Lamp February 2014

Page 1

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 71 No.1 FEBRUARY 2014

Historic strike at Bathurst +

CUTS IN THE WEST PEOPLE POWER STOPS PRIVATISATION BETTER DEAL FOR SOS NURSES

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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 71 No.1 FEBRUARY 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

14 | Historic strike to save services A strike by Bathurst Hospital nurses reflects community outrage over cuts at the local hospital.

5 6 8 9 37 39 43 44 47 49 50

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

COVER STORY

18 | Proposed cuts in the west leave patients vulnerable Some of the most vulnerable communities in the state are threatened as the local health district takes the axe to staff numbers.

PRIVATISATION

INDUSTRIAL

22 | People power stops privatisation!

25 | Lismore nurses reject staff cuts

12 | Gold and the Incas competition

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

The Lamp ISSN: 0047-3936

Patients will suffer if plans to reduce staff levels in a mental health unit go ahead.

YOU COULD WIN!

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

NSWNMA Bathurst branch secretary Cathy O’Neil PHOTOGRAPH: SHARON HICKEY

REGULARS

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

NURSES OVERSEAS

34 | Helping after Haiyan

When Super Typhoon Haiyan hit the Philippines it killed more than 6000 people and left 4.4 million homeless.

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 2014 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $55. Individuals $80, Institutions $135, Overseas $145.

THE LAMP FEBRUARY 2014 | 3


THE AUSTRALIAN NURSING/MIDWIFERY WORKFORCE SUR SURVEY VEY

Scoping Advanced Advvaanced Practice Practice Nursing: A National Sur Survey vey ALL REGISTERED NURSES AND MIDWIVES:

Are yyou ou cur currently rently emplo employed oyed in a clinical ser service vice en environment vironment and interested in joining yyour our colleagues to de develop velop a nursing and mid midwifery wifer y w workforce orkforce for the 21st century? centur y? W vite you to par Wee in invite participate ticipate vey*. in a 15 minute online sur survey*.

http://survey.qut.edu.au/f/179050/1289 http://sur veyy.qut.edu.au/f/179050/1289 .qut.edu.au . or http://anmf.org http://anmf.org.au .au (live on 19 FFebruary) ebruar y)

*QUT Ethics Approval Number: 1300000748


EDITORIAL BY BRETT HOLMES GENERAL SECRETARY

We can stop privatisation: look to Queensland Our Queensland colleagues have shown us that when nurses and midwives organise and persevere they can make even the most dogmatic and ideological of governments think twice about attacking the public health system.

“The Abbott Government is barely 100 days old and major attacks on Medicare are on the table…”

Throughout last year we reported in The Lamp attempts by Queensland’s Liberal National Party government to privatise various elements of the public health system, most notably a large hospital on the Sunshine Coast. At every step, this radical agenda to undermine an iconic and treasured public good was challenged by our colleagues at the Queensland Nurses Union. Their campaign of rallies, advertising and engagement with the public paid dividends, with news that the Newman Government has ruled out the prospect of private management of the new $1.8 billion Sunshine Coast hospital – the hospital will now be managed by Queensland Health and will be a proud, publicly owned and operated facility. Queensland Health Minister Lawrence Springborg said the decision was based on “value-for-money” as the private sector was unable, at this time, to match the capacity of the public sector. What he didn’t say was that privatisation of the Queensland health system has been political poison for his government. A poll in the Brisbane bayside suburb of Redcliffe, where a by-election has been called, revealed that for 22% of voters “privatisation and outsourcing of the public health system” was the most important issue in their voting decision. Another 59% said it was one of several issues important to them. The poll showed the government trailing in a seat they held by more than 10% after the last election. These developments are of great importance to us here in New South Wales. Before last year’s federal election the NSWNMA was so concerned about the

Coalition’s plans for healthcare that we made a television advertisement warning of the folly of going down the path of the largely privatised, American health system. We copped a lot of flak for taking such a position. The Association was accused of scaremongering and branded as liars, yet time has shown that we were prescient in our warnings. The Abbott Government is barely 100 days old and major attacks on Medicare are on the table with the government flagging the introduction of co-payments for GPs and emergency departments. The state government, meanwhile, has announced the privatisation of various public health services, including ADHC and the building and operation of the new Northern Beaches hospital. The Abbott and O’Farrell Governments have been very coy about their plans for Medicare and public hospital privatisations. They have advanced their agendas by stealth and clouded their actions with obfuscation. There is a reason for this – privatisation is deeply unpopular, as the Queensland experience shows. This should give us much heart. The community believes, as we do, that the public provision of health through a universal health care system is the right thing for this country. In the public mind, Medicare is sacrosanct as are our public hospitals. We will take inspiration from our colleagues in Queensland and do everything we can to inform the public of the dangers to their public health system and to rally their support in its defence.

THE LAMP FEBRUARY 2014 | 5


YOUR LETTERS

Thanks for help with underpayment I injured my back in July last year and had five days on workers’ comp. To add insult to injury I was only paid 90% of my average weekly earnings (AWE) for this period, instead of the stingey 95% prescribed by law. Months of emails and telephone calls to the pay office, the insurer and health support (an oxymoron), only confirmed I had been underpaid but got me no closer to a satisfactory result. The last comment from the LHD pay guy was “if you don’t like it, get a solicitor”! So I did. I contacted the NSWNMA, who promptly assessed my case and forwarded me on to NEW Law. Bob Whyburn took on the case personally and did something no other person had done (except the union guy): he listened to me, checked the facts and told me I was right to expect the remuneration I had calculated. He sent a well-worded email to the LHD and what do you know – I got an apology and the missing cash. Thank you NSWMNA for being there to support me, and great big thanks to Bob Whyburn for his professional, skilled and supportive service, because when you need a solicitor you need a good one. I have since found out that other work colleagues have been through the same process. My advice is that if you have been on workers’ comp in the past 18 months you should check to see if you have been underpaid. Maybe the Association could send out a circular to Branch Officials alerting members to this issue? David Hughes, Byron Shire

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.

Association helps athlete win bronze Thank you for your generosity in the funds I received from you, which helped me get to Italy to represent my country in the sport I love [water-skiing at the 2013 World Disabled Championships]. I was selected to carry the Australian sign in the Opening Ceremony, which filled me with pride. Representing my country as part of a six-member Australian team, I competed in slalom and trick events, winning a World Championship Bronze Medal in slalom. Australia came third out of 11 competing countries, winning me a World Championship Bronze Team Medal as well. Watching the Australian flag being raised for me gave me goose bumps and I felt so proud. My husband, two children, parents and uncles came to Italy to support me and I loved looking into the cheering crowd seeing my family wearing the Australian shirts and waving the Australian flags. It was a great experience being in a country that has a different culture and a language we couldn’t speak or understand. I loved the Italian people, the landscape, food and coffee. Water-skiing is taking me to beautiful places and giving me the opportunity to meet people I wouldn’t otherwise meet. It is a sport I love and that I can do with my friends and family and for that small amount of time I’m on the water I don’t feel disabled. I have applied to attend the University of Western Sydney, Macarthur Campus next year to study the Bachelor of Nursing degree to fulfil my dream of becoming a registered nurse. I am also working towards being selected to compete at the 2015 World Disabled Championships, which will hopefully be held in Australia. I really appreciate you taking the time to read my sponsorship proposal and deciding to support me financially to achieve my sporting dreams. Ski you later Belinda Sidman

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YOUR LETTERS

LETTER OF THE MONTH

Defend Medicare! I write in response to the Abbott Government proposal to introduce a $6 co-pay for GP and other services as part of an amendment of the Medicare agreement. Yes, health is becoming more expensive. The population is getting older, we are living longer and an older population invariably has co-morbidities. The hardest hit group will be our pensioners. In a pensioner household it is more likely that all of those in the household require medical care. Many see more than one specialist doctor on any given week. Some have to access medical care up to three times a week. The community chronic care platform is structured to provide support in the community and prevent hospital admissions. Introducing a $6 pay schedule per visit for those who can least afford it, and who require the most medical services, is abhorrent in the extreme. The effects on the incomes of this group of people will be profound. Will the federal government be offering a hefty increase in pensions and social security to offset the co-pay? I think not. People will stop accessing services and end up in hospital. It is not just $6 for this group of people. It is $6 multiplied. The foundations of a decent society centre on access to health and education for all. The US system is a shambles the rest of the world steers clear of. Medicare in Australia is hailed as one of the best systems in the world. We need to fight to keep it in its current form and fight for the poor and disadvantaged who do not have a voice. Amanda Short, Coffs Harbour

Loving Nurse Uncut Thank you so much for sending me my prize for the Nurse Uncut end-of-year contest. I really enjoy reading and contributing to Nurse Uncut (www.nurseuncut.com.au). I recently completed my Bachelor of Nursing at the University of New England in Armidale in the Northern Tablelands and have been fortunate to get a new graduate position at Tamworth Rural Referral Hospital. Now that I have completed my studies I have reinstated my NSWNMA membership. I look forward to a long association with the NSWNMA and a long and rewarding nursing career. Tim Snell, Armidale

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IN THIS R OLE YOU YO OU WILL: WI ROLE

POSITION V VACANT A ACANT

MEMBER DEVELOPMENT OFFICER $66,436 per annum + super + additional annual leave

Do you want to make a dif difference? ference? The NSW Nurses and Midwives’ Association (NSWNMA), the profes professional rofessiona f i and industrial body for or Nu N urses ses and Midwives M Nurses in n NSW NSW seeks see s ekss a Member M Me Develo evelopmeent nt Officer to join jo our ou o Development Member M ember Or rganising i i Team. T Te eam. eam Organising

2 Recruit members utilising recruitment strategies and face-to-face conversations 2 Participate in workplace campaigns 2 W Work ork closely with NSWNMA organisers.

TTO O BE CONSIDERED FOR THIS ROLE ROLE YOU YO OU REQUIRE: REQUIRE: 2 2 2 2 2 2

Excellent communication skills – including listening skills An ability to connect with many different types of people An ability to logically and persuasively present a message Experience as NSWNMA branch activists or equivalent A demonstrated commitment to unionism A current NSW driver’ driver’ss licence.

WHAT WHA AT WE WILL OFFER R YYOU? O OU? 2 In this role the NSWNMA will offer you opportunities tunities to deve develop velop skills in recruitment and organising 2 An excellent and dynamic working environment 2 A real opportunity to make a difference in improving proving ng the working ng conditions of nurses and midwives.

HOW HO W TO O APPL APPLY LY FOR THIS POSITION: Apply online at www www.nswnma.asn.au .nswnma.asn.au nswnma.asn.au jobs. jobs bs NSWNMA is an Equall Opportunity nityy Employer oyer and we invite you to be be part of o an association ssociation ion on that foste fosters fo sterss a d diverse wo workplace workplace. place. ce Applicatio ondayy 24 February Fe 2014 Applications close Monday 2014..

