The Lamp December 2013

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 70 No.11 DECEMBER 2013–JANUARY 2014

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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.11 DECEMBER 2013–JANUARY 2014

Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au Hunter Office 8-14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258

COVER STORY

12 | Hidden privatisation of disability revealed

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

The O’Farrell Government has announced that the disability sector will be fully privatised in New South Wales.

Produced by Hester Communications T 9568 3148

Michael Grant and Jenny Preston, RNs

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

PHOTOGRAPH: SHARON HICKEY

REGULARS

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

FRONTLINE JOBS

20 | Swift action halts hospital carve-up

17 | Lies and lucre

Families of Stockton Centre residents say the government is selling them out for commercial gain.

26 | Christmas giveaway

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

INSURANCE

The Lamp ISSN: 0047-3936

28 | Alexis lands in our safety net

The NSWNMA stepped into the breach with its own workers compensation scheme and RN Alexis Devine is glad we did.

COMPETITON

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

COVER STORY

MERCY SHIPS

32 | The love boat Outdoor furniture stacked in the empty pool, two-minute showers and share accommodation for six in a 2m x 3m cabin.

Is this the cruise ship from hell?

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 DECEMBER 2013–JANUARY 2014 | 3

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EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

Privatisation: a major policy shift underway, without debate An agenda of privatising public health services is now apparent in New South Wales.

“In a recent meeting with the NSWNMA the Minister for Disability Services denied that the privatisation of ADHC was privatisation.

It was, he said, a transfer of services to the private sector.”

First, we had the privatisation of the new Northern Beaches hospital, followed by the announcement that pilot mental health services were to be given to private companies and the non-government sector. Now we are told Ageing, Disability and Home Care (ADHC) is to be privatised and palliative care services hocked off to private consortiums (see page 19).

This is a major shift in public health policy being undertaken by the O’Farrell Government, without any public debate or consultation.

Nurses and midwives and the community are entitled to ask: what is the case for doing so?

Where is the evidence that this will lead to better public health provision and better patient care?

In fact, there is plenty of evidence that says this is a disastrous path to go down. The privatised and highly competitive US health care system is a test case in market failure. It swallows up a massive 17% of US GDP. Despite this massive commitment of money, huge numbers of Americans are without health cover and fall through the cracks. Of that health expenditure, 31% is spent on administration costs – a ridiculous waste of resources.

Britain is an even more relevant cautionary tale.

Historically it has a universal public health system similar to our own. Both Britain’s National Health System and Australia’s Medicare are iconic institutions, held in high regard by the public and representing the best values of our societies.

Since the Conservative Party came to office in Britain there has been an agenda of increased privatisation. A former head of the NHS, Sir David Nicholson, described the “medicine” of increased privatisation and the morphing of patients into customers as “toxic”.

Section 75 of Britain’s Health and Social Care Act codifies this march to privatisation. It stipulates that services must be tendered out.

Now 49% of services are open to the private sector. Management consultant McKinsey has predicted that the British private sector health market will be worth £200 billion British pounds by 2030.

In Australia, the Liberal Party has been coy about talking openly about privatising public health care. Privatisation is not popular in this country. Remarkably in a recent meeting with NSWNMA representatives, the NSW Minister for Disability Services denied that the privatisation of ADHC was indeed a privatisation. It was, he said, a transfer of services to the private sector. A masterclass in semantics!

The privatisation of ADHC is one of the largest in the history of NSW. In tandem we have learnt that the National Disability Insurance Scheme (NDIS) is to be a wholly privatised affair in NSW. None of this has ever been put to the public or to the staff or the disabled and their families.

In fact, it is a major policy decision delivered as a fait accompli when the bulk of policy development around the NDIS is yet to be started.

It is open to any one to question if these decisions are based on ideology rather than sound public policy.

It is consistent with the modus operandi of the O’Farrell Government – that with its massive majority it can bulldoze through an ideological agenda without effective public debate or consultation.

Late night sittings of the Legislative Council, where votes are traded by cross bench parties, does not replace informed public consultation and a genuine testing of ideas and recommendations.

THE LAMP DECEMBER 2013–JANUARY 2014 | 5

YOUR LETTERS

LETTER OF THE MONTH

Port Macquarie nurses support Bahraini health care workers On 2 September, NSWNMA members at Port Macquarie included an expression of solidarity with persecuted health care workers in Bahrain in our Global Nurses United rally.

The ACTU had requested union members to support our Bahraini colleagues – tortured, falsely accused and imprisoned simply for caring for others without discrimination.

We should treasure our freedom in Australia to be activists in our workplaces and community. Shame on the Abbott Government that one of their first actions was to revive its watchdog for the building and construction industry. This body has inquisitorial powers to interrogate workers – even leading to their imprisonment.

A fitting and moving end to our rally occurred when a community member shared an impromptu story of how a friend in her southeast Asian birth country was imprisoned for her activities as a trade unionist.

We do well to be vigilant against attacks, whether subtle or blatant, on our civil liberties.

Ken Procter Branch President NSWNMA Port Macquarie Base Hospital Branch

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.

letter of the

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

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6 | THE LAMP DECEMBER 2013–JANUARY 2014

Devouring The Lamp Many thanks to Joanne Lewis, or more specifically the editors of The Lamp, for publishing the article “Bringing Death to Life” (October 2013, page 30). I was able to use this article as the basis for a discussion on death and dying as part of our educator program here at North Shore Private Hospital. Joanne makes some very valid points and uses a common sense approach to end of life care.

Our session highlighted some very thought provoking and challenging issues on this topic and many present acknowledged the need to learn more about this very sensitive part of our nursing lives.

Once again, a heartfelt thanks to the editors. I devour every copy each month.

Christine Cherry, Roseville NSWNMA RESPONDS Thanks Christine! A podcast of Joanne Lewis speaking about end-of-life issues at our annual conference can be found on the education section of our website: www.nswnma.asn.au/education/cpd/nswnma-podcasts/

A letter to the Minister for Health This is an abbreviated version of a letter sent to NSW Minister for Health Jillian Skinner in July this year.

Dear Jillian, With reference to your letter emailed to the NSW Nurses and Midwives’ Association on 25 July, I would like to make some comments.

With regard to your statement “More than 4000 extra nurses and midwives have been recruited since March 2011” – are you saying this is the net amount? That is, nurse numbers have increased by this amount? This totally disregards the attrition of nurses over the period. Further, it disregards the type of employment i.e. full time equivalent, part time/casual?

I would like to emphasise that [our] campaign focus was primarily concerned with patient care. However, I believe that your response with regard to the pay rise and the linking of same to superannuation is, in my opinion, miserly.

Finally, the support you talk of, with regard to nurses and midwives delivering safe effective patient care, is at best dubious.

Should it continue along the same vein as being demonstrated currently, I personally hold grave concerns for patients and nursing outcomes both now and in the future in the public health system.

Yours faithfully Sue White, Coffs Harbour

EASY SY Y CPD CP

YOUR LETTERS

just got easier!

Pay increase I noticed recently that we received a pay increase. I’m guessing this was due to back payment for our pay rise. Does this mean that our award has been agreed upon, and we have let ratios go by the wayside?

Emma Harrison, RN NSWNMA RESPONDS Dear Emma We have not let ratios go by the wayside.We are in a serious struggle with the government for safer patient care and our campaign to extend and improve ratios will be a long game.

We need to be patient, innovative and determined to win. It needs more than what we have done in the past because we can no longer rely as much on the machinery of industrial relations.

We can still use what industrial processes we have at our disposal to enforce our wins of the past. As things now stand the Award has been varied to pay a 2.27% wage increase.

Meetings with the Ministry of Health have stopped. It is reasonable to expect that the next award pay increase is due in July 2014.

The Award is still active so there is an opportunity for the government to improve and extend ratios between now and July 2014.

There are also opportunities for nurses and midwives to put pressure on the government to do the right thing.

But we cannot confine our efforts to the industrial arena.We also have to fight the good fight in the political domain and in the court of public opinion.

All year we have been building that pressure with workplace activities, MP visits and paid advertising.We need to maintain that momentum, albeit strategically timed, between now and 2015.

NSW Nurses and Midwives’ Association In association with the Australian Nursing and Midwifery Federation

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NEWS IN BRIEF

Britain

Nurses at breaking point

82%

OF NURSES REPORTED GOING TO WORK SICK BECAUSE THEY FEARED PATIENTS WOULD BE AT RISK DUE TO UNDERSTAFFING.

A survey by the Royal College of Nursing (RCN) of more than 2000 British nursing staff found “unprecedented” levels of stress and illness as a result of staff cuts and the resulting increase in workloads.

The survey found that: • 82% of nurses reported going to work sick because they feared patients would be at risk due to understaffing.

• Half said their stress levels had increased significantly in the past year, due to increased workloads and staff shortages.

• More than half said they had been made unwell by work-related stress.

• A quarter said managers had bullied them.

The survey also revealed that increased pressure is driving hospital managers into “panic behaviour”.

Nurses reported increased levels of bullying by managers and a widespread blame culture that prevented frontline staff from voicing concerns about poor care, according to the Independent newspaper.

More than 5400 nursing posts have been cut since the Conservative Party came to government in Britain, with the National Health Service dealing with tighter budgets and a slowdown in health spending.

Dr Peter Carter, the RCN’s chief executive, told the Independent that the UK’s entire care system was facing a “huge challenge” of maintaining standards despite “increased demand and scant resource”.

“Individual nurses are clearly going the extra mile to make sure the job is done. However, the risk of burnout is very real, and very widespread,” he said.

United States

Childhood poverty link to adult emotion A new study suggests that the stress of childhood poverty imbeds itself in the brain, with lasting consequences for an adult’s ability to regulate their emotions.

The study, Effects of childhood poverty and chronic stress on emotion regulatory brain function in adulthood was published in the Proceedings of the National Academy of Sciences of the United States of America.

The study built on previous research that found childhood poverty is associated with a whole host of problems that can follow people throughout their lives. These include physical illness, psychopathology and an inability to handle stress. A lot of these problems stem from the chronic stressors that children face in a poor socioeconomic environment – which can cause serious, lasting changes in the brain.

The study found that income as an adult didn’t seem to make a difference, but levels of chronic stress throughout childhood did mediate the connection between childhood poverty and adult brain activity.

8 | THE LAMP DECEMBER 2013–JANUARY 2014

NEWS IN BRIEF

Australia

Nurse elected mayor Lucille McKenna, an NSWNMA councillor, has been elected mayor of Ashfield Council, the first female mayor in the council’s 142-year history.

Lucille, who is a Director of Nursing at St Mary’s Villa at Concord, said she was excited by the win after seven previous attempts.

