this new program and Sydney Nursing School’s full suite of postgraduate coursework programs, at our Postgraduate Information Evening, Thursday 17 October 2013, 5.30-8pm.

For more information visit:

sydney.edu.au/nursing

NEW IN 2014 CRICOS PROVIDER 00026A

SYDNEY NURSING SCHOOL

'3&& UBYBUJPO BEWJDF HJWFO XJUI BMM DPOTVMUBUJPOT &MFDUSPOJD MPEHNFOU EBZ SFGVOE

ZFBST UBYBUJPO FYQFSJFODF $PNQFUJUJWF SBUFT 'FF GSPN SFGVOE

&ORVJSJFT CZ EBZ OJHIUT PS XFFLFOET PS CZ QIPOF GBY PS FNBJM JG UIBU TVJUT ZPV "EWJDF CBTFE PO PDDVQBUJPOBM SVMJOHT -PDBUJPO o 3BOEXJDL %FSFL 3ZEFS JT B $1" 1SBDUJDF

t UBY !CJHQPOE DPN BV -JDFOTFE 5BY "HFOU

44 | THE LAMP SEPTEMBER 2013

BOOKS

BOOK ME Health Promotion and Aging: Practical Applications for Health Professionals (6th Ed.) David Haber Springer Publishing Company www.springerpub.com RRP $90 j ISBN 9780826199171

This revised edition of Health Promotion and Aging continues to provide information for health care professionals who promote health for older adults. It contains evidence-based guides to topics such as nutrition, exercise and physical activity, nutrition and weight management, mental health concerns, complementary and alternative medicine, and numerous clinical preventative services.

Writing Skills for Nursing and Midwifery Students

Dena Bain Taylor Footprint Books www.footprint.com.au/ RRP $42.95 j ISBN 9781446208335 This book aims to help the student master the writing process and teach them the flexibility to tackle any form of communication asked of them by course instructors, or in their career. It approaches writing skills by focusing on clear thinking (your ideas and the strategies for conveying them persuasively) and clear writing (the “correct” way to write in nursing).

Health Promotion: Strategies and Methods (3rd Ed.)

Garry Egger, Ross Spark and Rob Donovan.

McGraw-Hill Education www.mcgraw-hill.com.au RRP $57.95 j ISBN 9781743071830 This revised edition of Health Promotion, Strategies and Methods reflects on the advances in the science and art of health promotion. It encompasses the spectrum of individual, group, institutional, community and societal strategies and methods based on theory, research and experience. The book includes real life case studies throughout each chapter.

Harvard’s Nursing Guide to Drugs (9th Ed.)

Adriana Tizani Mosby-Elsevier Australia www.elservierhealth.com.au RRP $68.14 j ISBN 9780729541411 This edition of Harvard’s Nursing Guide to Drugs is specific to the Australian and New Zealand nursing and midwifery market. It contains up-to-date drug information regarding form, action, use, dose, adverse effects and interactions in compliance with current pharmaceutical guidelines. It features detailed descriptions of each therapeutic drug followed by an A-Z of drugs within that class.

SPECIAL INTEREST Changed: Living with Stillbirth

Liza Jankowski Big Sky Publishing www.bigskypublishing.com.au RRP $19.99 j ISBN 9781922132239 This book provides a moving and personal insight into the difficult journey of a parent who experiences the death of their child from stillbirth, or other causes. It provides a resource for those who seek to understand their own journey or that of a family member or friend who has experienced such a loss. This book could help bereaved parents as well as allied professionals looking to gain a better understanding of the feelings and emotions that arise after stillbirth, equipping them to support the bereaved parents in their care.

Claiming the Corner Office: Executive Leadership Lessons for Nurses

Connie Curran and Therese Fitzpatrick Honor Society of Nursing, Sigma Theta Tau International www.nursingknowledge.org/sttibooks RRP US$39.95 j ISBN 9781937554354 This aims to be a practical guide for the nurse who aspires to a senior executive role in a profit or non-profit organisation, an entrepreneur who aspires to creating a business, or the individual who wishes to serve in a governance role on a not-for-profit or corporate board. This book could also assist individuals who work closely with leaders, entrepreneurs and governance experts.

The experiences of several nurse entrepreneurs and senior executives are used to demonstrate the skills, competencies, and experiences required as the nurse develops a career strategy leading to a senior executive or entrepreneurial role.

All books can be ordered through the publisher or your local bookshop. NSWNMA members can borrow the books featured here, and many more, from our Records and Information Centre (RIC).

Contact Jeannette Bromfield gensec@nswnma.asn.au or Cathy Matias 8595 2121 cmatias@nswnma.asn.au. All reviews by NSWNMA RIC Coordinator/Librarian Jeannette Bromfield. Some books are reviewed using information supplied and have not been independently reviewed.