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VA L E

Roz Norman 20 May 1951 — 29 November 2013

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a mode l trade unionist roz norman, a pillar of the nswnma’s tamworth branch, was a committed nurse and an exemplary trade unionist dedicated to promoting nursing and midwifery at every level. NSWNMA General Secretary Brett Holmes said Roz was “much treasured at the Association”. “Roz was an important part of our lives, as she was within the nursing and midwifery professions especially in Tamworth and across New England. “Roz was a woman we had the highest regard for. She always understood her responsibilities as an NSWNMA councillor to the organisation’s proper governance, and to its goal of improving the working and community life of its members and the hospital, community health and aged care services its members provide to the community. “As a councillor Roz was all you could hope for – loyal but frank and honest; always prepared to face the media, she took on her whole role representing the whole of the membership not just her branch, her specialty, her sector or qualification group. “Yet, in her separate role on the Enrolled Nurse Professional Association she was a strong advocate for enrolled nurses. She was granted life membership of ENPA in September. “We will remember Roz as an inspirational unionist and activist.” Even though she worked in an acute hospital, Roz was a key advocate and tireless worker for those in aged care nursing. She was instrumental in getting aged care on the agenda – not just in Tamworth and New South Wales – but nationally through her connections with aged care nurses in her local area and through the mutual respect between Roz and the then local federal MP, Tony Windsor. Roz was a selfless contributor to her local community. She was a community representative on the Department of Housing committee, a Justice of the Peace, an executive member of the P & C and Mother’s clubs, and on the North West Life Education Committee. Roz was a member of the Lioness club, holding various positions, including district chairperson and past president. She was awarded the district Governor’s star award and the Lions Neil Williams award for her service to the club. Roz Norman, an enrolled nurse, joined the NSW Nurses’ Association, as it was then, and its Tamworth Hospital branch, on 2 May 1986. Eight years after Roz joined the union, in 1994, she became a Tamworth Base branch delegate to annual conference, serving for 19 years until 2013.

She served as the vice-president of the branch in 1996 and then again from 2000 until 2005. She was assistant secretary in 2006 and served in the secretary’s role from 2007 until 2013. In 2001, Roz was elected to the Association’s council – its governing body and committee of management – and served on the council until she passed away. In 2004, and again from 2008 until 2011, she also served on the Council’s executive. Roz is survived by her husband Garry, daughters Rebecca Wiley and Melissa Nicholson, son-in-law John Nicholson and treasured grandchildren Emily, Chloe, Shannon and Josie. The NSWNMA will establish a Roz Norman activist scholarship to provide an active member with an educational opportunity to expand their skills as a local leader within the Association.

TRIBUTES TO ROZ “The thing that struck me about Roz was not just her natural organising ability but her tenacity in everything she took on.” — Judith Kiejda Assistant Secretary of NSWNMA “I remember Roz best for her genuineness. She was a true leader. Roz always had other people's interests at heart and dedicated her life to enabling others to achieve their goals. Like a ‘wise old owl’ at the Council table, Roz always stood in the shoes of others to give us a perspective we might have otherwise missed. I will miss Roz terribly going into the future, but I really appreciate the 11 years I got to work with Roz on Council. It was such a privilege to have had that time together.” — Coral Levett, President, NSWNMA “She always had such good sensible advice and was happy to give it regardless of how trivial the issues may seem. She had a quiet, unending inspiration, often setting me back on the right track.” — Sue White, Guardian, NSWNMA “I feel richer as a nurse and unionist to have known and worked with Roz.” – Kerry Rodgers, Executive Council, NSWNMA “I’m sure Roz will be greatly missed by all for her tireless work on behalf of nursing in New South Wales and beyond.” — Susan Pearce, Chief Nursing and Midwifery Officer, NSW Health More tributes to Roz can be found on the NSWNMA website.

THE LAMP FEBRUARY 2014 | 9


NEWS IN BRIEF

Australia

Super funds to deliver daily news

To receive The New Daily subscribe via: http://thenewdaily.com.au.

United States

Eat nuts, live longer People who eat a handful of nuts seven times a week are less likely to die young according to a large Harvard study. The Atlantic reported that researchers at the Harvard School of Public Health reviewed records of 27,000 deaths over a 30-year period and found “a significant reduction in mortality associated with nut consumption”. “There is potentially a 20% improvement in mortality, which is quite striking,” Dr Charles Fuchs of the Dana-Farber Cancer Institute told the Atlantic. Eating nuts meant eating about a handful of any type of nut, seven or more times per week, for years. People who ate more nuts were not only less likely to die during the 30-year period, but also, the report says, be “leaner, less likely to smoke; more likely to exercise, eat more fruits and vegetables, and drink more alcohol.” Nut eaters also enjoy significantly fewer cancers, strokes, infections, and cases of kidney failure and cardiac disease.

10 | THE LAMP FEBRUARY 2014

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NEWS IN BRIEF

Australia

A nation of fat, overwrought pill poppers Australia is one of the fattest countries in the world and we are world-class pill poppers to boot, according to an OECD report. More than 28% of Australians are obese, according to the Health at a Glance 2013 report, compared with just fewer than 25% in Britain, which appears to have slowed growth over the past 10 years. Responding to the report Professor of Health Policy at Curtin University, Mike Daube, told the Sydney Morning Herald that Australia was in “policy denial” about obesity. “We aren’t just fat,” Professor Daube said. “We are on the medal podium – one of the fattest countries in the world. We have a top-class health system, we are smoking less, we eat a lot of fruit and vegetables and our life expectancy is now around 82 – but much of this progress is being put at risk because of our dismal failure to deal with obesity.” The report also found that Australians take more cholesterol medication than anywhere else in the OECD, with prescribing rates 40% above average. Australia was also the second-highest prescriber of anti-depressant medication, a rate that has doubled during the past decade. University of Sydney Professor of Psychopharmacology, Iain McGregor, told the Herald the sharp rise in anti-depressant use showed “something serious about the fabric of our society”.

“WE AREN’T JUST FAT,” PROFESSOR DAUBE SAID. “WE ARE ON THE MEDAL PODIUM — ONE OF THE FATTEST COUNTRIES IN THE WORLD.

Britain

Support for minimum nurse staffing Robert Francis QC, chair of the Mid Staffordshire Foundation Trust Public Inquiry (see story The Lamp April 2013) has called for a rethink on minimum nurse staffing levels less than six months after deciding not to recommend mandatory ratios. In his landmark report published last year, Francis called for nationally recognised tools for establishing appropriate staffing levels, but stopped short of backing the introduction of mandatory minimum nurse-to-patient ratios. The Nursing Times has reported that Francis revised this position after considering further evidence from the Safe Staffing Alliance – a confederation of nursing and patient groups that includes nurse unions. Francis told Britain’s Care Quality Commission that evidence heard by his inquiry in 2011 had been insufficient at the time to persuade him that a “minimum across the board staffing level” was needed. He now says monitoring staffing levels is a “way to show real support for staff ”. Sally Brearley, chair of prime minister David Cameron’s Forum on Nursing and Care Quality, told Nursing Times a “pivotal moment in the debate on minimum nurse staffing levels” has now been reached.

THE LAMP FEBRUARY 2014 | 11


COMPETITION

NEWS IN BRIEF

WIN A STAY IN CANBERRA AND SEE

United States

Sexercise: good for health but won’t burn calories Research published in the American journal PLOS ONE has found that sex – rated as moderately intense exercise – uses up to 4.2 calories a minute in men and 3.1 in women.

“ALMOST EVERYONE IN THE STUDY FOUND THE SEX MORE ENJOYABLE THAN THE TREADMILL.”

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The study asked 21 young couples to wear a SenseWear armband to measure the effects of moderate exercise on a treadmill, compared with sex. Sex took on average 24.7 minutes, with men using up 101 calories and women using 70. Almost everyone in the study found the sex more enjoyable than the treadmill. While there is plenty of evidence to link sex with health benefits, this latest research shows that sex only uses a few calories – the treadmill used about three times as many. A rider on the research warned that the sex was more likely to be more energetic because it was being monitored. Other studies claim that sex reduces heart disease and diabetes and improves sleep and immunity. Sex has also been associated with stress reduction and lower mortality rates. The cliché “not tonight, darling, I’ve got a headache” also seemingly contradicts medical evidence, which shows sex might actually relieve headaches, although less effectively than tablets.


NEWS IN BRIEF

Carolyn Guichard

Australia

Australia

Winning filmmaker drives online health initiative

New laws against bullying

Carolyn Guichard, a former winner at the NSWNMA’s short film festival, has been credited as the driver of a new health initiative for people on the mid-north coast. Your Health Link is an initiative of the Mid-North Coast Local Health District. It contains information on physical health, nutrition, sexual health, sport, mental health, finance, legal services, education and employment. It also includes a national events calendar, useful telephone numbers and the National Health Services Directory, which identifies health services in specific local areas. Carolyn, a Nurse Educator from Coffs Harbour, designed and developed the website. She was one of four finalists in the 2013 NSW Health Innovation Awards in the category of Staff Member of the Year. An advisory committee with 57 representatives from government and nongovernment organisations was involved in the development of the site. “Working with this dedicated group of community representatives has been the most rewarding part of this project. People who visit Your Health Link will benefit from the input, enthusiasm and personal experiences of our Advisory Committee members,” Carolyn said. Your Health Link can be accessed at: www.yourhealthlink.com.au. For more information about NSWNMA Short Film Festival visit the Association’s website.

Australia

Brace for the big business assault Australian workers have been given a taste of the sort of advice the Abbott Government will get from its influential business advisory group, led by chair Maurice Newman. In a speech to the Committee for Economic Development in Sydney, Mr Newman said many Australians had a “lazy and complacent mindset” while listing a comprehensive set of targets for the new federal government. Top of the list was the minimum wage. Newman argued it led to an uncompetitive economy and higher employment. (Measured in US dollars, the minimum wage in Australia for a 38-hour week comes to $33,355 per year compared to $15,080 for an American worker. In stark contrast to Newman’s argument, unemployment in Australia is 5.7% compared to 7.3% in the US.) Newman also said wages were “very high by international standards” and the workplace was “an important area of reform” for the Abbott Government. He described the previous Labor government’s funding of national disability insurance and the Gonski reforms as “reckless”. He said the Coalition’s promise to spare health, education and pensions from budgetary cuts was “hasty”. After putting forward big business’s hit list on government spending, Newman, without a hint of irony, accused the previous Labor government of “class warfare particularly aimed at business”.