“I just felt you need to step up if you really believe in something, if you believe in equality for women, you have to try and make it happen,” she told the Inner West Courier. “[Ashfield Council] has been a bit of a trailblazer. We have a woman general manager and women directors, so I think we are women friendly, but now we have accomplished the woman mayor so I’m very happy.”

“IF YOU BELIEVE IN EQUALITY FOR WOMEN, YOU HAVE TO TRY AND MAKE IT HAPPEN” Australia

Australia

The low paid shafted over super

11 million overweight or obese

It appears that the right for mining companies to earn super profits comes before the retirement incomes of the country’s lowest paid.

The Abbott Government has flagged the repeal of the Low Income Super Contribution (LISC) and a delay in the Superannuation Guarantee increase to 12% so that it can repeal the Mineral Resources Rent Tax. One of the major goals of Labor’s minerals tax was to boost the super of working people, especially the lower paid. This reform had the added benefit of boosting national savings.

Industry Super Australia (ISA) says the LISC addressed a fundamental inequity in the super system.

“Abolishing the Low Income Super Contribution will mean one in three working Australians will lose access to any tax break on their mandatory contributions.

ISA analysis indicates that its removal could mean as much as $30,000 less in retirement for a person on a low income.

“Between 1.5 million and 2 million industry super fund members benefit from the LISC. Around two thirds of these are women. Given that the average woman currently retires with around 43% less in retirement savings than men, it is critical that the government finds a way for the LISC to be retained.”

National Health Performance Authority data shows the Australian obesity rate rose from 11% in 1989 to 28% in 2011-12.

The data, compiled at the request of the Council of Australian Governments (COAG), confirms that overweight or obesity rates increase with geographic remoteness and lower

OBESITY RATE ROSE FROM 11% TO 28% socioeconomic status.

The fattest area was western New South Wales, where 79% of people were overweight or obese.

Eastern Sydney was the slimmest area with 49% of people overweight or obese, while Sydney’s north shore and northern beaches and inner northwest Melbourne followed at 50%.

The report regarded a body mass index of 25 or more as overweight and 30 or more as obese.

THE LAMP DECEMBER 2013–JANUARY 2014 | 9

NEWS IN BRIEF

Australia

Welfare cuts bad for health Authorised by B.Holmes, General Secretary, NSWNMA

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An Australian health expert warns that radical cuts to social welfare spending to reduce budget deficits could have unintended consequences that will impact on public health.

Dr Lesley Russell, a research associate at the Menzies Centre for Health Policy at the University of Sydney, says the experiences of the United States, where income inequality accounts for a significant component of its bloated healthcare costs, and Europe where there have been disastrous health consequences from economic austerity, are warning signals for Australia.

“There is growing evidence of the fraying of the social welfare and universal healthcare safety nets in Australia in recent times, highlighted by the growing disparities gap and increasing outof-pocket costs. This will inevitably lead to increased healthcare costs,” Dr Russell wrote in the Canberra Times.

Dr Russell warns that although the Australian healthcare system delivers better results at lesser cost compared to the US system, we cannot afford to be complacent.

“The 2013 Human Capital Report from the World Economic Forum shows Australia ranking just slightly better than the US in terms of social safety net protection and the Gini index, which measures the distribution of income or consumption expenditure among individuals or households within an economy.

“The indicators show we are approaching a tipping point and these reports send a warning signal: government efforts to balance the budget on the backs of social welfare, education and healthcare programs can result in untoward consequences with decreases in health status and substantial increases in healthcare costs.”

“THERE IS GROWING EVIDENCE OF THE FRAYING OF THE SOCIAL WELFARE AND UNIVERSAL HEALTHCARE SAFETY NETS IN AUSTRALIA…”

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NEWS IN BRIEF

Australia

Queensland to ban ratios The Queensland government has introduced a bill into parliament that pre-empts any attempt by Queensland nurses to have ratios included in an award.

Britain

Digital spies for care homes The Care Quality Commission in England has proposed using cameras and “mystery shoppers” to monitor services provided to elderly and mentally ill people.

According to the Guardian newspaper the Commission is considering “the potential use of hidden surveillance” to promote a culture of safety and quality.

The proposal immediately raised concerns within the sector about dignity and privacy.

“WE NEED TO TRAIN, SUPPORT AND INSPIRE THE NEXT GENERATION OF CARERS, NOT CREATE A BIG BROTHER CULTURE.” Davina Ludlow, director of care home directory, carehome.co.uk, warned about the impact on care users and staff.

“We urge full and meaningful consultation before digital spies infiltrate the care sector.

Not only will covert surveillance impact on resident freedom, it may also have a knock-on effect on the motivation of staff. We need to train, support and inspire the next generation of carers, not create a Big Brother culture where people are afraid to do this vital job.”

The new bill specifies core employment standards that exclude any content related to workloads and workforce planning.

The bill overhauls the Queensland IR system and at one level mimics the National Employment Standards and award modernisation process.

The Queensland Attorney-General Jarrod Bleijie says the bill will specify matters that can or cannot be included in awards.

“Modern awards will not contain non-allowable content such as matters relating to workload management and workforce planning,” he said.

The bill also: • Aims to “significantly reduce” the number of public sector awards.

• Prohibits employers deducting union membership fees from public sector employee wages.

Empowers the Industrial Relations Commission to reduce “protracted disputation” during bargaining and introduce timeframes for conciliation if industrial action threatens to “endanger the health, safety or welfare of the community or threatens access to, or the delivery of, services to the community”.

Australia

Bushfire appeal The NSWNMA has made a $10,000 donation to the Red Cross bushfire appeal on behalf of nurses and midwives in New South Wales.

NSWNMA General Secretary Brett Holmes extended sympathy and support to those members who lost homes in the bushfires.

“We encourage all members to contribute to the recovery efforts, both on behalf of those nursing and midwifery colleagues who lost their homes, and the wider communities which face a difficult recovery from such devastating fires,” he said.

Members who are suffering financial hardship as a consequence of the fires are invited to contact NSWNMA Membership services to discuss union fee relief.

Call (02) 8595 1234 (metro) or 1300 367 962 (regional) or email nswnma_membership@nswnma.asn.au.

THE LAMP DECEMBER 2013–JANUARY 2014 | 11

COVER STORY

Hidden privatisation of disability revealed The O’Farrell Government has announced there will be no state government involvement in disability services by 2018 and that the National Disability Insurance Scheme will be fully privatised in New South Wales.

“THE O’FARRELL GOVERNMENT HAS RUSHED THROUGH WITH OBSCENE HASTE LAWS THAT CODIFY PRIVATISATION AS THE ONLY OPTION.” Left to right: Michael Grant Vicki Yep and Jenny Preston.

12 | THE LAMP DECEMBER 2013–JANUARY 2014

THE BOMBSHELL OF AGEING DISABILITY and Home Care’s privatisation was announced in an email to staff by ADHC Director-General Michael Coutts-Trotter.

“By 2018 our department will no longer provide disability services. People with disability will get their supports from non-government organisations and possibly, the Commonwealth,” he wrote.

“One thing is crystal clear. To make sure there is no disruption to supports for people with disability we have to encourage as many of our staff as possible, who now support people with disability, to move to the non-government sector as NSW moves out of direct service delivery.

“Having our staff transition and continue to work in the sector is critical to the success of the NDIS.” The seeds of this agenda to privatise ADHC lie in the agreement between the O’Farrell and Gillard Governments on the adoption of the National Disability Insurance Scheme.

Buried deep in the agreement is a clause which states: “following the commencement of the full NDIS, the NSW Government will not provide any residual specialist disability services or basic community services”.

The O’Farrell Government has since rushed through legislation to “enable” the NDIS that codifies the privatisation, gives the government extraordinary powers of compulsion to move ADHC staff and unprecedented interference in the rights of workers.

The legislation was pushed through parliament with little consultation with staff and their representatives and after a hurried debate in which amendments to protect staff, proposed by the ALP and the Greens, were overruled by the Coalition majority supported by the Christian Democrats and the Fishers and Shooters Party.

Some of these extraordinary powers include: • It is at the discretion of the Minister whether a staff member gets a job or not.

• A transfer to an NGO or the private sector “does not require the consent of the person transferred”.

• There is no access to redundancy payments and no capacity to argue “comparable employment” or locality factors.

Key points commencement of the • Following full National Disability Insurance Scheme the NSW government will not provide any specialist disability services or basic community care services. is to be completed • Privatisation by 2018. is no certainty of • There employment for staff in the transfer. Continued employment will be at the discretion of the Minister. of employment “does • Anottransfer require the consent of the person transferred”. will be no access to • There redundancy provisions.

NSWNMA General Secretary Brett Holmes says both the intent and the method of the privatisation are disgraceful.

“This is another example of the O’Farrell Government bulldozing through parliament in the dead of night, without consultation or adequate debate, laws that further their ideological agenda.

“The NDIS is a worthy reform that is long overdue and strongly supported by nurses and midwives. But it has never been put before the community that it is to be a fully privatised system.

“The O’Farrell Government has rushed through with obscene haste laws that codify privatisation as the only option, and which have coercive elements towards staff, when much of the policy development around the NDIS is still to be done.”

Brett says the NDIS is a massive undertaking and there should be an open discussion with all stakeholders, including families and staff, about the right solutions for clients.

“Right now, having some public provision of disability services gives families a choice about the sort of care they can have.That choice is being taken away.

“Some of these people have very complex needs requiring intensive care.

Who is going to be the provider of last resort if a private provider finds these cases too difficult or unprofitable?”

THE LAMP DECEMBER 2013–JANUARY 2014 | 13

COVER STORY

“THAT’S MY CAREER GONE.” Vicki Yep, Residential Unit Nurse Manager, Norton Road Specialist Supported Living, North Ryde “The NDIS is a great reform that will deliver funding to people who desperately need it. But it’s being used as a cover for the privatisation of the whole system of disability services.

Families of some of our clients assume they will have the option of choosing to spend their NDIS funding packages on government-provided services for their sons and daughters.

However privatisation means that choice will be taken away from them.

I worked in the community sector for 10 years then large residentials and specialist supported living for 12 to 13 years, so I’ve seen both sides.

There are good non-government services but history has shown that the public sector has always taken the most difficult cases, the clients with intensive – and expensive – support needs.

Many non-govs are unable to fully support people with complex medical conditions and demanding behavioural needs – clients who do not have the ability to understand what our community deems acceptable, clients who assault, strip in public, destroy property. What happens to them after privatisation?

You need knowledge, confidence and discipline to implement a consistent approach in managing such difficult behaviour.