THE LAMP SEPTEMBER 2013 | 45

Proud P roud to to be the the lawyers lawyers for for NSWNMA NSWNM NM MA members members * *

*

*

*

*

*

*

*

*

POSTGRADUATE GRADUATE C COURSES OURSES IN MENTAL NTAL HEALTH HEALTH NURSING* NURSING* Developed specifically pecifically ffor or cli clinicians nicians entering entering into the specialist off Mental Health ialist aarea rea o Mental H ealth Contact information: mation: Ro Rose se M McMaster cMaster E: Rose.McMaster@acu.edu.au ster@acu.edu.au | T: T: (02) (02) 9739 9739 2369 2369

* SSubject ubject tto o fi final nal aapproval pproval

www.acu.edu.au/mental-health www.acu.edu.au/mental-health 46 | THE LAMP SEPTEMBER 2013

MOVIES

movies of the month

THE TURNING One of Australia’s best selling short story collections has been brought to the screen by 17 independent directors, writes Sue Miles.

Under the overall direction of Robert Connolly (Bilbao), Tim Winton’s collection of 17 short stories, The Turning, has been adapted for the screen by 17 different directors.

Each story was given its own cast and crew and each director left to interpret their allocated story in their own way.

Connolly was given the task of weaving the 17 short films together to make a whole film. The result is a three-hour collection of loosely interlocking and vaguely connected snapshots, each with its own distinctive cinematic style.

All are hauntingly beautiful and all are complete films in their own right.

Tender and confronting, dark and fragile, these 17 overlapping stories of second thoughts and mid-life regret are set in the fictional seaside town, Angelus, coastal Western Australia, and explore the lives of those living there over a 30-year period.

As well as experienced directors such as Tony Ayres (The Slap), Justin Kurzel (Snowtown), and Warwick Thornton (Samson & Delilah), performers Mia Wasikowska and David Wenham make their directorial debuts.

Rose Byrne plays an abused trailer-park mother finding Jesus; Hugo Weaving is an ex-alcoholic; appearances are made by Cate Blanchett, Robyn Nevin, Miranda Otto, Susie Porter and Richard Roxburgh, among others.

Most of the stories focus in some way around the sometime-protagonist Victor Lang – seen from early childhood to well into his adult years – and the people who share his life and town. Often you don’t know which characters or what stage of their lives you are viewing.

The actors playing Lang range from pre-teen to mature adult, redheaded or scarred, Caucasian and Indigenous.

Each is a totally believable story, despite the apparent inconsistencies, and Winton’s stories retain their integrity.

The film demands a lot from its audience but it has good intentions and more importantly the effort it demands is deserved.

Winton’s stories are a reflection of real life, and the film hides none of the difficulties that exist in the daily grind of small town Australia.

The Turning is sure to stand as a watershed moment in modern Australian filmmaking: Connelly and others attached to the project should be commended for creating such a unique visual experience.

This film is challenging viewing, but it is one you should make the effort to see.

IN CINEMAS SEPTEMBER 26 Sue Miles is a Mental Health Nurse at the RPA

MEMBERGIVEAWAY The Lamp has 4 dvds and one novel of The Turning thanks to Madman Entertainment. For your chance to win write your name, address and membership number on the back of an envelope and send to: Blue Jasmine DVD competition 50 O’Dea Avenue, Waterloo NSW 2017 Only one entry per member.

THE LAMP SEPTEMBER 2013 | 47

Grow your career

by joining ACN! We W e believe believe that that e each ach a and nd e every ver y n nurse urse iin n Australia have opportunity Australia should should h ave tthe he o pportunit y tto o grow and ffurther grow ttheir heir career career and urther our our profession. profession. > Education Education tthat hat p pays ays > True True representation representation > M Membership embership beneďŹ ts beneďŹ ts to to help help you you grow grow

48 | THE LAMP SEPTEMBER 2013

For For membership information and online application visit: www.acn.edu.au www.acn.edu.au or freecall 1800 061 660 Australian College of Nursing

MOVIES

movies of the month BLUE JASMINE Elegant New York socialite Jasmine (Cate Blanchett) is forced to move in with her checkout chick sister Ginger, (Sally Hawkins) when her marriage to wealthy husband Hal, (Alec Baldwin), falls apart.

Forced to confront herself, her relationship with her sister and the reality of life away from the security of a husband with a healthy bank account, Jasmine begins to go slowly mad.

The film is shot in New York and San Francisco, though ironically the film’s two female protagonists are Australian and English.

Blue Jasmine sees the pairing of director Woody Allen with the brilliant Blanchett. Allen has created many indelible female characters throughout his career, portrayed by some of the world’s greatest actresses.

As the troubled Jasmine, Blanchett will take her place in this gallery of multifaceted, complex, and richly observed women.