Compe Competition tition Prizee Winners Priz

The ACTU has welcomed new laws that came into effect on January 1, 2014 and give bullied workers a way to solve stressful, damaging, and sometimes deadly, workplace bullying issues. The new laws allow a worker to lodge an application with Fair Work Australia seeking an order that the bullying stop. Fair Work must respond within two weeks of an application being lodged. Unions have been fighting for these changes for over a decade. “We put bullying on the agenda as a workplace issue and welcome these longawaited laws that we hope will directly and swiftly assist bullied workers,” ACTU Assistant Secretary Michael Borowick said.

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THE LAMP FEBRUARY 2014 | 13


COVER STORY

Historic strike to save services A strike by Bathurst Hospital nurses reflects community outrage over cuts at the local hospital. BATHURST BASE HOSPITAL NURSES HAVE held an historic 24-hour strike followed by work bans to defend local health services. The strike received widespread support from Bathurst residents who are now focused on the fate of their hospital, as the Western NSW Local Health District (LHD) seeks to cut costs by cutting staff. A secret ballot of 70 members of the NSWNMA voted unanimously in favour of striking in protest of the shutting of five medical ward beds. Management of Western NSW LHD ordered the beds to be closed less than a fortnight after promising there would be no changes prior to the completion of an external review of operations. Management went ahead with the closures, despite being urged to wait for the outcomes of the review at a large public meeting in Bathurst. NSWNMA Bathurst branch secretary Cathy O’Neil said the strike was not just about lost medical beds but the steady downgrading of services over the past five years. “Bathurst is one of the fastest-growing regional centres in New South Wales yet we have suffered a 33% reduction in beds since 2008,” Cathy said. “I’ve been at the hospital for 21 years and I’ve never known local nurses to go on strike before, aside from statewide campaigns.” Nurses and midwives maintained a strike line outside the hospital for the whole 24 hours. Inside the hospital nurses provided night duty staffing levels to handle emergencies and ensure no patient was at risk. The strike line became a magnet for community participation. “At any given time we had 70 to 80 nurses present on the line,” Cathy said. “Members of the 14 | THE LAMP FEBRUARY 2014

“THE COMMUNITY EXPECTS A CERTAIN LEVEL OF CARE AND OUR MEMBERS WANT TO MAKE SURE THEY GET IT.” — CATHY O’NEIL

public were always popping in to bring us food and coffee. They were keen to hear nurses’ views about the state of the hospital and to learn what the LHD’s plans meant for them as a community. “Mostly they came to offer us encouragement for the future. They understood the strike was held, not for the nurses’ benefit, but to preserve adequate services and safe patient care for the community. “NSWNMA officials from Sydney worked in shifts to ensure there was always someone at the strike line to offer support and advice. That was very much appreciated by all the nurses.” Other unions, including construction

and fire brigade unions, visited to offer help and encouragement, as did Bathurst mayor Gary Rush who promised to take up the nurses’ fight through the local council. Local businesses pitched in to help with South Bathurst Butchery donating meat for the barbecue and Coates Hire donating outdoor heaters. Following the strike a meeting of the Bathurst branch of the NSWNMA voted to implement work bans at the hospital. The bans specified minimum staffing requirements and required patients admitted to the emergency department to be transferred to the wards within one hour.


NSWNMA Bathurst branch secretary Cathy O’Neil

“MANAGEMENT WILL NOW BE HELD ACCOUNTABLE TO THE PEOPLE OF BATHURST.” – CATHY O’NEIL The bans were part of a plan to handle surge beds in the medical and surgical wards.The surgical ward also lost five beds earlier this year. Cathy said the bans aimed to ensure the people of Bathurst got the care they deserve. “The community expects a certain level of care and our members want to

make sure they get it. We will not open beds without the right number of staff.” If more than two patients are awaiting transfer from the emergency department, branch members will advise that the emergency department is on by-pass. The maternity ward will not accept any non-obstetric patients and theatre will not operate on patients without a staffed

post-operative bed available in the facility. Previous action by Bathurst nurses helped to force the Western NSW LHD to scrap a plan to drastically cut nurse numbers in the intensive care unit. Following public outrage, management promised to quarantine the ICU from staff cuts and commissioned an external review of all hospital services. THE LAMP FEBRUARY 2014 | 15


COVER STORY

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All eyes on decisionmakers The politicians and bureaucrats who will decide the fate of Bathurst Base Hospital are under unprecedented scrutiny following a strike by nurses. A STRIKE BY NURSES AND MIDWIVES at Bathurst Hospital has prompted Bathurst Regional Council to form a health watch committee while community leaders have established a health forum to bring together hospital stakeholders including the local branch of the NSWNMA. “The strike has benefited us in so many ways,” NSWNMA branch secretary Cathy O’Neil said. “Management will now be held accountable to the people of Bathurst and surrounding area for the quality of the health service they are providing.” She said the branch also expected to be represented on the health watch committee, which was formed by a unanimous vote of Bathurst Council. Deputy mayor Ian North, who has taken up the nurses’ cause, joined with Bathurst MP Paul Toole to set up a health services forum with representatives from LHD management, health unions including the NSWNMA, pensioners and the local business lobby. The forum will reconvene to look at

the recommendations of the LHDcommissioned review of health services. The nurses’ action also forced LHD management to front a public meeting of hundreds of Bathurst residents in the lead-up to the strike. Cathy O’Neil said many residents had no idea of problems arising from staff shortages at the hospital until they heard from nurses at the public meeting. NSWNMA general secretary Brett Holmes told the meeting that nurses and midwives felt they had no choice but to go on strike, after management dismissed their concerns. Brett said the Health Minister, Jillian Skinner, also failed to respond to a plea by nurses to adequately fund the hospital to avoid service cuts. “We are concerned that other vital hospital and health services will be cut in the Bathurst region in the months ahead,” he warned. Brett said he would write to Premier Barry O’Farrell to ask him to intervene and ensure sufficient funding for the hospital.

“WE ARE CONCERNED THAT OTHER VITAL SERVICES IN BATHURST WILL BE CUT IN THE MONTHS AHEAD.” – BRETT HOLMES

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COVER STORY

Proposed cuts in the west leave patients vulnerable Some of the most vulnerable communities in the state are threatened as the local health district takes the axe to staff numbers. NURSING HOURS COULD BE CUT AT UP to 21 rural health services in Western New South Wales under a plan to reduce the Local Health District’s (LHD) budget deficit. Nurses across the LHD have condemned the cuts, which follow the LHD’s announcement of a $19.5 million deficit for the previous financial year. LHD management is trying to sell the cuts as a necessary step to “equalise staffing levels” and promote primary care over hospital care (see story page 12). However, Acting General Secretary of the NSWNMA Judith Kiejda described the cuts as a money grab that would make it even harder for nurses to safely care for vulnerable people in remote parts of the state. “Cuts at some of these facilities will grossly compromise the delivery of safe patient care and will place people at risk,” she said. The LHD put 21 multi purpose sites and small hospitals on notice late in 2013. It said it would implement a new staffing formula at six of these facilities as a first step: Canowindra, Coonamble, Condobolin, Nyngan, Oberon and Rylstone. NSWNMA organisers Darius Altman and Margaret Burgess visited 24 western NSW hospitals late last year to brief nurses on the planned cuts and seek their opinions. In a 5000-kilometre, four-week trip, Darius and Margaret visited the 21 facilities marked for cuts plus three spared the knife because they were already badly understaffed due to unfilled vacancies. Darius said members were angry the LHD did not consult them or the NSWNMA to determine what nursing hours are required to care for their patients and residents. 18 | THE LAMP FEBRUARY 2014

Coonabarabran branch

“DOES THE WESTERN NSW LHD INTEND TO RELY ON THE GOODWILL OF NURSES TO FILL THE GAPS?” — JUDITH KIEJDA

He said nurses at every site they visited unanimously opposed the cuts. He said LHD managers at all meetings he attended said “if nothing is done to reduce costs within NSW Health, the NSW health budget will consume the entire state budget within 10 years”. The 21 affected services cover five state electorates stretching from Rylstone north to Lightning Ridge, west to Burke and south to Grenfell. Lightning Ridge and Walgett hospitals will each lose 16 hours per day of direct nursing care under management’s proposed staffing formula. Other losses include Nyngan 14 hours per day and Brewarrina MPS 12 hours per day, while Coonamble, Narromine, Gilgandra and Bourke will each lose eight hours per day.


Multiple excuses for cuts Western NSW Local Health District chief executive Scott McLachlan has put forward various explanations for why the LHD is enforcing district-wide cuts to nursing hours. These include the need to achieve “equitable staffing” and a desire to shift resources into community health care. He has also mentioned the need to reduce the LHD’s $19.5 million budget deficit. Minister for Western NSW and Barwon MP, Kevin Humphries, has blamed the “alarming and continuing trend of increased and unfunded staffing levels” for helping to create the LHD’s $19.5 million deficit in 2012-13. Nyngan branch

Mr McLachlan told the Central Western Daily the new staffing formula was aimed at achieving “equitable staffing” across 34 health services. In the Dubbo Daily Liberal Mr McLachlan said the proposed reduction of nurse hours would “see money eventually redirected to community-based care to reduce hospitalisation rates …”. In “the future” the health district would call for expressions of interest from nurses keen to develop skills needed for working in the community, he said.

Gilgandra branch

The NSWNMA is campaigning to extend safer nurse-topatient ratios from big city hospitals to facilities not yet subject to mandatory ratios, such as small country hospitals and multi-purpose services. The new staffing formula being pushed by Western NSW LHD would, on average, guarantee just over half the nursing hours per patient day (NHPPD) being sought by the NSWNMA. For example, staffing for acute patients is 4.5 NHPPD compared to 6 NHPPD under the union’s claim. The LHD formula for renal patients is 3.8 NHPPD. High care residents will get only three care hours (not necessarily nursing hours) and low care residents just two. Judith Kiejda said casual, permanent part-time and agency nurses would bear the brunt of the reduced hours. Judith says the facilities targeted for cuts are home to elderly people in small communities who need to be cared for and have nowhere else to go. “Take the example of an elderly person who has to be fed, then showered and toileted, very often by two staff members. Under this proposed staffing formula there will be many hours when patients are left alone. “Does the Western NSW LHD intend to rely on the goodwill of nurses who already work through their breaks and work unpaid overtime to fill the gaps?” Judith said the staffing formula failed to take into account the geographical isolation of many of these facilities in some of the poorest parts of the state. “People in these small towns with only one or two GPs tend to go to ED because it can be hard to get a doctor’s appointment. “And when hospitals in small communities are short staffed it’s difficult to get replacement nurses at short notice. “The situation is made worse by the LHD’s refusal to put anyone on call and to have a proper escalation plan for when things turn bad.”