Public sector wages and conditions are better so we tend to attract the better-qualified and experienced people.

I don’t want to be forced out of the public sector and told you’re no longer a nurse, you’re a disability support worker.

That’s my career gone.”

Privatisation agenda gathers pace 2013 HAS SEEN A NUMBER OF MAJOR ANNOUNCEMENTS OF PUBLIC HEALTH SERVICES TO BE PRIVATISED BY THE O’FARRELL GOVERNMENT

MAY 2013 — Northern Beaches Hospital NSW Health Minister Jillian Skinner announced that the private sector would design, construct, operate and maintain a public hospital on Sydney’s northern beaches. The new Northern Beaches Hospital will take over acute services relocated from Mona Vale and Manly hospitals.

AUGUST 2013 — Mental Health Services NSW Minister for Mental Health Kevin Humphries announced that two pilot mental health services would be put out to tender to private companies and the nongovernment sector to deliver mental health, physical health and drug and alcohol support.

14 | THE LAMP DECEMBER 2013–JANUARY 2014

OCTOBER 2013 — Palliative Care Health Minister Jillian Skinner announced that palliative care services in the local health districts of Central Coast, Northern Sydney, South Eastern Sydney, Western NSW, Murrumbidgee, Southern NSW and Far West would be given to a private consortium made up of Hammond Care, Sacred Heart and Calvary Health Care.

Silver Chain Group will be given palliative care services in the LHDs of South Western Sydney, Nepean Blue Mountains, Western Sydney, Sydney and Illawarra/Shoalhaven.

Silver Chain Group will also care for patients in Hunter New England, Mid North Coast and Northern NSW.

NOVEMBER 2013 — ADHC NSW Minister for Disability Services John Ajaka announced the privatisation of ADHC with 14,000 jobs including 1,200 nurses to move to the non-government sector in one of the state’s largest privatisations.

“OUR CLIENTS WILL LOSE NURSES’ EXPERTISE.” Michael Grant RN, president of NSWNMA Stockton Centre branch “This is a tough time for our staff because they care about their clients and fear for their future. And they know their own livelihoods and careers are under threat.

Privatisation threatens to eliminate our career paths, regardless of whether you are an AiN, EN or RN. All of us face the potential of having our careers terminated.

The non-government sector has disability support workers with a few nurses in a few situations but the only ones paid relatively appropriately are in the government sector.

I gather the enabling legislation [to the NDIS] says our wages and conditions will be maintained for an undisclosed period of up to five years. Then we revert to whatever award is followed by whatever company takes us over. I don’t know of any nongovernment award that would pay any of our staff the rates we are currently on.

If privatisation results in nurses leaving the disability sector our clients will lose those nurses’ expertise. These clients are people who are multihandicapped and with medical, psychological, and psychiatric issues.

Many can’t do much for themselves, many others have issues with aggression and inability to control themselves, all of them require specialist nursing care, and their families are worried about their futures.”

“THERE IS CURRENTLY NOWHERE ELSE FOR CLIENTS TO GO.” Gary Dunne RN, ADHC Summer Hill centre “We haven’t been told anything about the future of Summer Hill. I assume the service will have to continue because there is currently nowhere else for our clients to go.

The non-govs have not wanted our clients in the past because, being both disability and complex health, they are by far the most expensive to look after. They need an experienced registered nurse close by, 24/7, plus easy access to allied health professionals such as physio and OT. Yet it seems the government wants all of us off their books by 2018.

If the service is put out to tender, will a private agency continue to offer the same level of staffing and service? It’s hard to see how a private provider could run Summer Hill for less except by cutting the service.

Many long-term staff members have said they would transfer back to general nursing in the public hospital system rather than work under a private provider.

We find it hard to get staff now for what are public service positions. There is a nursing home down the road that’s paying more per hour for RNs. Any new management will have a difficult time just getting enough experienced staff to keep the service running.

It’s not that we are desperate to hang on to our jobs, but we are desperate to hang on to what we have built up and the quality care we currently provide for a very unique group of vulnerable people.”

THE LAMP DECEMBER 2013–JANUARY 2014 | 15

COVER STORY

“PRIVATE COMPANIES COULD PUT PROFIT BEFORE CARE” Jenny Preston, RN and NSWNMA branch delegate, Tomaree Lodge residential centre, Shoal Bay “We had no idea the government was going to privatise disability services – it was a huge shock to us all. Our concern is that private companies could put profits before quality care.

Paying low wages for staff with basic training and working with low staff numbers would lead to high staff turnover, which adversely impacts on clients.

It looks like the government will close Tomaree and relocate our clients. It’s anyone’s guess where they will be sent. I think most would prefer to stay together, in the local area. They have known each other a long time and care about each other.

Our centre provides cluster housing, which mirrors the type of accommodation the government says it wants people with disabilities to live in. But it is on prime waterfront land and developers have been trying to get their hands on it for years.

A local councilor said recently the site should be redeveloped as a casino with our clients relocated on a farm somewhere.

If our clients are forced out of Tomaree they will lose their strong interaction with the local community. They access local medical services and local volunteers help with activities on site and in the community. There’s a fishing club and a group who travel to Newcastle to see the Jets play soccer and the Knights play rugby league. How will they rebuild those community connections somewhere new?

The NDIS is a fantastic scheme but its not a one size fits all.

There are clients who have tried to live in the community and failed dismally. They need to have somewhere they can live a life with a degree of freedom and support – including from experienced nurses.”

What the politicians had to say The full privatisation of NSW disability services is enshrined in the National Disability Insurance Scheme (NSW Enabling Bill) 2013.

The bill was debated for five hours in the NSW parliament. This is what some of the participants in the debate had to say.

“There is a side to this legislation that is aimed at the comprehensive transfer of all disabilities service provision to the private sector. The legislation is not about the National Disability Insurance Scheme; it is about privatisation of the 40% of service delivery that currently occurs in the public sector. This is probably the largest single privatisation that NSW has ever seen.”

— Dr John Kaye (NSW Greens spokesperson on health)

“The government is targeting and manipulating workers because it knows how much the community wants and needs a national disability scheme. It is disappointing that the O’Farrell Government is playing political games with disability support workers. It takes the gloss off this wonderful reform.”

— Shaoquett Moselmane (ALP)

“Non-government organisations are mainly inclusive, participatory and quality-focused and have the capacity to generate social capital in a way that the government and the private sector cannot.”

— John Ajaka, (Liberal Party) Minister for Disability Service

“This legislation is about devolution. I think we all believe passionately that through allowing devolution and choice we will see a thousand flowers bloom in the form of local solutions.”

— Catherine Cusack (Liberal Party)

16 | THE LAMP DECEMBER 2013–JANUARY 2014

Lies and lucre Families of Stockton Centre residents say the government is selling them out for commercial gain.

Wendy Cuneo and her son David, a Stockton Centre resident. PHOTO: RYAN OSLAND, NEWCASTLE HERALD

AS THE STATE GOVERNMENT EXITS DISABILITY services it appears set to break another promise and close the Stockton Centre, which houses about 400 people with disabilities.

A government official has denied the motive is to sell the prime beachfront site near Newcastle to a housing developer.

Soon after winning the 2011 election the Coalition government recommitted to keeping Stockton open – noting that it needed upgrading. However, in October, Minister for Disability Services John Ajaka said Stockton residents would have to leave by 2018 when the centre would be “redeveloped”.

The government will not commit to some form of accommodation for disabled people being available onsite after the redevelopment, the Newcastle Herald has reported.

The paper quoted a government official working on the Stockton redevelopment, John Ryan, as saying that while Stockton is a beach it is too isolated and far from being an ideal place for community housing. He denied any of the changes were driven by a desire to sell sites to developers.

“This is not about the real estate,” he said.

Gregory Howley’s brother Doug has been a resident of the Kanangra Centre and Stockton Centre for 50 years.

Mr Howley wrote to the Newcastle Herald: “As recently as April 2011 we were told that residents would not be forced out.The Stockton Centre would remain open for as long as residents needed.

“Now it seems that was a lie, with a closure date of 2018 again proposed. The families learned this from a report in Thursday’s Newcastle Herald, not from the government.

“Doug requires 24-hour supervision and care in a secure environment and this is provided by the state via the wonderfully dedicated staff at Stockton.

“Stockton has been home for most of Doug’s life and the staff there are very much part of his family.”

Mr Howley says residents contribute to the cost of their accommodation and upkeep from their Commonwealth Disability Support Pensions.

“It is a good system that private operators with a profit motive could not match.

“How ironic, that the National Disability

Insurance Scheme initiative may be the window of opportunity for New South Wales to push through its economic rationalist agenda, at a cost to some of those the scheme was designed to help.”

In a letter to Minister John Ajaka,Wendy Cuneo said she had a son at Stockton and a daughter in a group home and had experience of both systems.

“The NGOs [non-government organisations] pick and choose whom they want,” Mrs Cuneo said.“What happens if after moving our people into another home, the NGO decides it can no longer support that person?

“This has happened to us three times and each time a person is moved, their mental health deteriorates. These are people we are talking about, not pawns in a chess game.”

Meg Panov, the mother of another resident, told the Herald that community agencies would not be able to handle some clients.

“My son was taken out of community care by two policemen in a paddy wagon 22 years ago because they couldn’t handle him and the only place he could go was Stockton,” she said.

THE LAMP DECEMBER 2013–JANUARY 2014 | 17

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Cloud looms over palliative nursing Fewer patients are likely to get care from a trained nurse under changes to palliative care services in New South Wales.

THE STATE GOVERNMENT HAS ANNOUNCED it will deliver palliative care to more people at home – mainly by contracting out services to private providers.

Health Minister Jillian Skinner said the $35 million program was aimed at giving more people the option of dying at home.

The centerpiece of the program is the provision of up to 2863 packages of home support by 2015/16 “designed to ensure safe and comfortable end of life care at home,” she said.

“While 70% of Australians say they want to die at home, only 16% do. Over half die in hospitals, 20% in hospices and 10% in nursing homes.”

The support packages for people dying at home are being delivered under threeyear contracts for specific local health districts.

A consortium made up of Hammond Care, Sacred Heart and Calvary Health Care will service the local health districts of Central Coast, Northern Sydney, South Eastern Sydney, Western NSW, Murrumbidgee, Southern NSW and Far West.

South Western Sydney LHD in partnership with Silver Chain Group will cover the LHDs of South Western Sydney, Nepean Blue Mountains, Western Sydney, Sydney and Illawarra/Shoalhaven.

Silver Chain Group will care for patients in Hunter New England, Mid North Coast and Northern NSW. Mrs Skinner described the $35 million as “new money” on top of the $86 million annual spending on palliative care.