A powerful drama that is wise, tender and funny in equal measure.

IN CINEMAS SEPTEMBER 12

MEMBER GIVEAWAY The Lamp has 15 in-season double passes to give away to Blue Jasmine thanks to Hopscotch Entertainment.

The first 15 members to email their name, membership number, address and telephone number to lamp@nswnma.asn.au will win.

SITTING PRETTY? REVIEWERS WANTED. Join our movie review team – share your opinions with your fellow Association members and see free screenings of next month’s new release films!

Email lamp@nswnma.asn.au to join our Nurse Reviewer email list and receive notification of upcoming screenings.

THE LAMP SEPTEMBER 2013 | 49

DIARY DATES

conferences, seminars, meetings NSW Psychogeriatric Nurses’ Association Conference 6-7 September Parramatta www.pgna.org.au Callan Park History Week: Foundations of Madness 8 September bookings essential, 0413 733 218 focp.admin@gmail.com Exhibition: Images of the Nurses 10 and 12 September Sydney University Noeline Kyle or Lynette Russell 02 9351 0635 / 0403 868 051 noeline.kyle@sydney.edu.au Understanding dementia for RNs, ENs Australian College of Nursing 13 September Burwood www.acn.edu.au/ Nursing patients with intellectual disability for RNs, ENs Australian College of Nursing 17-18 September Burwood www.acn.edu.au/ Clinical assessment: models of assessment and care for RNs, ENs Australian College of Nursing 18-20 September Burwood www.acn.edu.au/ Wound Management for RNs, ENs Australian College of Nursing 19-20 September Wagga Wagga www.acn.edu.au ENs Professional Association NSW Annual Conference 19-20 September Sydney Members $310 Non-members $340 1300 554 249 rjroseby@gmail.com Family Planning NSW Nurse Education Day 11 October www.fpnsw.org.au education@fpnsw.org.au PANDDA 24th Conference 16-17 October Parramatta www.pandda.net Damian Heron 9842 2306 damian.heron@pandda.net Australian Nursing and Midwifery Conference 17-18 October Newcastle Amy McIntosh 0423 497 038 www.nursingmidwiferyconference.com.au

2013 Transplant Nurses’ Association Conference 24-25 October Sydney www.gemsevents.com.au/tna2013/ Karitane 2013 Gala Ball 26 October Sydney Vanilla Bean Events 9712 3861 amy@vanillabeanevents.com.au 2013 Hospital in the Home Conference 31 October - 1 November Sydney www.hithsociety.org.au/conference Sally.Bromley@ashm.org.au 02 8204 0723 NSW/ACT Branch Renal Society of Australasia Workshop 1 November Liverpool Imelda De Guzman (02) 8738 7114 Imelda.DeGuzman@sswahs.nsw.gov.au Stalking: Assessment, Treatment and Management One-day training by Dr Karl Roberts 12 November Sydney enquiry@crimesolutionsinternational.com Neuroscience Conference: Navigating Neuro 1 March 2014 Wollongong Jo McLoughlin 0422 418 255 Joanne.mcloughlin@sesiahs.health.nsw.gov.au

ACT 12th Australian Palliative Care Conference 3-6 September Canberra www.dcconferences.com.au/apcc2013/ Congress of Aboriginal and Torres Strait Island Nurses 15th National Conference and AGM 6-8 October Canberra • www.catsin.org.au National Nursing Forum Australian College of Nursing 20-22 October Canberra www.acn.edu.au/forum_program

INTERSTATE Chronic Diseases Network Conference 9-10 September Darwin www.cdnconference.com.au/ Public Health Association 42nd Annual Conference: Tackling physical, social and psychological inequality 16 -18 September Melbourne www.phaa.net.au/42nd_Annual_ Conference.php