Acting General Secretary of the NSWNMA Judith Kiejda said cutting acute services staff to promote a so-called primary care health model was “putting the cart before the horse”. “There is no attempt to boost community awareness and primary health services first, to see what impact that has on demand for hospital services. “If this is about providing alternatives to hospital admission and treatment, why is the LHD also cutting staff from high and low-care residences?” She said the “equitable staffing” argument was flawed because the affected health facilities cover such a wide geographical area and serve very different communities. “Some of these facilities serve big Aboriginal communities and also farmers who have been battling drought for 10 years. They must deal with severe physical and mental problems associated with high levels of drug and alcohol abuse and violence.”

“IF THIS IS ABOUT PROVIDING ALTERNATIVES TO HOSPITAL ADMISSION AND TREATMENT, WHY IS THE LHD ALSO CUTTING STAFF FROM HIGH AND LOW-CARE RESIDENCES?” —JUDITH KIEJDA THE LAMP FEBRUARY 2014 | 19


COVER STORY

State Government hell bent on undermining your pay The O’Farrell Government is relentless in its efforts to deny nurses and midwives their right to a modest 2.5% pay rise. IN THE WEEK BEFORE CHRISTMAS, WHEN we celebrate the birth of one of the original champions of social justice, the O’Farrell Government unleashed a campaign to deny nurses and midwives the right to their full 2.5% wage increase. The NSW Industrial Relations Commission (IRC) had just decided in favour of a union application to give public sector workers, including nurses and midwives, the full 2.5% wage increase – originally set out in the O’Farrell Government’s own wage policy. Since May last year the state government has tried to discount this promised 2.5% pay increase by 0.25% to pay for the increase to the Superannuation Guarantee legislated by the federal government. NSW unions successfully argued that the 2.5% should not be discounted and the IRC agreed, awarding the full 2.5% in June last year. That decision was upheld before Christmas, leading to a concerted three-pronged attack by the state government, launched on Christmas Eve, to undermine the IRC’s decision: • Firstly, the O’Farrell Government tried to stymie this decision with yet another appeal.The IRC threw out its feeble arguments. • Secondly the government signalled it would appeal the full 2.5% increase in the Supreme Court of NSW.This hearing will be heard in February.

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“THIS GOVERNMENT’S CONTEMPT FOR NURSES, PUBLIC SECTOR WORKERS, OUR PARLIAMENT AND THE INDEPENDENT INDUSTRIAL UMPIRE KNOWS NO BOUNDS.” — BRETT HOLMES

• Finally, the government has reintroduced a regulation that would overturn the IRC decision. An initial attempt to subvert the pay increase by regulation was defeated in the Upper House last year. NSWNMA General Secretary Brett Holmes says the government has become obsessive about obstructing a modest pay increase to nurses, midwives and other public sector workers. “The O’Farrell Government’s aim is to limit your wage to 2.27% per annum from 1 July 2013. NSW Health is already paying this amount as a fait accompli in defiance of your legal right to the whole 2.5%, determined on more than one occasion in the NSW Industrial Relations Commission. “Last year the government sought to use its massive majority in the state parliament to throw out the independent umpire’s decision and pass a regulation overturning it.This arrogant attempt to move the goal posts was soundly defeated in the Upper House. Without any shame, it is now attempting to bulldoze the same regulation through Parliament again. “This government’s contempt for public sector workers, our Parliament and the independent industrial umpire knows no bounds,” he said.


“Huge” union win over electoral funding The High Court has overturned laws introduced by the New South Wales government that put a cap on the total amount an organisation could spend on political advertising and related election material.

THE LAWS ATTACKED “COMMUNITY GROUPS AND CHURCH GROUPS WHO DISSENTED THE GOVERNMNENT’S POSITION ON A RANGE OF ISSUES” — MARK MOREY Responding to a challenge by Unions NSW and four unions – the AMWU, the TWU, the USU and the NSW Teachers Federation – the High Court found the laws were invalid because they breached the implied freedom of political communication enshrined in the constitution.

RALLY TO SAVE MEDICARE The Abbott Government wants to charge $6 for all GP visits, with the possibility of extending the charge to emergency room visits. The NSWNMA is supporting a campaign against this attack on universal healthcare, part of Tony Abbott’s broader agenda of attacks on public services. The government has already threatened Aboriginal legal services, the roll out of the National Disability Insurance Scheme and funding for education. It is considering privatising the HECS (HELP) scheme, Australia Post and Medibank. An attack on healthcare is an attack on worker’s rights. It’s time to come out and demand a free, fully funded healthcare system. Join the rally at 1pm, Saturday February 15, at Sydney Town Hall, to say “no!” to Tony Abbott’s attacks on Medicare. The rally’s demands are: • No fees for GPs • A free and fully funded healthcare system • No privatisation or cuts Join the NSWNMA contingent at the February 15 rally and take a stand against Abbott’s attacks on public services.

Visit the Facebook page here: www.facebook.com/events/206825719520826

The court also revoked a law that banned corporations and associations from making political donations in state and local government elections. Unions NSW Assistant Secretary Mark Morey said “the court has spoken very loudly to confirm people have the right to come together, to put their money together and to participate in the political process”. He said the laws attacked “community groups and church groups who dissented the governmnent’s position on a range of issues”. NSWNMA General Secretary Brett Holmes welcomed the decision: “The government’s laws restricted our ability to campaign in support of our members’ interests. “They reflected a worrying trend by political parties of all persuasions to restrict the power and influence of individuals and groups to examine, analyse and criticise governments. “They want to preserve the field for politicians and parties to control the flow of information – or misinformation – to the electorate at large. “The Association has always maintained that the best course of addressing concerns about the influence of money upon politicians and political parties is by way of full disclosure.”

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PRIVATISATION

People power stops privatisation! The Queensland government backed down in the face of a concerted public campaign to keep the management of a new hospital in public hands. THE NEWMAN GOVERNMENT IN QUEENSLAND has back flipped on a plan to privatise the management of the new Sunshine Coast University Hospital.The $1.8 billion hospital will be publicly managed by Queensland Health, using Queensland Health clinical staff. The hospital is due to open in 2016 with 450 beds and a clinical staff of 2500. It has the potential to expand to 738 beds by 2021. The government backed down following a concerted campaign by the Queensland Nurses Union (QNU) that garnered strong public support. The campaign included an advertising campaign, community rallies and a major petition. QNU secretary Beth Mohle says the government has made the right decision in line with overwhelming evidence that shows privatised public hospitals are either more expensive to run, lead to reduced services or eventually require the introduction of patient fees, as private operators cream a profit margin off the contract payment. “The state government should abandon the costly privatisation idea and just get on with keeping Queensland’s great free public hospital system strong,” she said. “Privatisation would have turned back decades of achievement by our parents and grandparents, who built our public hospital system – often in the face of determined opposition from powerful vested interests in the private sector. “Congratulations to everyone, including local nurses and midwives, involved with the Sunshine Coast campaign against the privatisation of the new hospital. This has not only saved the Sunshine Coast from a substandard outcome, it has saved all of Queensland from a dangerous precedent.” Queensland Health Minister Lawrence Springborg told the Sunshine Coast Herald that the decision for clinical services to remain inhouse was based on value-for-money. He said analysis had determined that the private sector offer was unable, at this time, to match the capacity of the public sector. 22 | THE LAMP FEBRUARY 2014


Privatisation of health a Queensland vote changer Privatisation of the Queensland health system is the number one issue for voters in a state by-election, according to a Lonergan Research poll. Of those polled 22% said “privatisation and outsourcing of the public health system” was the most important issue in their voting decision and another 59% said it was one of several issues important to them. More than half (59%) said they thought Campbell Newman’s LNP government had made the state’s health system worse. Only 23% thought the LNP government, elected in a landslide victory in 2012, had made the health system better. The by-election in the bayside seat of Redcliffe, just north of Brisbane, was triggered when former LNP MP Scott Driscoll was forced to leave state parliament and fined $90,000 for being dishonest about his business dealings.

ONLY 23% THOUGHT THE LNP GOVERNMENT, ELECTED IN A LANDSLIDE VICTORY IN 2012, HAD MADE THE HEALTH SYSTEM BETTER. Maitland next on privatisation push? The New South Wales government has refused to rule out that the new Lower Hunter Maitland hospital could be privately run and operated. Last year the government announced the private sector would construct and run the new Northern Beaches hospital at Frenchs Forest. The new Hunter facility, to be built at Metford, is planned to become the main hospital for the rapidly growing Maitland city. It will also service Port Stephens and Raymond Terrace. Acting NSW Health Minister Kevin Humphries told the Newcastle Herald he would not rule out that a private partnership was a possibility. “It is too early to know what the procurement model for the Lower Hunter hospital will be,” he said. “All options will be considered.” A Health Infrastructure spokeswoman told the Herald “the next phase of planning will determine the clinical and support services required for the new hospital. All procurement models will be considered during the subsequent phases of planning.”

THE LAMP FEBRUARY 2014 | 23


INDUSTRIAL

Better deal for SOS nurses A substandard WorkChoices agreement covering a group of home care nurses in Tamworth has finally been replaced with a better agreement. ABOUT 100 HOME CARE NURSES HAVE finally got an enterprise agreement with guaranteed pay increases, after the NSWNMA fought and won several court cases on their behalf. The agreement covers nurses employed by Tamworth-based SOS Nursing and Home Care Service, who travel in their own cars to visit clients at home. “These nurses have been stuck on miserable WorkChoices conditions since the dying days of the Howard Government in August 2007,” Acting General Secretary of the NSWNMA Judith Kiejda said. The new enterprise agreement includes three wage increases of 2.75% over the next three years. It includes provisions to allow employees – all currently casuals – to convert to

“THESE NURSES HAVE BEEN STUCK ON MISERABLE WORKCHOICES CONDITIONS SINCE THE DYING DAYS OF THE HOWARD GOVERNMENT.” — JUDITH KIEJDA permanent employment. It also guarantees minimum shifts in line with awards. Previously there was no minimum shift period meaning nurses could be asked to work for as short a time as 30 minutes. There is also an explicit provision for payment for time spent travelling between clients – an issue the NSWNMA and SOS Nursing have battled over since 2007. The union went to the Fair Work Commission on behalf of SOS nurses in

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2013 after the company finally moved to replace its WorkChoices agreement. Judith Kiejda said that because the company’s replacement agreement was marginally better than the WorkChoices deal, employees voted for it. But it was still inferior to the award, which is regarded as the bare minimum standard. The Association challenged the agreement in the Fair Work Commission, arguing that it failed to meet the “better off overall” test designed to ensure that agreements are at least as good for workers as their award. The commission upheld the Association’s case and asked SOS Nursing to improve the agreement. Instead the company walked away from the proposed agreement, leaving nurses on the old WorkChoices agreement. “The only way to get rid of a WorkChoices agreement is to replace it with a new agreement or to terminate it,” Judith said.“So we went back to the commission to ask it to terminate the WorkChoices agreement, and called two SOS nurses as witnesses to give evidence about their sub-standard conditions. “The commission agreed to terminate the WorkChoices deal, which forced the company to come up with a new enterprise agreement or move to the award. “SOS then offered an improved agreement which employees endorsed in a secret ballot. “During the second ‘better off overall’ test, the union argued the agreement should be further improved, especially with regards to weekend penalty rates.This time, SOS came to the party and made the changes and the enterprise agreement has come into force.”