However NSWNMA Assistant General Secretary Judith Kiejda says the program

“Privatising services previously delivered by the public sector has the potential to reduce nurse employment in palliative care.”

– Judith Kiejda

presents “significant professional and industrial concerns” for nurses.

“Privatising services is likely to downgrade the level of care available to patients,” Judith said. “Most of the private providers do not employ registered nurses for home care and their patients are more likely to be cared for by palliative care aides.

“Privatising services that previously were delivered by the public sector therefore has the potential to reduce nurse employment in palliative care.

“Ministry representatives were not able to tell us what level of clinical care would be provided in the different areas under the new arrangements.

“The ministry advised that while some service teams would be led by clinical nurse consultants, others would be headed by palliative care aides.

“This means palliative patients will be treated differently depending on which LHD they live in.

“The ministry was also unable to provide information on the training of the non-nursing workers who will be involved in the services.”

Mrs Skinner said that in addition to athome care the $35 million program would pay for a “pop up model of care” to mobilise clinical expertise and support for a dying child as close to home as possible.

She said the program would also establish an after-hours telephone support service staffed by palliative care nurses.

Mrs Skinner said the Health Ministry would spend an additional $3 million to fund 30 extra clinical nurse specialists and clinical nurse educators in palliative care in 2013/14.

THE LAMP DECEMBER 2013–JANUARY 2014 | 19

FRONTLINE JOB CUTS

Swift action halts hospital carve-up Public outcry has forced health bureaucrats to shelve a decision to close beds and cut staff at Bathurst Base Hospital – for now, at least.

Western NSW LHD management has broken its commitment to STOP PRESS: conduct an independent review before proceeding with any cuts to Bathurst Hospital services.

Angry nurses said they felt betrayed by a shock announcement that five beds in the medical ward will close from December 9.

Management is also refusing to give new graduate nurses any commitment to ongoing employment next year. A meeting of 67 NSWNMA members called on management to reverse the bed closures. The branch has called for a public forum on the hospital crisis to be held on December 2.

Union members from every department met at the hospital to discuss the cuts.

T HE W ESTERN NSW L OCAL H EALTH District has backed down from a decision to abolish about 15 full-time equivalent (FTE) frontline nursing positions plus allied health and clerical positions at the hospital.

Following a week of community outrage LHD management announced an external review of hospital operations to identify cost-cutting measures.

All changes to bed numbers and staffing were put on hold pending the outcome of an investigation to be finished before Christmas.

Nurses were stunned by the original decision to implement bed closures and staff cuts affecting the rehabilitation unit, emergency department, intensive care unit and operating theatres.

“We deserve to have an input into the process.”

— Kathi Hamilton, RN

20 | THE LAMP DECEMBER 2013–JANUARY 2014

Announcement of the reductions came without any warning or consultation. It followed the closure of five surgical beds earlier this year and a dispute over serious understaffing of the ED. Hospital general manager David Wright, accompanied by a human resources functionary, delivered news of the latest cuts to affected staff and heads of departments on October 29, saying cuts were imminent and necessary because of a budget blowout.

Nurses in redundant positions would be moved to other parts of the hospital involuntarily if there were not enough volunteers.

The next day more than 80 union members from every department met at the

hospital with organisers from the NSW Nurses and Midwives’ Association.

Assistant Secretary of the union’s Bathurst branch, registered nurse Kathi Hamilton, said nurses were in shock when the news came through.

“People are very disheartened and frustrated and very worried about the services that will be lost to the community,” Kathi said at the time.“We just had a battle in May and June over the closure of surgical beds, and now this happens.

“If there is a need to save money we deserve to have an input into the process to decide where savings can be made.”

NSWNMA Assistant General Secretary Judith Kiejda said these were the biggest cuts at Bathurst anyone could remember.

“I cannot believe government and management think this is the way to go,” Judith said. “Bathurst is a large and growing regional city so service demand will increase.

The hospital is a major rural referral centre that was redeveloped in 2007. It makes absolutely no sense to cut services and staff.”

Judith said the impact on the community would be severe with patients forced to travel long distances to other hospitals and many going without care.

“The LHD says this must happen because of a budget imperative. They have no idea what this does to a regional area.

“The union will fully support whatever decision the Bathurst nurses take to defend their hospital and their community.”

Bathurst Medical Staff Council chairman Dr Ray Parkin said the cuts would have a massive impact not only on existing service levels but also on the hospital’s ability to attract specialist staff.

The Bathurst-based Western Advocate newspaper urged the community to get behind hospital staff and called for a protest rally outside the hospital.

“If the doctors and nurses at Bathurst Base Hospital are ready to fight for its future, then the rest of the community has no choice but to stand beside them,” the paper said.

“The state government needs to understand that … it cannot rely on the solid support of the people of Bathurst based solely on the extraordinary result of the last state election.

“If the state government thought the people of Bathurst were an easy touch, then they are about to learn they were very wrong.”

Just three days after General Manager David Wright walked around the hospital telling individual nurses their positions were about to be eliminated, public reaction was already forcing the authorities to backtrack.

On November 1 the chief executive of the LHD, Scott McLachlan, issued a media release complaining that press reporting of the issue “lacked balance”.

He claimed, incredibly: “There is absolutely no plan to downgrade or downsize

Bathurst Hospital. No decisions have been made about changes to staffing or service levels at Bathurst Hospital. Any changes will be made in collaboration with the hospital’s doctors, nurses and staff as well as the community.”

Mr McLachlan then maintained that Bathurst was too expensive to operate without changes because it admitted patients who could be cared for at home and who stayed longer than patients at other hospitals.

Health Minister Jillian Skinner entered the debate, describing any talk of Bathurst Hospital being downgraded as “nonsense and scaremongering”.

The general manager and director of nursing addressed a second meeting of the union’s Bathurst branch on November 7.

In front of 85 members they confirmed that all changes were on hold pending an external review of the Bathurst health service.

They added that intensive care unit bed and staff numbers would be quarantined from changes.

The branch adopted a unanimous resolution seeking input and sign off of the inquiry’s terms of reference and an assurance that management would talk to the branch about the inquiry’s recommendations before making any changes.

Biggest cuts in hospital’s history management’s plan for bathurst hospital included: REHABILITATION UNIT

• Cut bed numbers from 16 to 11.

• Shift 4.30 FTE nursing positions (RN and EN) to other parts • •

of the hospital.

Reduce nurse staffing by one per shift, seven days a week.

Management to consider running an outreach service from the rehab unit to assist people at home.

INTENSIVE CARE UNIT

• Move 5.50 FTE registered nurses to other parts of the hospital.

• Cut nurse staffing from three per shift to two per shift, seven days a week.

• Enhance the role of the NUM to take over ICU, high dependency unit and emergency department.

• NUM2 positions in both ICU and ED would be lost with the creation of the NUM3 position over the ED/Critical Care areas.

EMERGENCY DEPARTMENT

• Reduce the clinical nurse educator position from 0.84 FTE to 0.42 FTE.

• Remove the NUM position.

THEATRES

• Reduce elective surgery including in orthopaedics, urology, obstetrics and gynaecology, general surgery and ophthalmology.

• 1.65 FTE nursing vacancies will not be filled.

CRITICAL CARE ROTATION

• All 3.0 FTE critical care rotation nurses put on temporary contracts.

• Their contracts not renewed and the 3.0 FTE positions •

not filled.

The three nurses would become casual employees.

CASUALS AND TEMPS

• All temporary nursing contracts not renewed so nurses become casual employees. Casual nurses to lose hours.

THE LAMP DECEMBER 2013–JANUARY 2014 | 21

FRONTLINE JOB CUTS

Community outcry sa

“WE SIMPLY CANNOT ALLOW ANY CHANGES AT OUR HOSPITAL THAT FURTHER ERODE OR COMPROMISE PATIENT CARE.” — NSWNMA delegate Lyn Sloane

NSWNMA delegates Lyn Sloane (left) and Tatiana Muller

22 | THE LAMP DECEMBER 2013–JANUARY 2014

aves ICU PLANNED CHANGES TO BATHURST Hospital’s intensive care unit would have effectively disabled the unit, NSWNMA branch delegate Lyn Sloane says.

The plan, now apparently scrapped following public outcry, was to cut nurse numbers from three on morning and afternoon shifts to just two, seven days a week.

Lyn said patient numbers would have to be cut from seven at a time to a maximum four.

She said it would have been impossible and dangerous for only two nurses to staff the unit with a ventilated patient.

ICU staff members also perform all Medical Emergency Team calls, because an LHD directive bars emergency department staff from doing so.

Lyn said any cut to the unit’s ability to manage critically ill patients would have a flow-on effect to every other part of the hospital.

“There was an outcry in the community because critically ill people more than likely would have to be shipped out of town to another hospital in either Orange or Sydney.

“Nurses were quite flattened and demoralised by the news.

We had no involvement in any discussion about it; it came as a shock.”

She said cuts to rehabilitation bed numbers would force patients to go elsewhere for care or be sent home earlier.

Nurses would be transferred to fill vacancies in areas where they had no training or clinical expertise.

“The changes as originally planned would have left us with a very basic hospital and changed the whole character of the Bathurst medical service,” Lyn said. “We are a training hospital but it would have been difficult to place students here because they wouldn’t have been able to get the training they require.”

MP urged to take a stand NSWNMA delegate Lyn Sloane said it was disappointing that Bathurst MP Paul Toole of the National Party spoke to health service management but did not talk to nurses and other frontline staff.

The Western Advocate pointed out that Mr Toole had indicated a willingness to fight the cuts and was in the best position to lead the community campaign.

“He must put loyalty to his constituents ahead of loyalty to his government in this case or he will pay the price at the ballot box,” the paper warned.

“We simply cannot allow any changes at our hospital that further erode or compromise patient care, particularly at a time when we see more and more services being sent to Orange. Cutting services as the population grows is a recipe for disaster.

“We thank the Western NSW LHD for reconsidering its original plans, but promise that any future plans to hurt our hospital will be met with the same passionate opposition.”

State Opposition leader John Robertson was forced to speak to hospital staff over a fence, during their morning tea break, because he was denied permission to set foot on hospital grounds. The NSW Labor leader told a large gathering of nurses, cleaners and allied health staff that he would take their stories to parliament.

THE LAMP DECEMBER 2013–JANUARY 2014 | 23

THE YEAR IN REVIEW

The

2013

year

in review

The long struggle to improve patient care in the New South Wales public health system continued through 2013, in the face of a state government committed to rolling back the public sector.