Crossword solution G A S T R O S P A S M S I C K

U S E C R P H I G L O F F A A S C H I C A L E

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

T O R Y E I C U L O L O N O J W H O F F I E E N T V E E I D R R O N E T O F I C H A

A G N E A T E E B L I A N A G E I N E A C H T A N S I I M S T

50 | THE LAMP SEPTEMBER 2013

O S I N T E E R G A T E S I O T C S U L I T I A I L L A B R I N

A N E E N V S O R E G

2013 ANMF (Vic) Professional Issues in Practice Conference 19-20 September Melbourne Carole de Greenlaw 03 9275 9333 cdegreenlaw@anmfvic.asn.au www.cvent.com/events/2013-professionalissues-in-practice-conference Australian College of Nurse Practitioners 2013 Conference 24-27 September Hobart www.dcconferences.com.au/acnp2013/ CRANAplus 2013 Annual Conference 25-28 September Darwin crana.org.au/about/conference/ conference@crana.org.au 2013 Australasian College for Infection Prevention and Control (ACIPC) Conference 30 September-2 October Gold Coast www.acipcconference.com.au Australian College of Midwives 18th Biennial Conference 30 September-3 October Hobart www.acm2013.com Australian Day Surgery Nurses Association 2013 National Conference 12-13 October Melbourne www.adsna.info Michelle Berarducci (02) 9799 1632 nswadmin@adsna.info 5th Australian Rural and Remote Mental Health Symposium 14-16 October Geelong (07) 5502 2068 hanzmh.asn.au/rrmh/ Dementia and Community Care Conference 30-31 October Melbourne Wayne Woff 03 9571 5606 office@totalagedservices.com.au www.totalagedservices.com.au Indigenous Allied Health Conference 26-27 November Adelaide iaha.com.au/events/2013-conference National Eating Disorders and Obesity Conference March 2014 Gold Coast eatingdisordersaustralia.org.au

OVERSEAS Australasian Nurse Educators Conference 2013 9-11 October New Zealand www.nursed.ac.nz/ Epidemiology and Social Psychiatry Meeting 2014 May 2014 Germany www.epa2014ulm.eu International Conference on Infectious and Tropical Diseases January 2015 Cambodia ictid.webs.com/

REUNIONS Sydney Hospital Sydney Eye Hospital Graduate Nurse reunion lunch 2 October Sydney Jeanette Fox 02 4751 4829 bekysa@tpg.com.au Mater Graduate Nurses Association reunion 20 October North Sydney Liturgy 11.30am Lunch 12.30pm Joan Stort 0401 344 363 joans2458@yahoo.com Rydalmere Hospital Staff reunion lunch 25 October Rosehill Janice Sillett 0298422404 Janice.Sillett@facs.nsw.gov.au St George Hospital Graduate Nurses Association AGM / annual reunion 26 October Ramsgate Judith Cornell jcornell@netspace.net.au

Aged Care Lectures ausmed.com.au/listen

FIT FOR FOR

HARD

AVARA NAVY

WORKING

FEE FEET T

AVARA BLACK

AVAILABLE IN WIDTHS

AVALON

The Athlete’s Athlete’s F Foot oot sstock tock a rrange ange of p premium remium m men’s en’s and w women’s omen’s Asc Ascent ent duty shoes. These shoes ffeautre eautre slip resistant and oil rresistant esistant rubber resistant outsoles with an abundanc e of support outsoles abundance for all day day (or night) and cushioning for comfort. The Athlete’s Athlete’s F oot ar e pr oud comfort.

Foot are proud to e xclusively sstock tock Asc ent shoes, a to exclusively Ascent brand that provides providess comfort, c ort, dur ability brand durability and a great fit. The Athlete’s ete’s Foot Foot high trained Fit Technicians ians use highly ® exclusive FitPrint technology ology to find the right

VOYAGER BLACK

VOYAGER ROUGE

OVER 45 STORES ACROSS NSW 1800 677 621

NISSAN & KIA

Super

S i n g hout r p S

Nis Nissan N issan Pulsar Pulsar ST S S Sedan Se or o Hatch Hattcch

ffrom rom rro

$19,990 $19, 9,990 drive dr rive ve away aw way ay

our shout shout 555ard It’s’sththisour is month month

$

Gift C

Kia Cerato Kia Ceraatto to YD Y D

w with ith a FFREE REE GIFT GIFT C CARD ARD for ffoor eevery very nnew ew car carr purchase! purchhase!*

ffrom rom ro

$19,990 $19 9,,990 90 drive dr rive ve away aw way ay

So many features nothing will surprise you

Niissan Nissan N s Dualis Duaalis ST Du S 5 or 7 Seater SSe Seate eaater

ffrom rom rro

$27,990 $27 7,9 7 ,9 ,990 drive dr rive ve away aw way ay

Kia K iaa Sportage Spporttaage Spor ag Series Ser Se rries es 2

ffrom rom ro

$26,990 $26 6,990 drive dr rivvee away aw way ay

NO NOW OW WITH WITH SAT SA ATT NAV NAV AV & CAMERA CA AMEERA AS STANDARD STA TANDARD

N ss n Maxima Nissan Maxim ma ST-L S T L Plus Plus u

$29,990 $29 9,990 0 drive dr rivvee away away

FREE UPGRADE TO SAT NAV & CAMERA

ONLY

6

ffrom rom rro

AVAILABLE

Highly awarded

Kiaa Kia Optima O ptima

ffrom rom ro

$29,990 $29 9,99 990 drive ddr rivvee away aw way ay

Optimise your drive

ONLY

3

AVAILABLE F

NISSAN & KIA 02 888 444 77 | 37 Blacktown Road | Blacktown www.landernissan.com.au

www.landerkia.com.au

ONLY ONL LY 4 MINS FROM PROSPECT HWY TURN OFF ON THE M4