Branch president Gillian Turnbull with branch secretary Christopher Parker.

Lismore nurses reject staff cuts Patients will suffer if plans to reduce staff levels in a mental health unit go ahead.

“PATIENT CARE AND SAFETY WILL DEFINITELY BE COMPROMISED IF STAFF NUMBERS ARE FURTHER REDUCED.” — GILLIAN TURNBULL

MENTAL HEALTH NURSES AT LISMORE BASE Hospital voted to close beds and start work bans if management moved to cut staff in the mental health unit. The Lismore mental health branch of the NSWNMA took the decision after management announced that staffing would be reduced. A unanimous resolution from the mental health branch said it was unsafe for patients and staff to treat the three mental health units as a single 40-bed operation. The resolution advised that if staffing was reduced as management planned, nurses would have no choice but to protect patients by closing beds to match staff numbers provided. If beds were already full nurses would apply work bans to a range of non-clinical tasks that would not affect patient safety. The bans would remain until patients had been discharged and beds could be closed.

“We are a very busy unit with high acuity and at times it is quite difficult to provide the specialised care that our clients require,” said branch president Gillian Turnbull. “Patient care and safety will definitely be compromised if staff numbers are further reduced. “This is a very serious issue for both nurses and our patients. Management’s plan to reduce staff numbers will have a significant negative impact on all concerned. “Nursing staff do not agree that their work can be carried out safely with the number of nurses management intends to provide.” Gillian said union representatives had met management several times to try to reach a solution, without success. The dispute was before the NSW Industrial Relations Commission at the time of writing.

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NSWNMA EDU Appropriate Workplace Behaviour – 1 Day TARGET GROUP: c c c c MEMBERS NON-MEMBERS Are you meeting your CPD requirements? – ½ Day TARGET GROUP: c c c c c c c c c c MEMBERS NON-MEMBERS Legal and Professional Issues for Nurses and Midwives – ½ Day TARGET GROUP: c c c c c c c c c c MEMBERS NON-MEMBERS

Practical Strategies to Manage Stress and Prevent Burnout – 1 Day TARGET GROUP: c c c MEMBERS NON-MEMBERS Tools in Managing Conflict and Disagreement – 1 Day TARGET GROUP: c c c MEMBERS NON-MEMBERS Aged Care Nurses Forum – 1 Day TARGET GROUP: c MEMBERS NON-MEMBERS Mental Health and Drug and Alcohol Nurses Forum – 1 Day TARGET GROUP: c MEMBERS NON-MEMBERS Enrolled Nurses Forum – 1 Day TARGET GROUP: c MEMBERS NON-MEMBERS

SPECIAL EVENT Environmental Health Seminar Friday 14 March, NSWNMA, Waterloo MEMBERS $50 NON-MEMBERS $75


ucAtioN cAleNdAr policy and guideline Writing – 1 Day

Basic Foot Care for Nurses – 2 Days

TargeT group: all nurses and midwives c Thursday 6 March, Parramatta c Thursday 26 June, Gymea c Thursday 13 November, Waterloo MeMBers $85 NoN-MeMBers $170

TargeT group: RNs, ENs and AiNs c Thursday 1 & Friday 2 May, Coffs Harbour c Wednesday 25 & Thursday 26 June, Albury c Wednesday 20 & Thursday 21 August, Newcastle c Wednesday 29 & Thursday 30 October, Ballina MeMBers $203 NoN-MeMBers $350

Computer essentials for Nurses and Midwives – 1 Day TargeT group: all nurses and midwives c Wednesday 2 April c Wednesday 7 May c Wednesday 18 June c Wednesday 6 August VeNue: Prince of Wales Hospital, Randwick MeMBers $85 NoN-MeMBers $170 practical, positive Leadership – 3 Days TargeT group: all N/MUM, CNS, CNC, Educators c Wednesday 16 April, Monday 12 May, Monday 9 June; NSWNMA, Waterloo MeMBers $250 NoN-MeMBers $400 Leadership series for senior Nurse Managers and DoNs – 2 Days TargeT group: all DONs and SNMs c Wednesday 6 August & Wednesday 10 September; NSWNMA, Waterloo MeMBers $250 NoN-MeMBers $400 Leadership skills for the aged Care Team – 4 Days TargeT group: all aged care nurses c Wednesday 7 May, Monday 16 June, Wednesday 23 July, Monday 25 August; Parramatta MeMBers $320 NoN-MeMBers $480

ethical Leadership and Decision Making – 1 Day TargeT group: all nurses and midwives c Friday 4 July, NSWNMA, Waterloo c Wednesday 10 September, Parramatta MeMBers $85 NoN-MeMBers $170 aged Care seminar series – 1 Day TargeT group: RN, EN, AiN c Wednesday 12 March, Tweed Heads c Friday 20 June, Parramatta c Thursday 28 August, Batemans Bay MeMBers $75 NoN-MeMBers $170

regIsTraTIoN registration form is available from

www.nswnma.asn.au/ education/education-calendar For additional courses & enquiries contact NsWNMa Metro: 8595 1234 or rural: 1300 367 962


ORGANISING

Learning how to talk to each other At the heart of organising is the simple idea of building a community where people learn how to talk to one another, suggests US activist Maribeth Larkin.

DICTIONARIES DEFINE THE VERB “organise” as an action to form parts or elements of something into a structured whole. For Los Angeles based Roman Catholic nun Maribeth Larkin, organising is a passion and a career. Maribeth was in Australia to mentor members of the Sydney Alliance, a network of 52 member institutions. The Sydney Alliance provides training and mentoring so that individual groups are able to form coalitions representing different political, geographic, economic and cultural strata of society, in order to exercise power for the common good of their community. The NSWNMA is a founding member. As a social worker and a nun in the Benedictine order of the Roman Catholic Federation of the Sisters of Social Service Los Angeles, Maribeth saw 28 | THE LAMP FEBRUARY 2014

early on in her career the limitations of institutions working alone. Her job was to attend welfare offices with clients to whom the system was impenetrable and unhelpful. “Because I’m white, from the church and a professional social worker I was recognised as somebody who counts and needs to be paid attention. Whoever was with me felt relieved but also very aware they didn’t have that kind of standing. I was very uncomfortable with that aspect of my work.” This was in 1976, a time when many churches, schools and labor unions in Los Angeles were talking about combining their power to challenge institutions that had become insensitive to the impact they had on their clients. “That made sense to me and I started to think ‘why doesn’t our church become

part of this so we’re not just doing the emergency crisis charity work.” OneLA, an organisation of 65 different organisations, was founded in 2004. Since then it has created the LA Mortgage Modification Program, using up to $10 million in federal funds to develop principal reduction strategies to save homes and communities. Other achievements include educating students who would otherwise fail high school maths and assisting more than 500 families to receive permanent modifications, allowing them to stay in their homes. This year OneLA has smoothed the path to enrolment of 20,000 people into ObamaCare, America’s Affordable Care medical insurance for low-income people. It has educated them on what is required to enrol and set up a system to immediately check and challenge


“That’s always the problem in politics, you can win once but it’s going to be back around. So you want to win big when you win so you stave off that possibility.”

rejections, 99% of which it knows will be made through computer error. OneLA (onela-iaf.org) is an affiliate of Industrial Areas Foundation (IAF www.industrialareasfoundation.org) America’s oldest network of local faith and community-based organisations, made up of religious congregations, nonprofits, civic organisations and unions. It operates in the US, UK, Germany, Canada and Australia. Maribeth was in Sydney in her role as a senior organiser with IAF. She says the first question Sydney Alliance members need to answer is “how do we get those folks like [NSW Premier] Barry O’Farrell and others to recognise us and work with us, and not just blow us off because they think we’re a bunch of bleeding heart or bomb throwing liberals?” Her answer, of course, is to organise. “Build a community where people learn

how to talk to each other.” One of her first experiences of the power of organising was partnering with unions, health care workers, schools and congregations in a campaign to prevent the closure of emergency rooms in Los Angeles’ seven public hospitals.The reason might sound familiar to Australians — a budget crisis. “We did it with such a resounding win it hasn’t come up again. That’s always the problem in politics, you can win once but it’s going to be back around. So you want to win big when you win so you stave off that possibility.” When an unprecedented freeze in Los Angeles caused a 300-car pile up on a major freeway, and hundreds of people went to public ER departments, “It was all over the news ‘what if we were to close those hospitals?’

“I began to realise that all of us can learn to operate differently as public persons. I could do okay in an argument with a caseworker or a police officer but I didn’t see myself as having the capacity to stand before people and talk about my experience. I was too shy for that. “I found out in organising that my skills and perspective on who I am changed dramatically, and I saw myself in a series of relationships with hundreds of people and thousands of people, far less prepared for public life than I was, by education and by experience, who were gaining the confidence to stand up for themselves and become actors in public life. “That’s what I love about organising, it teaches us to take ourselves seriously and learn skills and capacity to build relationships across the things that divide us in society.” THE LAMP FEBRUARY 2014 | 29


WORKERS COMPENSATION

Useful, diligent, experienced, expendable Pat Towells has 30 years experience working with elderly people, 20 of those in the service of her last employer. But despite demonstrating a capacity to fulfill a multitude of suitable duties she was shown the door after suffering a workplace injury.

Pat Towells

30 | THE LAMP FEBRUARY 2014

ASSISTANT IN NURSING PAT TOWELLS WAS on night duty with a lone RN on shift, carrying out a routine task, when she suffered an injury that was to devastate her life. “We were using a slip sheet. I went to pull it and she pulled it as well so I went forward instead of backwards and I fell on the resident. It was like someone stuck a knife in me. The pain ran right down my back,” she said. “I worked the rest of the shift then went home and had the next day off. On a Sunday morning it hit me and down I went. I woke up screaming with pain. I saw the doctor when I could hardly move. An x-ray showed four to five vertebrae out of place.” Pat had worked as an AiN at the BUPA facility in Armidale for 20 years and was seen as a pillar of the workplace. “I had young staff asking me for advice. I was like a mother to kids who had left home and gone to university to become a nurse. I loved my work. I felt comfortable in it. I like having to deal with oldies. I’ve been handling old folks for 30 years.” Inevitably, Pat had to take time off work to recover from the injury. “I used up all my sick leave, annual leave and my long service leave of 20 years. BUPA accepted responsibility for the accident and

put me on light duties when I was ready to return to work,” she said.“I was doing office work, feeding and grooming residents, handing out meals. I was doing all sorts of things under the sun.They were even calling me in on my days off. I was useful and BUPA Armidale had plenty of things for me to do.” Then out of the blue, on 28 August, a termination notice came from the head office in Sydney. “I was devastated. I’m the only working person in the household. My husband is sick with pancreatitis. My income had been keeping both of us. Thank God we don’t owe any money. I’m not entitled to the pension so we are living off savings and my husband’s pension.” BUPA refused to reinstate Pat, despite the NSWNMA putting a list of 52 meaningful suitable duties that Pat could carry out at the facility. Her doctor also certified her as fit for suitable duties. Pat is 64 and had planned to retire in the next year or two. She is restricted by age, skills and the limitations of her rural location from finding other means to support herself and her family. “It’s hard to get another job in Armidale. There are not many jobs here. I don’t know what I’m going to do now.”