Nurses and midwives throughout the state engaged in workplace activities, visited their local MPs, and participated in a statewide strike as we pressed for extended and improved ratios that would deliver much-needed improvements to the public health system. These actions were backed by a high profile advertising campaign by the NSWNMA.

24 | THE LAMP DECEMBER 2013–JANUARY 2014

Our successful campaign for ratios has been much admired globally and the baton has been taken up in a number of other countries. 2013 saw the birth of a new international grouping of nurses and midwives – Global Nurses United – which coordinated a very successful joint day of action in September.

Privatisation of public health services has also emerged as a major issue in NSW in the wake of a similar and more advanced agenda in Queensland.

“We can’t put profits before patients.”

The fight for better ratios and a challenge to further privatisation will continue to be major campaigns in the coming year.

THE LAMP DECEMBER 2013–JANUARY 2014 | 25

COVER STORY

26 | THE LAMP DECEMBER 2013–JANUARY 2014

THE LAMP DECEMBER 2013–JANUARY 2014 | 27

JOURNEY INSURANCE

Alexis lands in our safety net When the O’Farrell Government gutted the state’s workers compensation scheme in 2012, the loss of cover for injuries suffered during journeys to-and-from work bit nurses and midwives particularly hard.

The NSWNMA stepped into the breach with its own scheme and RN Alexis Devine is glad we did.

28 | THE LAMP DECEMBER 2013–JANUARY 2014

WHEN ALEXIS DEVINE SET OFF FOR HOME from her job in intensive care in June this year she was no more weary than normal after a 12-hour shift.

“I was feeling fine for the majority of the drive home and suddenly I felt so tired.

When I got into a familiar street close to home I felt a wave of exhaustion. I had a micro-sleep behind the wheel of the car, mounted a verge and ended up running into a tree,” she told The Lamp. “I injured my knee and fractured a rib. I was off work for six weeks.”

Alexis, an agency nurse, says the accident could have been a financial disaster.

“It was huge for me, I rely on each shift to get pay and I don’t get any sick leave or annual leave or employment insurance. It meant I had to go straight into my savings to maintain my living expenses.

“I was lucky that I didn’t have any major surgery. There were some bills that came from the hospital. I also copped a fine. It affected me hugely. I had to eat into my savings so I could get through every day.”

Alexis’ accident came almost 12 months after the O’Farrell Government had made drastic cuts to the state’s workers compensation scheme, including for injuries suffered when travelling to and from work. She was not entitled to compensation she would have received if the accident had occurred a year earlier.

“Initially I didn’t think I could be covered and I left it a long time until I realised that my injuries were lasting longer than I expected,” she said.

“I was in the hospital in the emergency department getting a check over and one of the younger nurses mentioned that the NSWNMA provides cover for those members who have been in an accident.

“It was nice to know that the Association was there to provide that assistance.”

“They had stepped up and taken over that role to provide some compensation financially. I was over the moon. It was nice to know that the Association was there to provide that assistance. I am so impressed and indebted to them for it.”

Alexis says what has happened to her has prompted conversations with other nurses about the impact the change to workers comp has had on nurses.

“It affects us hugely, unfortunately.

We work so hard through the night to care for people and then for someone like me, through no fault of my own, to have an accident with injuries that will be with me for a long time. I felt disappointed by the government for taking it [compensation] away. It saddens me a lot.”

NSWNMA’s Accident Journey Insurance

“I can’t stress enough how important it is for all members to ensure they are financial.

Don’t hesitate to contact the Association to inquire about your membership status.”

— Brett Holmes

On June 2012 the O’Farrell Government rolled back the rights of workers in New South Wales, leaving nurses and midwives vulnerable in the event of an injury while travelling to or from work.

General Secretary Brett Holmes says the Association decided to step in and establish a safety net for nurses and midwives.

“We now offer all financial members of the Association accident journey insurance as part of their membership,” he said.

“This insurance provides assistance to members injured on a journey to or from work, where they would have previously been covered by workers compensation.

“It can’t completely replace workers compensation but it does provide members with a limited safety net that provides 85% of lost weekly wages, death and disability insurance up to $100,000 and rehabilitation expenses.”

Brett says it is important to know that only nurses and midwives with current financial membership of the NSWNMA at the time of their accident are covered by the scheme.

“I can’t stress enough how important it is for all members to ensure they are financial. Don’t hesitate to contact the Association to inquire about your membership status.”

How to apply Financial members of the NSWNMA should lodge a workers compensation claim in the first instance.

If that is denied they can download a claim form from the NSWNMA website and lodge all the necessary documentation including a medical certificate with the Association.

The Association will verify that the claimant was a financial member at the time of the accident and then forward the claim on to the insurer.

Alexis Devine says that once she had sorted out the paperwork with her employer the process to get compensation moved quickly and smoothly.

“The paper work is always a bit of a drag but once it was off I was really impressed how quickly the Association processed it and how communicative they were. They rang me and let me know what was going on. Then my payment arrived and it was like Christmas!”

THE LAMP DECEMBER 2013–JANUARY 2014 | 29

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30 | THE LAMP DECEMBER 2013–JANUARY 2014

(w) EEmail Cheque

Mastercard

Visa

Bankcard

Money Order

Expiry date Signature

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MERCY SHIPS

The love boat Outdoor furniture stacked in the empty pool, two-minute showers and share accommodation for six in a 2m x 3m cabin.

Is this the cruise ship from hell? No, it’s from the heavenly side of cruising and there’s a waiting list to get onboard.

IN PORT THE EXCURSIONS ARE IN REVERSE – from shore to ship. One excursionist is Ellison, 7. His legs are twisted like pretzels from the knees down. He lives under a bridge and begs to support himself and his disabled grandmother.

After a day surrounded by scary people with large machines called x-rays, Ellison wants to leave. There is only one language that will convince him to stay, so that one day soon he might be able to run and walk.

Australian nurse Lynne White knows what that is.

“I go and sit with him and just put my arms around him.After dinner as night closes, tears well up in his eyes and Ruth, my translator, tells me that Ellison wants to ‘go home’ back to the bridge,” Lynne wrote in her diary blog that night.

“A lot of people talk to Ellison to no avail. I am listening quietly, but in my mind, regardless of race, I don’t think it’s too beneficial to negotiate with seven-year-olds for long lengths of time. Maternal instinct tells me there is only one answer and that is always DISTRACTION!” And so Ellison is revealed as a master builder with a stacking game, and after 100 games he is laughing uproariously. He goes

to sleep clutching Lynne’s koala hand puppet as she sings to him.

For Ellison this is the first day of a journey that will, among many other things, make him the hero of a documentary film soon to be screened on SBS. It was Lynne’s first day at work on Africa Mercy of the Mercy Ships charity, which operates medical ships to the world’s poorest.

The ship’s doctors and nurses deal with a range of disfiguring and crippling orthopaedic deformities, gross facial tumours, watermelon-sized goitres and inguinal hernias so large, patients carry them on a wheelbarrow. In many cases, facial tumours have grown so large they are leading to starvation and suffocation.

Lynne, 53, from Sydney, lived and worked for two months on the Africa Mercy in 2012, while it was docked in Guinea. And despite the undeniable discomfort of living in cramped quarters and the sadness and tears that are as inevitable as the joys of seeing patients given a normal life again, she volunteered again this year, this time for the Congo. But there was already a full quota of nurse volunteers.

Volunteering on a Mercy ship is not for everyone, according to Lynne.

32 | THE LAMP DECEMBER 2013–JANUARY 2014

“You need to be quite resilient and assimilate quickly,” she says. Many volunteers are young and Lynne found herself lending them a lot of emotional support, earning herself the nickname Mercy Mama from younger crew members, struggling at times with the challenges of six women, all on different shifts, sharing three bunks, one toilet and a shower.

“It’s character building stuff and it’s tricky, but no sacrifice compared to the suffering down the gangway outside.”

Most, but not all, volunteers are committed Christians, but all shared one aim, to serve others before self.

“My passion and heart has always been for Africa, don’t ask me why, there are many in great need everywhere. I think God just wires you to lend yourself to a particular group,” Lynne says.“The African people that we loved and tended were blown away that we would touch and care for them so freely.”

On her third day at an onshore screening site Lynne realised there would be no help for some, like Aduba, 16.

“His tummy hurts and he says his anus is not completely open … his abdomen feels rigid on both sides.”

Aduba’s father offers to work 24/7 on

YaYa

the ship in exchange for help for his son.“Somehow I have to get him to understand that the ship does not have the right equipment to help. My heart was breaking for them. I’m afraid that as things stand Aduba will eventually die. But this child could definitely be helped in the first world.”

Back on board to air conditioning and toilets that flush, Ellison, has revealed his real name is YaYa. His grandmother and uncle have given consent for surgery on his legs and while he awaits surgery he earns yet another name,The Little General, giving orders as he hops along behind Nick the ortho tech, holding the saw between cuts as Nick removes casts from other children.

A few days before Lynne leaves Africa Mercy,YaYa is back on her ward.

“He is now upright, has special boots Velcro-strapped on and is weight bearing through his legs, leaning against a stool with a game perched on the top. By the time we have played the game he has stood for 15 minutes. I have really been blessed to see this progress before I leave. It will be a very long-term recovery,” Lynne reported in one of her final blogs.

“I just loved him so much and so did everyone on board,” Lynne told The Lamp.“He is highly intelligent and anxious to learn. If it had been possible and in his best interests I would have taken him home with me.

“I have been able to arrange with a missionary couple to watch over him and organise schooling for him and I will fund the cost for as long as he needs,” Lynne said. “I can’t wait to see him again on film and hear his gruff voice, he truly has a piece of my heart.”

Aboard the Mercy Ship A variety of long and short-term, onboard volunteer positions are available on Africa Mercy. They include housekeeping, galley, deck crew, doctors and nurses.

Volunteers pay their own travel costs to and from the ships and from $US700 room and board for up to three months. For more visit www.mercyships.org.au or call 1300 739 899. The documentary The Surgery Ship was scheduled to screen on SBS on December 10.

THE LAMP DECEMBER 2013–JANUARY 2014 | 33

BULLYING

Bullying at work can have a serious impact on individuals and organisations. It should not be regarded as normal workplace behaviour and it should not be tolerated.

NEW NATIONAL ANTI-BULLYING LAWS will come into force next year, giving the Fair Work Commission power to issue orders against individuals and employers.

The state government’s workplace safety authority, WorkCover NSW, considers bullying a serious health and safety issue.

“The stress caused to someone who is bullied, or to those who work in a climate of bullying, can result in psychological injuries such as anxiety and depression, and can indirectly cause physical injuries,” WorkCover says.

It says employers should take steps to prevent and manage bullying and should encourage workers to report bullying incidents.

Workplace health and safety professional officers at the NSW Nurses and Midwives’ Association say that while staff-related bullying is usually manager to staff, it can involve staff to staff, or staff to manager. Bullying can be done by individuals and groups.

WHAT IS BULLYING? WorkCover defines bullying at work as “repeated unreasonable behaviour directed towards a worker or group of workers that creates a risk to health and safety”.

34 | THE LAMP DECEMBER 2013–JANUARY 2014

Bullying can be direct or indirect.

Examples of direct bullying include: • verbal abuse • putting someone down • spreading rumours or innuendo about someone • interfering with someone’s personal property or work equipment.

Examples of indirect bullying include: • unjustified criticism or complaints • deliberately excluding someone from workplace activities • deliberately denying access to information or other resources • withholding information that is vital for effective work performance • setting tasks that are unreasonably above or below a worker’s ability • deliberately changing work arrangements to inconvenience a particular worker or workers • excessive scrutiny at work.

“Reasonable management actions carried out in a fair way” are not defined as bullying.

WHAT CAN I DO? If you can, tell the bully that their behaviour is unreasonable and inappropriate, and that you want it to stop.

IF MEMBERS ARE HAVING PROBLEMS MAKING A COMPLAINT TO SOMEONE IN AUTHORITY IN THEIR WORKPLACE, OR ARE AFRAID TO DO SO, THEY SHOULD CONTACT THE NSWNMA FOR ADVICE. Keep a written record of all bullying incidents including dates, times and witnesses to the behaviour.

If you feel threatened, try to have someone with you when you meet the bully until the matter is resolved.

Check your employer’s policy and procedures on bullying and follow them to lodge a complaint.

Most public sector organisations have specific policies and procedures. NSW Ministry of Health directive PD2011_018 outlines how to make a complaint about bullying, including contacting an AntiBullying Contact Officer or the antibullying advice line.

Sectors such as aged care often have no specific bullying policies and no clear protocols on how to respond if bullying happens.

If members are having problems making a complaint to someone in authority in their workplace, or are afraid to do so, they should contact the NSWNMA for advice.

WorkCover will not look into a bullying complaint unless management has first been given an opportunity to fix the problem.

If management fails to act on your complaint, or is unable to stop the bullying, you can complain directly to WorkCover or ask the NSWNMA to do so on your behalf.

You can download the complaints form here: http://tinyurl.com/k9q3vgf

The cost of bullying A 2010 Productivity Commission report estimated that the annual cost of workplace bullying, to employers and the economy, ranged from $6 billion to as much as $36 billion.

New powers to act Under new national anti-bullying laws coming into force from January 1, 2014, the Fair Work Commission will have the power to order that bullying must stop.

The Commission will also have the power to issue orders against individuals and employers, such as to direct an employer to develop policy and provide training to combat bullying.

While amendments to the Fair Work Act give the Commission power to make an order that bullying must stop, the Commission cannot impose financial penalties or order reinstatement or compensation.

The amendments were designed to complement state workplace health and safety laws rather than replace them. They are designed to allow workers affected by bullying to apply directly to the Fair Work Commission for a quick and affordable hearing of their complaint.

If the Commission makes an order this does not prevent further action being taken under state work health and safety legislation.

The previous government initiated the changes following a parliamentary inquiry into bullying in the workplace.

However the new Abbott Government has indicated it is not happy with some of the changes to the Act, and may seek to make them more employer-friendly.

Direct costs of bullying result from absenteeism, staff turnover, legal and compensation costs, and redundancy and early retirement payouts.

Hidden direct costs include management time consumed in addressing claims for bullying, investigating allegations of bullying through formal grievance procedures and workplace support services such as counselling.

Other costs to the economy include public sector costs such as the health and medical services needed to treat bullied individuals, and income support and other government benefits provided to victims of bullying who become unemployed as a result.

THE LAMP DECEMBER 2013–JANUARY 2014 | 35

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ASK JUDITH Fact finding meeting I received a letter from my manager this week directing me to attend a factfinding meeting. The letter alleges that I shouted at a colleague, which I do not think is true. What are my rights and what can I expect at this meeting?

Management has an obligation to investigate allegations made against members of staff.

Facilities should have their own policies regarding disciplinary processes and the conduct of fact-finding meetings.

You should be advised that you may have a support person of your choosing present at the meeting and should be given an opportunity to present your response to the allegations. At this meeting management should also outline the process that will be followed in conducting their investigation.

The Members Only section of the NSWNMA website contains a document (listed under NSWNMA policies file) entitled Substantive and Procedural Fairness Guidelines that can further assist you.You can also contact the NSWNMA to speak to an Information Officer who can provide you with further assistance.

Sick leave on contract I am employed in a nursing home working three shifts per week on a permanent part-time basis. I regularly work Monday, Wednesday and Friday.

Recently I agreed to work two extra shifts on Tuesday and Thursday of the same week. I worked all my shifts except for Friday as I was unwell and

called in sick. My employer has refused to pay me sick leave for the Friday shift saying that, as I worked the extra shifts, I have gone over my contracted hours and am not entitled to sick leave.

Is this correct?

No, this is not correct. If you call in sick for any rostered shift, you are entitled to be paid sick leave. However, your employer may request that you provide them with evidence such as a medical certificate or a statutory declaration confirming that you were unwell.

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

for a further period not exceeding six months.”

This means that if the leave you have applied for and been granted is leave you are entitled to, then any changes after the granting of the leave must be by mutual agreement.Your manager cannot unilaterally cancel your leave.You should speak to either your DoN or the manager of human resources at your hospital or LHD. If your employer will still not allow the leave please contact the Association for further advice.

Christmas public holidays Leave approved then denied I am an RN in a public hospital and have applied for annual leave, which was approved. My manager is now telling me that the leave has been cancelled. Can my employer do this?

Firstly, retain a copy of any leave approval you received as you may need to use this as evidence should problems arise in relation to the period of leave requested.

If your employer has approved your request in writing they cannot later cancel your leave. If you are taking the annual leave within six months of it falling due after your anniversary date, the Public Health System Nurses’ and Midwives’ (State) Award 2011, clause 30 Annual Leave, sub clause (vii) states; “Annual leave shall be given and shall be taken within a period of six months after the date when the right to annual leave accrued; provided that the giving and the taking of such leave may be postponed, by mutual agreement between the parties

I work in the public sector and would like to know which days have been allocated as public holidays over the Christmas period. Also, as we don’t get the August bank holiday in August, do we get it with the Christmas public holidays?

Gazetted public holidays for December 2013 and January 2014 during the Christmas period are as follows: Christmas day – Tuesday 25 December Boxing day – Wednesday 26 December August bank holiday – Thursday 27 December New Years day – Tuesday 1 January 2014 You can access all gazetted public holidays for 2013, 2014 and 2015 on the NSW Industrial Relations web site at www.industrialrelations.nsw.gov.au. The August bank holiday is listed with these gazetted days, but this day is usually allocated to the Christmas/New Year period, with the date advised by the Ministry closer to the period.

THE LAMP DECEMBER 2013–JANUARY 2014 | 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

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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

SOCIAL MEDIA

NURSE UNCUT

WHAT’S

HOT

A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES

THIS MONTH

www.nurseuncut.com.au

Watch the blog for our end-of-year contest – lots of goodies to be won!

Do you have a story to tell? An opinion to share? Nurse Uncut is written by everyday nurses and midwives. Send us your ideas at nurseuncut@nswnma.asn.au. Nurse Uncut is also on Facebook: www.facebook.com/NurseUncutAustralia and on Twitter @nurseuncut

Mabel’s “spell” www.nurseuncut.com.au/mabels-spell/

Retired cardiothoracic nurse Ann knew that she should just watch and wait when her patient appeared to faint.

Are you both EN and RN? www.nurseuncut.com.au/are-you-both-an-en-and-rn/

Concurrent registration as Registered and Enrolled Nurse ends in May 2014 – contact us if you’re in that situation.

Student movie night www.nurseuncut.com.au/student-movie-night/

Nursing and midwifery students from across the metropolis came together at Sydney University recently to watch some flicks.

Seashells – the power of nurses www.nurseuncut.com.au/seashells-the-power-of-nurses/

Oliver Spence pays tribute to the nurses who supported him and his four siblings when they lost their mother to cancer last year.

Field notes on death www.nurseuncut.com.au/field-notes-on-death/

Former palliative care nurse Lea McInerny traces her relationship to the dead and dying – what happens in those final moments?

Social media – use it more, use it well! www.nurseuncut.com.au/social-media-why-we-should-use-it-more-and-better/

Mental health nurse Rhonda Wilson is a keen advocate for nurses using social media – blogs, Facebook, Twitter, the lot!

New on SupportNursesYouTubechannel Alexis on Accident Journey insurance Registered nurse Alexis was injured on the way home from work after night shift. See what happened next. > youtu.be/VRiojacC7Cw Sutherland Hospital rally for ratios A local lunchtime rally was sweetened by an ice-cream van. > youtu.be/fQurxiERr2s

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 Ratios put patient safety first >> www.facebook.com/safepatientcare Aged Care Nurses >> www.facebook.com/agedcarenurses THE LAMP DECEMBER 2013–JANUARY 2014 | 39

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40 | THE LAMP DECEMBER 2013–JANUARY 2014

Australian College of Nursing

SOCIAL MEDIA Keep me logged in

WHAT

Forgot your Password?

NURSES & MIDWIVES SAID & LIKED on facebook

www.facebook.com/nswnma

Beating heart

How can someone go into heart block then come back to normal?

A retired cardio nurse told a story on Nurse Uncut of watching a patient “faint” and doing nothing – with an ECG readout to illustrate the case.

There is evidence in the literature that heart blocks and ventricular standstill can spontaneously reverse. If anyone is interested, check articles in the Journal of Pacing or simply Google.

That is amazing, one of the very clever nurses I work with said this happens quite frequently.

Aww, I love this story – we’re often caught up with the routines and tend not to observe alternatives!

Albury work bans

Care for the nurses we have; stories like this do not attract the young choosing professions.

Mental health nurses in Albury imposed work bans due to workload issues.

Endemic nurse shortage A letter to a rural paper about an elderly relative’s bad hospital experience sparked discussion.

Give them as much as they need or you will lose them.

Good on you and the nurses who are continually expected to do more with less.

I retired from nursing because I was unable to care adequately for the patients in my care – hate to think what will happen when the rest of us baby boomers retire.