Injured workers suffering hardship and despair It’s now 18 months since the New South Wales government introduced changes to the state workers compensation scheme. Research by Unions NSW shows that the changes are deeply unpopular and catastrophic for injured workers. The survey found that: • 93% of people opposed the changes. • 92% of people opposed cuts to injured workers weekly payments after 2.5 years. • 92% opposed the removal of medical payments from injured workers one year after their weekly payments stopped. Respondents to the survey were equally damning of the changes by the government to workers compensation journey claims. 92% of people believed that workers should be covered by workers compensation when travelling to and from work. Unions NSW said the previous scheme “acknowledged the dangers that workers are exposed to when travelling to and from work. “Workers compensation claims played an important role in the NSW legislation prior to June 2012 and assisted thousands of workers to return to work as quickly as possible with the support they needed.” Unions NSW says that in the survey “injured workers wrote of the frustration they felt when told their weekly payments would be stopped. Many of these workers are now experiencing severe financial hardship, high levels of stress, and anger at a system they thought was designed to assist injured workers.” Many workers also spoke of the discrimination they face in the workplace when they declare they have a workers compensation claim. For those who experienced the discontinuation of their weekly payments, the fact that their medical payments will also cease in 12 months also causes significant anxiety and fear. The survey also revealed many stories of unbearable strain on families. “Not receiving payment while recovering from injury has strained my family financially. The strain on relationships has increased – the stress of people living with me due to my depression and anxiety that I never suffered before the injury,” said one respondent.

93%

opposed the changes to workers compensation

92%

opposed cuts to injured workers weekly payments

92%

opposed the removal of medical payments from injured workers

The main elements of the O’Farrell Government changes Limited coverage for injuries while travelling to and from work.

Cuts to weekly payments to injured workers from day one.

Stopping weekly payments for most injured workers after two and a half years.

Placing limits on medical payments for injured workers.

Preventing partners of those killed at work being compensated for nervous shock.

Eliminating access to lump sum payments for pain and suffering. In their analysis of the O’Farrell Government’s cuts to workers compensation, Unions NSW points out that the changes do nothing to address the underlying cause of the problem – unsafe workplaces. “Focusing on preventing injuries and illnesses in the first place, helping injured workers back to work and reducing the costs paid to insurers for administration is the most cost effective and equitable solution for the New South Wales government to pursue.Very little of the government’s reforms went towards preventing workplace accidents,” it says.

THE LAMP FEBRUARY 2014 | 31


TE ATATI R

Sh P

All those working in the professions of nursing and midwifery have unique stories to tell.

M W ES Y & N DA

S or y omp petitio

CONDITIONS OF ENTRY » » » » »

let’s celebrate International Midwives’ and International Nurses’ Days 2014 by sharing our stories in prose or poetry.

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HOW TO ENTER » » » » » »

DEADLINE Entries close 5 pm Frida Fridayy 21 March 2014 WINNERS W Winners inners will be notified on Monday Monday 28 April 2014.

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NURSES OVERSEAS

Helping after Haiyan When Super Typhoon Haiyan hit the Philippines it killed more than 6000 people and left 4.4 million homeless. Angie Gittus, a Clinical Nurse Specialist in emergency at the Murwillumbah Hospital, volunteered her skills in the aftermath.

34 | THE LAMP FEBRUARY 2014


“I VOLUNTEERED IN THE PHILIPPINES following Super Typhoon Haiyan with the idea that I was the one giving. Now I know that I was the one who was gifted. What I will remember most from my experience is the enormous heart of the Filipino people. The gratitude expressed to us for every little thing we did.The hospitality shown to us by people who had nothing – in some cases less than nothing – was humbling. The resilience of the people, to get up after such tragedy and keep going with life, was astounding. Their hopefulness in the face of such adversity was an inspiration. I was gifted with the amazing generosity of their spirit and I was gifted with renewed appreciation for just how incredibly lucky I am. It was two weeks since the assault of Haiyan when we finally arrived in the

small town of Basey, north of Tacloban and set up a clinic. By then, time had triaged those with severe injuries – people had either survived or perished. The main need was for primary health care: treatment for wounds and skin infections, headaches and musculo-skeletal pains, respiratory tract infections and asthma, fevers and gastrointestinal tract problems. There were clean-up injuries. A lot of cuts and puncture wounds from moving debris. Along with the supplies we brought from Australia we managed to source some tetanus vaccines and gave out all that we had. Medications such as antihypertensives, hypoglaecymic agents and ABs for TB, were needed as people’s tablets were washed away along with their homes. There were healing fractures that would have benefitted from reduction/relocation at the time of the injury and an incredible

do nothing to ease their emotional pain except listen and express our sympathy.We hugged them, we cried with them, we laughed with them and we showed them that they mattered.And although that’s not measurable, I feel it made a difference. Our team of 11 clinicians, the first of three deployments by Medical Rescue Australia, treated more than 1300 people in one week. We worked in an old school hall that miraculously had its roof intact. Each day half the team went by truck or boat to provide medical care to people unable to travel into town. It was unbelievably hot and humid and every day we put on a uniform of thick socks, boots, long sleeved shirts, long pants and hats to protect us from the rubbish and debris. We slept on yoga mats on a concrete floor and washed with a bucket of water. The conditions were rough but

angie gittus (pictured left) volunteered through medical rescue australia www.medrescue.com.au. if you want to donate, two major international ngos – médecins sans frontières australia (www.msf.org.au) and australian red cross (www.redcross.org.au) are still on the ground in the philippines.

electrocution burn (entry and exit burns) on a surprisingly alive man! One lady presented with chest pain and a cough after being struck by a falling tree during the typhoon. When trying to determine how to treat her, without x-ray, CT or pathology, we had to fall back on the skills of look/listen/feel and really think about the pathophysiology of injury. Many people came in for “blood pressure check” and after we’d attended all their obs, listened to lung fields, checked them out as A1 physically they’d disclose that they’d lost their home, a friend, or a member of their family during the typhoon. What they wanted was reassurance and understanding.They wanted to know that someone, that the international community, cared about their loss. These were the people we felt most at a loss to help.We had analgesics, antibiotics, dressings and fluids with us, but we could

I’ve never been happier to work so hard. Although it had no roof, the homeless were living in the local church under a leaking tarpaulin. Mass was still held three times a day. For the first time in my life I felt an appreciation for religion, for the strength it can give in times of hardship. The Filipino people have enormous faith. Perhaps when you have nothing the importance of something intangible like faith, that can’t be taken away from you, is amplified, and that was all a lot of them had left. In Tacloban I met a young nurse whose father we were transferring to a hospital in Cebu. We talked about lots of things but one thing she said stuck with me: “If I could give one message to the international community it would be ‘we need your support, but please give to NGOs. The only aid we’ve seen get to our people is through NGOs that deliver direct to the people’.”

PHOTO COURTESY UNION AID ABROAD–APHEDA

THE LAMP FEBRUARY 2014 | 35


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ASK JUDITH Long service leave cancelled I am an EN in a public hospital and have applied for long service leave (LSL), which was approved by the NUM. However, she is now saying that the DoN has cancelled my leave. Can this happen? Yes. As opposed to annual leave, while your NUM can support your application for LSL they do not have the delegated authority to approve it. A higher level of management, such as the DoN, must do this. While you have a right to LSL, the employer has the right to ensure services provision needs are not compromised and this is often the deciding factor in the granting of LSL. If service provision is the mitigating factor in the DoNs decision, he/she should consult with you and advise of a suitable time, as close to your request, that the period of extended/LSL can be granted and taken. If your employer will not discuss an appropriate time with you please contact the Association so we can provide further assistance.

How do I register? I am currently working as an EN and about to complete my Bachelor of Nursing program to become an RN. What do I need to do to become a Registered Nurse? Once you have obtained your qualification from your university you will need to apply to the Australian Health Practitioner Regulation Agency (AHPRA), using the application form available on their website, to become a Registered Nurse and be placed on the Register of Practitioners.

They provide a centralised web-based application process for graduate RNs and midwives for employment in NSW public hospitals and some not-for-profit private hospitals. There is a Transition to Professional Practice Handbook available on the website that outlines the application process and provides information on writing your CV and the interview process. It also includes the timeframe involved for the process.

Time in lieu for training? I am employed as a permanent part-time RN in a public hospital and have been directed to attend mandatory education on one of my days off. My manager told me I will not be paid for my attendance, however, previously we were allowed to take time in lieu when attending mandatory training. Is this no longer the case? Any nurse who is directed to attend mandatory training on a day off is considered, for the duration of the training session, to be “on duty” and should be paid as per the award provisions. The Public Health System Nurses’ and Midwives’ (State) Award 2011, clause 55, Learning and Development Leave, sub clause (i), Definitions states; “Leave is not required for the following types of employer-supported learning activities that are undertaken by employees on a routine basis, and at which employees are considered to be ‘on duty’: In-house courses or activities Mandatory training and education. Sub clause (v) further states;

The other part of the process is to apply for a Transition to Professional Practice (Graduate Nursing & Midwifery Recruitment) position via NSW Health.

“Leave approved pursuant to this clause will be paid at the employee’s ordinary rate of salary and excluding penalty rates”

www.health.nsw.gov.au/nursing/employ ment/Pages/Recruit.aspx

All payments for mandatory training should be at base rate of pay and are exclusive of penalty rates. Overtime is not payable for mandatory training.