I agree as a fellow nurse baby boomer ... a lot of us at work won’t see 40 or 50 again and this issue is mentioned a lot – pretty scary. :( I was in hospital in July, the staff were wonderful under very difficult conditions – they were run off their feet!

We get more staff then we are loaded with more paperwork.

I have been a nurse for 35 years. Yes, all hospitals need more nurses, the workload is horrendous, the population is aging and there aren’t enough staff members to cope with all their needs.

Job cuts

Given 4000 new nurses on one hand (police still searching for their whereabouts) and cutting much-needed nurses jobs at Bathurst hospital, government absolutely bonkers or suffering from mental health issues - no cure for stupid!

More than 80 angry nurses gathered at Bathurst to discuss proposed cuts to jobs and beds.

Petition ban Prince of Wales Hospital warned employees not to circulate a petition about staffing numbers in public areas of the hospital, even when off-duty.

The community in Bathurst must get behind the hospital and fight for their services! People power!

I can’t help thinking that making the public health care system look bad can only make privatisation look more attractive. I hope I’m wrong...

Why doesn’t Jillian Skinner step in, fire these Health CEOs for refusing to adhere to her directive that frontline services are not to be affected. Health management around NSW continue to cut frontline services (but refuse to cut staff in their own offices) to save on budget. It’s the frontline staff that deals with the patient and family, not management.

Why cut GSO staff, next they’ll have rampant infections and cleaning issues, increased Work Cover issues cos the staff that are left to clean will be burnt out. And don’t get me started on nursing cuts! Hang in there PoW, we’re behind you.

On time Health makes a fortune on unpaid labour.

Go home on time was held on November 20

I often have my breaks late due to workload, but will get in trouble if I don’t take a break.

I would love to be able to walk out the door right on time. Rarely happens.

Award anyone?

All of us!

Know someone in nursing who deserves a Hesta Australian nursing award?

THE LAMP DECEMBER 2013–JANUARY 2014 | 41

NURSING RESEARCH ONLINE

While it is too early to tell how effectively the American Affordable Health Care Act – “Obamacare” – will achieve its aims, the selection below reminds us of how vital it is to protect the Australian system of universal health insurance from well-organised interests seeking to privatise healthcare in the interest of private profits.

Why the U.S. Should Take Notes from Britain’s Health Care System Henry Blodget The American health care system sucks. We pay more for health care than any country in the world and we only get average results. And tens of millions of Americans have no health insurance.

Our latest attempt to address this situation, Obamacare, is a mind-numbing kluge of laws and policies that is off to a very rough start. And even if Obamacare ends up working, it will only fix part of the problem.

The answer is a fully national health insurance system, in which all Americans are covered in the same massive group and for-profit insurers and health care providers can’t pick and choose who to cover and how much to charge them. This system would effectively extend the current Medicare and Medicaid system to the whole population, and, in so doing, make it even more efficient.

As in some other countries with national health insurance, Americans insured under this system would also be free to buy additional health care services, including additional private insurance.

But a lot of Americans still hate that idea. They have been told since birth that “national health care” is a disgrace. They have been brainwashed so thoroughly by America’s vastly profitable medical industrial complex, their resistance to reality and change has become a religion. http://www.slate.com/blogs/business_insider/20 13/11/10/national_health_insurance_britain_ s_system_is_great.html

Making sense of Obamacare: Key questions 1. What is Obamacare?

Passed in 2010, Obamacare is a national law with two goals: making health insurance better for people who already have it and getting health insurance for more of the 60 million Americans who are uninsured.

2. Why did America need to change things in the first place?

According to research, 82% of Americans were quite pleased with their health care before Obamacare. The problem really was with the other 18%. People routinely got kicked off their plans for getting pregnant, having a pre-existing condition, or losing a job. Afterward, no one would sell them insurance. Many people also had bad health plans that imposed all kinds of restrictions.

In addition, 60 million Americans had no health insurance at all, and as a result, many people lost

their homes, endured bankruptcy, and suffered other hardships trying to pay for treatment for their illness.

3. Why are some people so mad about Obamacare?

Obamacare isn’t perfect by any means. But there are two groups that really hate it: those who wanted a single-payer, fully socialised system, and those who claim to be free-market zealots. http://www.smh.com.au/world/making-senseof-obamacare-seven-key-questions-201310022uri4.html

The right wing plot to stop the public option: Behind the scenes as the Koch Brothers, Sarah Palin and Fox News fought to defeat progressive health care reform Thom Harman Fear of “death panels” was one of several myths spun out of the right-wing messaging campaign funded by big for-profit health insurance corporations opposed to any sort of health reform. It was given credence by Sarah Palin in an August 2009 Facebook post in which she wrote, “The America I know and love is not one in which my

42 | THE LAMP DECEMBER 2013–JANUARY 2014

parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society’, whether they are worthy of health care. Such a system is downright evil.”

The ironic thing about Palin’s message was that so-called death panels are actually a very real thing in America. Every single day, death panels at for-profit health insurance corporations determine whether or not it’s worth paying out a certain claim or signing on to a certain lifesaving medical procedure.

In those cases, a “subjective judgment” is made on how a cancer patient’s chemotherapy will affect the corporation’s bottom line.

It was exactly this sort of abuse that President Obama’s Affordable Care Act was trying to curb.

But in the perversion of the health reform debate, somehow that message got reversed. And even though there was no such thing as a “death panels” provision in the health reform bill, it was an issue that dominated much of the health care debate in the summer of 2009. http://www.salon.com/2013/11/10/%e2%80%9c we_have_a_radical_philosophy_the_plot_to_ stop_the_public_option/

test your

knowledge 1

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Across 1. Localised twitching of a muscle group (13) 9. Relating to the mouth (4) 10. Nanocurie (1.1.1) 11. A digit of the foot (3) 12. Lumbodorsal junction (1.1.1) 13. The flexor anterior surface of the hand (4) 14. Small bubbles or foam associated with the escape of gas from a fluid (13) 15. 12 paired bones forming the major part of the thoracic skeleton (4) 16. A gum disease that destroys the structures and the bones supporting the teeth (13)

18. Inactive (5) 19. The conscious sense of the self (3) 20. US units of weight (6) 22. To have pain (3) 23. A whole quantity (5) 24. Conditions of being comfortable or relieved (5) 27. Lower limbs (4) 31. Suited for a particular purpose (9) 32. Wetness due to any liquid (8) 33. Moral obligations relating to biological research and its applications (9) 34. Magnesium oxide (8)

Down 1. An impression of the cutaneous ridges of the fleshy distal portion of a finger (11) 2. Rigid (5) 3. Between ribs (11) 4. Ballooning of the lower end of the ureter into the bladder (11) 5. Distributions (11) 6. Court orders that prevent a party from performing a specified act (11) 7. Lacking personality (11) 8. Skin stains, alterations, defects, or flaws. (9) 17. Recording again (10)

21. The study of methods for controlling the characteristics of populations through selective breeding (8) 25. A minute unicellular protozoon (6) 26. To use a specific tool or technique in a task (6) 28. An appliance designed to prevent the return of a reduced hernia (5) 29. A salt of uric acid (5) 30. One of midwives’ classification (1.1)

THE LAMP DECEMBER 2013–JANUARY 2014 | 43

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BOOKS

BOOK ME Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020 Gerd Gigerenzer (Editor) J. A. Muir Gray (Editor) MIT Press (through Footprint Books) mitpress.mit.edu j www.footprint.com.au RRP $20.00 j ISBN 97802625185298 According to the contributors to this book, one of the main problems in providing uniformly excellent health care is not lack of money but lack of knowledge on the part of doctors and patients. They call for a new, more enlightened health care, with better medical education, journals that report study outcomes completely and transparently, and patients in control of their personal medical records, not afraid of statistics but able to use them to make informed decisions about their treatments.

Essentials of Clinical Geriatrics (7th ed.)

Communicating Health Strategies for Health Promotion (2nd ed.)

Edited by Nova Corcoran SAGE Publications (through Footprint Books) www.sagepub.com j www.footprint.com.au RRP $55.95 j ISBN 9781446252338 This popular textbook gives healthcare students and practitioners the practical knowledge and skills they need to effectively communicate and promote health and wellbeing. The second edition has been fully updated in response to recent changes in social policy, reflected by health communications and campaigns. It is valuable reading for all students and health care professionals who wish to reflect upon and develop their practice.

SPECIAL INTEREST

Robert Kane, Joseph G. Ouslander, Itamar B. Abrass and Barbara Resnick McGraw-Hill Professional www.mhprofessional.com RRP $65.00 j ISBN 9780071792189 This updated edition of Essentials of Clinical Geriatrics combines practical information to help clinicians and other practitioners, from a variety of disciplines, to more effectively address the challenges posed by the older patient. It features coverage of all the important issues in geriatrics, along with concise, practical guidance on the diagnosis and treatment of the diseases and disorders most commonly encountered in an elderly patient.

Safeguarding Adults in Nursing Practice Ruth Northway and Robert Jenkins SAGE Publications (through Footprint Books) www.sagepub.com www.footprint.com.au RRP $48.95: j ISBN 9781446256381 Safeguarding Adults in Nursing Practice seeks to raise nurse awareness of vulnerability, abuse and neglect, while providing them with the knowledge and skills required to safeguard those within their care. It encourages nurses to make links between theory and practice, to think critically in order to achieve the necessary balance between protection and empowerment, and to examine how their personal practice may be improved. While the book is aimed at nursing students it could also be useful for qualified nurses, helping them to improve their practice and their role as mentors to students.

Can I Tell You About Dementia?

A Guide for Family, Friends and Carers Jude Welton, illustrated by Jane Telford Jessica Kingsley Publishers (through Footprint Books) www.jkp.com j www.footprint.com.au RRP $15.95 I j SBN 9781849052979 In this book readers learn about dementia from Jack, an older man suffering with the condition. Jack invites readers to learn from his perspective, helping them to understand the challenges faced by someone with dementia and the changes it causes to memory, communication and behaviour. Set out in an easy-toread style, this book can help family, friends and carers make sense of the condition.

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 DECEMBER 2013–JANUARY 2014 | 45

MOVIES

movies of the month

PHILOMENA Powerful, gutsy and emotionally gut wrenching – this is a cracker of a film, writes Anni Cameron.

Based on real events, this film has the ability to make you laugh out loud in those moments when you do not want to weep unrestrainedly.

Philomena is the gripping story of a mother’s lifelong, single-minded search for her long lost son. It is an outstanding bittersweet tale of love, loss and exile. At its centre is Philomena Lee (in a seminal performance by Judi Dench) who we first meet as a gentle, elderly Irish woman, lighting a candle for her beloved son’s birthday; a son she has not seen for almost 50 years.

Flashing back to a young unmarried mother confined to a life of drudgery and privation in the convent’s laundry at Roscrea, given access to her son for only one hour a day, Philomena was powerless to stop the nuns selling her beloved three-year-old boy to a wealthy, childless American couple.

In scenes reminiscent of The Magdalene Sisters (2002), Dench makes us aware of the massive grief and remorse her character feels for her “carnal incontinence” and “indecency”.

Many years later Philomena and world-weary journalist Martin Sixsmith (played with admirable restraint by comedian Steve Coogan) are brought together by her daughter.

He has just lost his job as a government spin-doctor and, although scorning human-interest stories, needs work. After meeting Philomena his interest is piqued.

They make a splendid comic odd-couple: Dench’s Philomena shows kindness and enjoys chattering while Coogan’s character is cynical and disdainful.

However, the bond that develops between them is profoundly moving and very funny.

They travel to her old convent in Ireland where they encounter evasion and smokescreen from the ever so charming nuns, then on to the United States to encounter more obfuscation and evasion from the adoptive family. After further probing, revelations of the extraordinary story of what happened to her son are revealed .

The film, under the deft hand of veteran director Stephen Frears, touches adroitly on such weighty themes as the abusive way in which unmarried mothers were treated by the state and the Church in 1950s Ireland, and the perils facing gay couples in the Reagan-Bush era of the United States.

46 | THE LAMP DECEMBER 2013–JANUARY 2014

Despite this the film never sentimentalises or patronises and this is one of its strongest features.

It is an emotionally rewarding drama with a brilliant warm-hearted script and stellar performances.

IN CINEMAS DECEMBER 26 Anni Cameron, RN, BHA MEd, is a Teacher of Nursing at St George TAFE, Sydney Institute.

MEMBER GIVEAWAY The Lamp has 15 in-season double passes to give away to Philomena thanks to Hopscotch Films. The first 15 members to email their name, membership number, address and telephone number to lamp@nswnma.asn.au will win.

THE RAILWAY MAN A powerful story, convincingly acted by a strong cast, writes Murray James.

Imagine surviving being tortured as a prisoner of war and years later meeting your torturer.

This is the pivotal scene in The Railway Man, a movie based on the courageous life of Eric Lomax, an English soldier who was imprisoned by the Japanese and forced to work, on the Thai-Burma railway.

The film opens with a romantic interlude in which Eric (Colin Firth) meets Patti (Nicole Kidman) on a train to Edinburgh. They fall in love and get married.

In marriage, Patti witnesses the horrors of Eric’s nightmare flashbacks to his past imprisonment and torture. She discovers that the young Japanese officer who haunts her husband is still alive and working at a war museum, and she assists Eric on a path towards healing what we now understand to be Post Traumatic Stress Disorder.

Much has been uncovered and continues to be learnt about this disorder, which now encompasses a broader range of trauma experiences.

MEMBER GIVEAWAY The Lamp has 15 in-season double passes to give away to The Railway Man thanks to Paramount Pictures. The first 15 members to email their name, membership number, address and telephone number to lamp@nswnma.asn.au will win. participated in a film documentary of his life and reunion with Nagase, his torturer.

Lomax met with actors Firth and Kidman to encourage them in their interpretation of his life, but sadly died before this film was completed.

Ultimately this is a profound story about endurance, forgiveness and reconciliation. The confronting presence of violence is worth enduring for the heroic and cathartic climax that will shake audiences.

Nearly 2700 Australians died working on the ThaiBurma “Railway of Death”. Prior to this Australian/UK co-production, directed by Sydney born Jonathan Teplitzky, Eric Lomax had already

IN CINEMAS DECEMBER 26 Murray James is an RN in the Mood Disorders Unit at St John of God Health Services, Burwood.

THE GILDED CAGE A comedy with appealing characters, a brisk pace and some great chuckle-out-loud moments, writes Sharon Ketelaar.

Portuguese-born Maria (Rita Blanco) and José (Joaquim de Almeida) have been working hard since moving to Paris 30 years ago.

Although they have always intended to return to Portugal, it seems they are trapped in France by their own virtues and work ethic, becoming indispensable to their family, neighbours, friends and employers.

Maria is the overworked concierge of the posh apartment building in which they are allowed a small apartment of their own. José is a building foreman relied upon, and put upon unapologetically, by his jovial boss.

José is overjoyed when he inherits the family vineyards back in Portugal and with Maria begins planning their return home.

But the couple are oblivious that the news has leaked, while they are pondering how to break it gently, and Maria’s larger-than-life sister, Lourdes, begins plotting to undermine their fresh start.

News soon spreads to Jose’s boss through their Portuguese friend, Rosa, who also happens to be his cleaner. Maria and José are yet to find out that their daughter is secretly engaged to the son of José’s boss.

The residents of the apartment block know they will never find another concierge as dedicated, hard working and accommodating as Maria and go to

she speaks her mind, with only a mild reaction from the other characters. I felt disappointed in characters I’d grown fond of and it overshadowed my general enjoyment of the film.

Written and directed by Ruben Alves, The Gilded Cage is based loosely on his own life growing up in Paris among the large Portuguese community, where his mother was an apartment building concierge.

IN CINEMAS DECEMBER 12 Sharon Ketelaar is an RN and editor of medical texts.

great lengths to retain her. Comedy abounds when it seems half of Paris is conspiring against them leaving.

Amazed at the efforts of all those connected to them in their Parisian life, and feeling appreciated at last, José and Maria question whether they really want to return to Portugal, and whether they’d be lost without the jobs they thought they wanted to escape.

I would have found this film amusing from beginning to end were it not for one fleeting incident involving violence toward a female character when

MEMBER GIVEAWAY The Lamp has 15 in-season double passes to give away to The Gilded Cage thanks to Palace Films. The first 15 members to email their name, membership number, address and telephone number to lamp@nswnma.asn.au will win.

THE LAMP DECEMBER 2013–JANUARY 2014 | 47

Mangrove Yoga Ashram 2014 Programs

The Neuro Science of Yoga January 10-12 These two programs are based on research done at the University of South Australia by presenter Dr Maarten Immink.

Theory component: 8.5 hrs, Yoga practical: 6 hrs +

Yoga for Pregnancy with Swami Gurupremananda March 28-30 This course expands the knowledge for the yoga teacher and the pre natal student and is the first in a series of workshops.

At Satyananda Yoga Academy Australasia we believe that collaboration between yoga teachers, researchers, and medical and allied health practitioners holds the greatest potential for evolving research into yoga and its therapeutic effects.

Yoga for people with neurological conditions and motor impairments January 17-19 Dr Maaten Immink When working with people affected by a neurological disability, yoga practices provide a means to improving the brain, body connection while also enhancing the patient or clients sense of acceptance and wellbeing.

Theory – 8.5 hrs; yoga practical – 6 hrs+ Yoga Relax for Medical and Allied Health Professional with Swami Omteertha (Ruth Burgess, R.N.) January 10 – 12 This weekend offers a space to unwind with yoga techniques. Learn skills to apply to manage stress both at home or the workplace.

Theory component: 5 hrs, Yoga practical: 9 hrs +

The Effects of Yoga on Sleep Cycles, Anxiety and Depression July 18-20 With (Phillip Stevens) Chronobiologist, scientist and neurophysiologist. Participants will learn simple yoga practices for their own wellbeing and the skills to teach these to others to assist in the treatment of anxiety and depression.

Theory component 5.5 hrs, Yoga Practical 9hrs + Satyananda Yoga Nidra Training August 28 -5 Sept This course is designed for people to learn and teach a deep relaxation practice that can be practiced in 20-30 min.

Email for booking courses and see the website for more course information reception@satyananda.net • www.mangroveyoga.org SATYANANDA YOGAŽ teachers with professional backgrounds in medicine and allied health are available to run workshops and seminars in your workplace.

Professional areas include: physiotherapy, elderly, peri-natal, stroke, mental health and PTS, nutrition, naturopathy and fitness.

YOGA ASHRAM MANGROVE TM SATYANANDA YOGAÂŽ is a trademark of IYFM used under license. 300 Mangrove Creek Rd Mangrove Creek NSW

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Women’s Health 45+ 9-10 December Sydney www.ausmed.com.au 45 03 9326 8101 Wound management 12-13 December Burwood acn.edu.au/cpd School Nurses Association of NSW 2014 annual conference 20-21 January 2014 Sydney snamembersonly.weebly.com/conferences.html National Disability Services NSW state conference 10-11 February Sydney Miriam Sosin miriam.sosin@nds.org.au www.nds.org.au/events 02 9256 3133 Trauma and the mental health workforce – 2014 Summer Forum 20-21 February 2014 Sydney www.themhs.org/ Neuroscience Conference — Navigating Neuro 1 March 2014 Wollongong Jo McLoughlin 0422 418 255 Joanne.mcloughlin@sesiahs.health.nsw.gov.au Palliative Care Nurses Australia Conference 2014 6-7 April 2014 Sydney www.pcna.org.au/conference Paediatric Perioperative Seminar Westmead Children’s Hospital 13 September 2014 claudia.watson@health.nsw.gov.au georgina.whitney@health.nsw.gov.au

18th National Otorhinolaryngology Head and Neck Nurses Conference 29 March-1 April 2014 Brisbane www.ohnng.com.au/national_conference.html No 2 Bullying 2014 Conference 7-8 April 2014 Noosa www.no2bullying.org.au National Eating Disorders and Obesity Conference 26-27 May 2014 Gold Coast eatingdisordersaustralia.org.au

ACT Perioperative anaesthetic nursing Australian College of Nursing 13 December Canberra acn.edu.au/cpd

OVERSEAS Epidemiology and Social Psychiatry Meeting 2014 21-24 May 2014 Germany www.epa2014ulm.eu 4th International Conference on Violence in the Health Sector 22-24 October 2014 USA www.oudconsultancy.nl/MiamiSite2014/index. html International Conference on Infectious and Tropical Diseases 16 -18 January 2015 Cambodia ictid.webs.com/

REUNIONS Gladesville Hospital/Riverglades reunion BBQ 16 February 2014 Gladesville Hospital $15 per person includes food Colin Campbell or Warren Martin (02) 9489 5907; 0428 727 384 warrenjmartin@hotmail.com NEC Prince Henry/POW Hospitals Oct 197275 Group 25-26 October 2014 Margret Brignall (née Samuel) 0418 646 959 Sonia Keeling (née Graf) 0407 221 407 Marcia Jarvis (née Fitch) 0438 415 647 Dianne Walkden (née Edwards) 0400 621 470 Gill Gillon (née Horton) 0401 048 205

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