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

Penalty rates on call? I am an RN working in the public sector and am usually rostered on-call on my days off, which are generally Saturday and Sunday. I am paid the appropriate on-call allowance for my days off; however, if I am called back to work should I be paid overtime rates or weekend and public holiday penalties? You should be paid at the appropriate overtime rates if and when you are called back to work. Clause 12, Special Allowances, sub clause (vii), part (d), of the Public Health System Nurses’ and Midwives’ (State) Award 2011 states: “An employee called out during the period of on call shall be entitled to the prescriptions of clause 25, Overtime”. Clause 25, Overtime, Sub Clause (ii) (a), further states “Subject to paragraph (b) of this sub clause all time worked by employees in excess of the rostered daily ordinary hours of work shall be overtime and shall be paid for at the rate of time and one half for the first two hours and double time thereafter in respect of each overtime shift worked or in respect of overtime worked prior to or at the conclusion of a normal shift. Provided that overtime worked on Sundays shall be paid for at the rate of double time and on public holidays at the rate of double time and one half ”. Sub clause (iii), further states, “An employee recalled to work overtime after leaving the employer’s premises shall be paid for a minimum of four hours work at the appropriate rate each time so recalled. If the work required is completed in less than four hours, the employee shall be released from duty.”

THE LAMP FEBRUARY 2014 | 37


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SOCIAL MEDIA

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

Do you have a story to tell? An opinion to share? Send us your ideas at nurseuncut@nswnma.asn.au.

WHAT’S

HOT THIS MONTH

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

Bernhard’s story – nursing at Lidcombe www.nurseuncut.com.au/bernhards-story-nursing-at-lidcombe/

Bernhard Racz began nursing in 1971 at the old Lidcombe Hospital – read his entertaining tale.

Rapid HIV testing by nurses www.nurseuncut.com.au/rapid-hiv-testing/

Timmy Lockwood, clinical nurse specialist at Sydney Sexual Health Centre, welcomes the 10-minute HIV test.

Mandala-making on Blue Knot Day www.nurseuncut.com.au/mandala-making-on-blue-knot-day/

Sarah Coconis, a mental health clinical nurse specialist, organised a creative event for adult survivors of childhood trauma.

Amanda – nurse volunteer in Cambodia www.nurseuncut.com.au/amandas-story-a-nurse-volunteer-in-cambodia/

Amanda tells of her humbling experience volunteering in a Siem Reap clinic.

Infant formula advisory group scrapped www.nurseuncut.com.au/infant-formula-advisory-group-scrapped/

The Abbott Government has scrapped the advisory group on the marketing of infant formula – leaving new mothers exposed.

Philippines typhoon – nurses respond rapidly www.nurseuncut.com.au/philipines-typhoon-nurses-respond-rapidly/

RNRN (the RN Response Network) was just one of the avenues for rapid response to the disastrous typhoon in the Philippines.

New on SupportNursesYouTubechannel bathurst nurses and community fight cuts A strike and a public forum attract strong community support. youtu.be/Q-ljWZPQAwY nswnma at medicare rally Annie Butler speaks at the January rally to defend Medicare. > youtu.be/Ut5Vvstuk80

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 FEBRUARY 2014 | 39


Make your voice heard

Be part of the ‘Fit for the future’ Survey Nurses are the biggest professional group in the Australian health workforce, and the main providers of health care and health education for the Australian community. But what do we know about nurses’ and

midwives’ health? We know the Australian population is ageing, and the profile of the Australian nursing and midwifery workforce is ageing with it. We expect increasing chronic disease in the community as our population ages, but what about the health of nurses and midwives? How fit and healthy are we now? And what could we do to promote healthy lifestyles and healthy futures for nurses and midwives? An innovative project led by Lin Perry, Christine Duffield and Robyn Gallagher at the University of Technology, Sydney, partnered by the NSW Nurses and Midwives’ Association and funded by the Australian Research Council, sets out to answer these questions. Look out for a survey coming your

way early in the New Year, and be part of it. For more information on the Fit for the future: safeguarding the health and well-being of the Australian nursing workforce to sustain future healthcare service delivery study, please contact the NSWNMA  85951234 (metro) or 1300 367 962 (non-metro)  gensec@nswnma.asn.au


SOCIAL MEDIA

WHAT

Keep me logged in

Forgot your Password?

NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Gilgandra nurses unite Gilgandra members were told their hours were to be drastically cut to meet the LHD budget.

Great to see Gil nurses united. Unity and community support prevented Cobar Hospital suffering the total cuts originally proposed by the LHD.

Not happy in Narromine Narromine nurses are unhappy with the LHD proposal to remove eight hours of clinical nursing.

Home Care Service The Home Care Service in NSW is to be privatised – more privatisation by stealth! Aged care training review A major review of aged care training criticised cheap, short courses.

Accept the wage increase Premier! The NSW Industrial Commission ruled in favour of the 2.5% wage increase for public sector nurses and midwives. We declared time for the O’Farrell Government to accept that decision. Medicare threat Medicare is under threat, with the federal government floating ideas about a GP copayment.

Management will engage top professionals to assess how they can cut costs – then they will ignore their advice and always cut nursing and doctors.

I don’t think the public are truly aware of the ramifications of this nasty development. You mean overpriced short courses? Hope they stop the Cert III Aged Care as a mandatory course for people on Centrelink benefits. It takes a very dedicated person to do this job well. Not just anyone can do it! :) You’re so right. Centrelink and JSAs push completely unsuitable people into these courses, it’s a way of meeting their C/L requirements and the JSAs make a profit. I’ve heard some doozies come out of the mouths of students that were just completely inappropriate for the job: “We don’t have to, like, touch them do we?” *facepalm!* It’s a hell of a hard job and I’ve told plenty of unsuitable students if they think they’re there for the money or the praise, than they’d be better off stacking shelves. Add on top of that these ridiculous three-week courses, run by sub-par RTOs don’t even require any placement hours! The O’Farrell Government will more than likely hold an emergency session and change the state law again to force the NSW Industrial Commission to accept their views. Pathetic! No respect for the very people employed in essential services … without them our society would be in a shambles! We have one of the best health systems in the world when people really need help. Adding a fee to GP visits will only increase the waiting time in emergency. I am an Australian based in the UK and the Conservatives over here are doing the same. The world is apparently a welfare state for the rich. And those same rich are using double-speak to lay blame on the poor. I have paid taxes all my life and never begrudged spending on health (I’d like to see free dental too), education, transport, the arts, etc. Maybe cut back on politicians and their wages, especially now they have sold off most of our assets.

Cuts across the west Cuts to nursing hours are happening right across western NSW. 2.

1. Lightning Ridge, 2. Coonabarabran 3. Nyngan,

Medicare is held up as an exemplary system worldwide; privatise health and we will see the worst of what human despair can be. It’s astonishing what one human can do to another when they can’t afford to have their child’s illness treated, or when they have watched a loved one die unnecessarily. This frustration and anguish leads to a very angry and embittered society. Take one look at the United States. The trouble is that the system is so abused by its consumers. It’s very sad. We don’t understand just how lucky we are to have free healthcare. I don’t think it is abused, some people who shouldn’t be at the doctor (e.g. people with the flu) have to go to get a medical certificate for their employer in order to have their sick leave paid. Really, more an issue with how industrial law is written. THE LAMP FEBRUARY 2014 | 41


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Across 1. Pertaining to the stomach and intestine (16) 9. The upper part of a fraction (9) 10. Performs surgery on (8) 11. Exists as the cause of the properties of a body (7) 13. Obstruction (8) 15. US unit of weight (5) 17. Tending to repair (10) 18. Antidiuretic hormone (1.1.1) 19. A tumor marker associated with prostate cancer (1.1.1) 20. To evaporate (10) 22. Tickle (9) 23. The upper edge of a basin (4)

25. Intestine (3) 27. The process of becoming accustomed to a new environment (11) 30. Tricuspid stenosis (1.1) 31. Pimples (4) 32. Equilibrium (7) 34. A condition of temporary cessation (10)

Down 1. Excessive growth of the male breast (13) 2. Produced by chemical manipulation of naturally occurring substances (13) 3. Cause to perform again (5) 4. Induction chemotherapy (1.1.1) 5. Inflammation of a vein associated with thrombus formation (16) 6. Albuminoid (13) 7. Rendering neutral (12) 8. A workplace for conducting of scientific research (4) 12. Exudes from or pass out of a vessel into the tissues (12)

14. Any of the primary parts or constituents of a thing (7) 16. Dismissals, displacements, disqualifications (10) 21. Occupational therapy (1.1) 24. Reactive oxygen species (1.1.1) 26. A less common name for urticaria (5) 28. Gonorrhoea (4) 29. An acronym for the major dietary antioxidants (4) 33. The symbol for the element iron (2)

THE LAMP FEBRUARY 2014 | 43


NURSING RESEARCH ONLINE

Bangladesh, the eighth most populous country in the world, has recently been applauded as an exceptional health performer. Improvements in the survival of infants and children under 5 years of age, life expectancy, immunisation coverage, and tuberculosis control are part of a remarkable success story for health in the South Asian country. This despite low spending on health care, a weak health system, and widespread poverty. But this nation of about 153 million people still faces considerable problems, including deep poverty and malnutrition, and this is being exacerbated by an evolving set of 21st century challenges. A six-part series published in The Lancet (www.thelancet.com) takes a comprehensive look at the challenges that lie ahead as Bangladesh moves towards universal health coverage. especially investment in community health workers using a doorstep delivery approach; (2) experimentation with informal and contractual partnership arrangements that capitalise on the ability of nongovernmental organisations to generate community trust, reach the most deprived populations, and address service gaps; and (3) rapid adoption of context-specific innovative technologies and policies that identify country-specific systems and mechanisms. www.thelancet.com/series/bangladesh

Bangladesh: Innovation for Universal Health Coverage The Bangladesh paradox: exceptional health achievement despite economic poverty Prof AMR Chowdhury, Prof Abbas Bhuiya, ME Chowdhury, Sabrina Rasheed, Zakir Hussain, Prof LC Chen. Bangladesh has recently been applauded as an exceptional health performer. We present evidence to show that the country’s success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality, alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highlyfocused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health: positives such as the empowerment of women, widespread education, and mitigation of the effect 44 | THE LAMP FEBRUARY 2014

of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints. www.thelancet.com/series/bangladesh

Community-based approaches and partnerships: innovations in healthservice delivery in Bangladesh Shams El Arifeen, Aliki Christou, Laura Reichenback, Ferdous Arfina Osman, Kishwar Azad, Khaled Shamsul Islam, Farugue Ahmed, Henry B Perry, David H Peters. Rapid advancements in coverage of many health interventions have coincided with impressive reductions in fertility and rates of maternal, infant, and childhood mortality. These advances, which have taken place despite such challenges as widespread poverty, political instability, and frequent natural disasters, warrant careful analysis of Bangladesh’s approach to health-service delivery in the past four decades. With reference to success stories, we explore strategies in health-service delivery that have maximised reach and improved health outcomes. We identify three distinctive features that have enabled Bangladesh to improve health-service coverage and health outcomes: (1) experimentation with, and widespread application of, large-scale community-based approaches,

Alayne Adams, Tanvir Ahmed, Shams El Afifeen, Timothy Evans, Tanvir Houda, Laura Reichenback. A post-Millennium Development Goals agenda for health in Bangladesh should be defined to encourage a second generation of health-system innovations under the clarion call of universal health coverage. This agenda should draw on the experience of the first generation of innovations that underlie the country’s impressive health achievements and creatively address future health challenges. Central to the reform process will be the development of a multi-pronged strategic approach that: responds to existing demands in a way that assures affordable, equitable, high-quality health care from a pluralistic health system; anticipates health-care needs in a period of rapid health and social transition; and addresses underlying structural issues that otherwise might hamper progress. A pragmatic reform agenda for achieving universal health coverage in Bangladesh should include development of a long-term national human resources policy and action plan, establishment of a national insurance system, building of an interoperable electronic health information system, investment to strengthen the capacity of the Ministry of Health and Family Welfare, and creation of a supra-ministerial council on health. Greater political, financial, and technical investment to implement this reform agenda offers the prospect of a stronger, more resilient, sustainable, and equitable health system. www.thelancet.com/series/bangladesh


and go in the draw to

r e b m e m w e n a it Recru

Get lost in Singapore

Are Are your workmates or friends members of the NSWNMA? Why Why not ask them. And, if not, invite them to sign up. up. Like Like you, they need the security of belonging to a strong and dynamic dynamic union. Not only will you be building your union by by signing up new members, you and a friend could win this Singapore. e. The more more members fabulous holiday to Singapor up,, the mor moree cchances have you sign up hances you ha ve to win! airfares twoo The prize includes rreturn eturn airfar es for tw from Sydney with Scoot Airlines; 5-nights Shangri-La accommodation at the Shang ri-La Hotel, Singapore; Attractions Singapor e; Attr actions Pass for 2; and taxi transfers tr ansfers from airport rreturn. eturn. Remember ffor or every every new member you recruit/ha recruit/have ve recruited from 1 Jul Julyy 2013 to 30 June 2014 means you will ha have ve your name submitted to the dra draw. w.

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

An ever ever-changing -changing city, city, Singapore Singapore offers offers a diverse mix of experiences ffor or you to enjoy this lush, modern and vibrant destination destina tion at at your own pace. The recentl recently-opened y-opened Gardens bbyy the Bay Bay is a sight to behold. Home to a-quarter a-quarter-of-a-million -of-a-million rare plants and a plethora of buzzing activities, it promises an all-encompassing experience for for the whole famil family. y. After the sun sets, don’t miss the sky show of dazzling lights and sounds in the OCBC Garden Rhapsody, Rhapsody, which takes place nightlyy amidst the Supertrees. We’re nightl We’re certain sleep will be the last thing on your mind with all the new and exciting things that that are way. www.yoursingapore.com/getlost coming your wa y. Go to www .yoursingapore.com/getlost w.yoursinga . Located city,, Shang Shangri-La Singapore Loca ri-La Hotel, Singa pore is just ted in the heart of the city city’ss main shopping, entertainment and dining a short walk to the city’ district. The hotel is well situated Singapore’s extensive situated within Singapore’s network of buses and trains, and it is only only a 10-minute drive to the CBD and 30 minutes to Changi Changi International International Airport. Contact www.shangri-la.com/singapore www.shangri-la.com/singapore Australia’ss newest low cost airline flying direct to Introducing Australia’ Singapore pore from Sydney Sydney and the Gold Coast. If you are looking Singa effective save ffor or the most cost ef fective way way to Asia, fly scoot and sa ve loot. www.flyscoot.com Book now aatt www .flyscoot.com


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BOOKS

BOOK ME Chronic Illness and Disability: Principles for Nursing Practice (2nd ed.)

Compact Clinical Guide to Critical Care, Trauma, and Emergency Pain Management: An Evidence-Based Approach for Nurses Liza Marmo and Yvonne M. D’Arcy Springer Publishing www.springerpub.com RRP $55.63 ISBN 9780826108074

Esther Chang and Amanda Johnson Churchill Livingstone (available through Elsevier Australia) www.elsevierhealth.com.au RRP $84.09 ISBN 9780729541619

This book is for the health care professional that cares for patients in critical care, trauma and emergency room settings. It provides some basic concepts on pain and pain medications, then focuses on specific types of pain such as abdominal and chest pain. Useful case studies are provided. Both pharmacological management therapies and non-pharmacologic interventions are included along with information about pain assessment screening tools for special populations.

Nurses in Australia are increasingly caring for people with chronic disease and disability, across a range of settings. This text to provides the holistic framework, principles of practice and models of care for nurses caring for individuals and families experiencing chronic illness and disability. This new edition provides diverse, supportive evidence in the areas of major and common chronic illness and disability, including heart disease, stroke, cancer, asthma, diabetes, obesity, dementia, mental illness and palliative care.

Doing a Research Project in Nursing and Midwifery: A Basic Guide to Research Using the Literature Review Methodology

Dementia Support for Family and Friends

Carroll Siu and Huguette Comerasamy SAGE Publications (through Footprint Books) www.footprint.com.au RRP $51.95 ISBN 9780857027481 This is a basic text that guides undergraduate and postgraduate students through their research projects. Though aimed at nursing and midwifery students, the principles of the comprehensive literature review methodology can be adopted across other disciplines and professions. Each chapter consists of a set of goals to achieve, as well as visual representations in the form of figures, flowcharts and tables that complement theoretical discussions in the text.

Dave Pulsford and Rachel Thompson Jessica Kingsley Publishers (available through Footprint Books) www.footprint.com.au RRP $33.95 ISBN 9781849052436 Written specifically for friends and relatives of people with dementia, this book explores each stage of the condition and explains not only how it will affect the person with the condition, but also those around them, and how best to offer support and where to get professional and informal assistance. The content is derived from the authors’ experiences as practitioners, teachers and researchers in the field of dementia. They also bring in the voices of family members and friends of people with dementia, who have offered their own experiences for caring for and supporting someone with dementia.

SPECIAL INTEREST Anne Summers Conversations Presents Julia Gillard: Australia’s First Female Prime Minister (DVD) Anne Summers Reports Pty Ltd j annesummers.com.au RRP $29.95 In her first interview since losing the leadership of the Australian Labor Party in September 2013, Julia Gillard appeared on stage at the Concert Hall of the Sydney Opera House before a sold-out audience and engaged in a candid conversation with editor and publisher Anne Summers. She spoke about her time as Australia’s first woman prime minister and answered unscripted questions from the audience for 30 minutes. The following night, Julia Gillard and Anne Summers had another conversation before a packed Melbourne Town Hall and again Gillard answered audience questions. These two unforgettable and never-to-be-repeated conversations are shown in full on this souvenir DVD.

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 FEBRUARY 2014 | 47


MANAGING YOUR NEW YEAR DEBT.

SOME TIPS TO HELP.

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MOVIES

movies of the month

DALLAS BUYERS CLUB A great story of a flawed hero, writes Murray James. In this true story, we are immediately engaged with the escapades of Ron Woodroof (Matthew McConaughey), a Texan electrician, drug addict, and womanising hustler, who has lots of unprotected sex. Following an emergency hospitalisation he is shocked to be diagnosed as HIV positive and given a probable 30 days to live. To survive, he illegally takes the new AZT, which is soon to be approved by the Food and Drug Administration (FDA). The incorrect dosages nearly kill him, and so he finds ways to smuggle in other anti-viral medicines and supplements, which are still illegal in the USA. Seeing a business opportunity Ron establishes the Dallas Buyers Club, where people with HIV/AIDS can become members and buy these illegal medicines. He finds an unlikely ally and business partner in Rayon (Jared Leto), a transsexual who challenges his rampant homophobia. Woodroof also receives support, reluctantly at first, from local doctor (Jennifer Garner). The painted villain of the piece is the FDA, which attempts to thwart Woodroof’s enterprise. We get a picture of the community fear and prejudice that was played out in the conservative legal and political climate of the mid to late 1980s. It reminds us of how lucky we were in Australia to have more enlightened and progressive public health policies implemented by our federal government at that time. We can too easily forget that our own education programs for the gay community and IV drug users were heralded and adopted by many other countries worldwide. Canadian director Jean-Marc Vallée (Café de Flore,

METRO MEMBER GIVEAWAY Email The Lamp by the 10th of this month to be in the draw to win a double pass to Dallas Buyers Club thanks to Pinnacle Films. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win! The Young Victoria) tells a great story of an often unlikeable, flawed hero, who in real life died in 1992. Matthew McConaughey, who reportedly lost 20 kilos to look emaciated, gives an Oscar level performance as Ron Woodroof, along with a moving performance by Jared Leto. The friendship between these two unlikely characters is very entertaining. Jennifer Garner is convincing as the dedicated doctor battling politics to care for her patients. Having worked at an HIV/AIDS clinic in the early 90s, and seen many young men, friends, colleagues and patients, die of this disease, watching this film was a moving experience for me, and a reminder of a tragic chapter in our own social history, where many battled heroically. IN CINEMAS FEBRUARY 13 Murray James is an RN in the Mood Disorders Unit at St John of God Health Services, Burwood.

ARE WE OFFICIALLY DATING? Jason (Zac Efron) and Daniel (Miles Teller) are determined to support their friend Mikey (Michael B Jordan), devastated after discovering his wife has been cheating on him. In a bid to cheer him up the men make a pledge to bachelorhood. But staying single ends up being more difficult than they had imagined, especially when Jason meets Ellie (Imogen Poots). As all three friends find themselves falling for someone they resort to more and more complicated arrangements to keep their relationships secret. As they weave a twisted web around each other the three men begin to examine their relationships, not only with their partners, but also with each other. IN CINEMAS FEBRUARY 13

METRO MEMBER GIVEAWAY Email The Lamp by the 10th of this month to be in the draw to win a double pass to Are we Officially Dating? thanks to Studio Canal. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

RURAL MEMBERS DVD GIVEAWAY

email your name, membership number, address and telephone number to lamp@nswnma.asn.au by the 20th of the month to go into the draw to win a dvd! THE LAMP FEBRUARY 2014 | 49


DIARY DATES

conferences, seminars, meetings NSW National Disability Services state conference 10-11 February Sydney www.nds.org.au/events Miriam Sosin 02 9256 3133 miriam.sosin@nds.org.au Diabetes update for RNs, ENs 18-19 February Burwood Australian College of Nursing www.acn.edu.au Workshop on the Mental Health Peer Workforce 19 February Sydney www.themhs.org Trauma and the mental health workforce – summer forum 20-21 February Sydney www.themhs.org/pages/summer-forum.html Neuroscience Conference – Navigating Neuro 1 March Wollongong Jo McLoughlin 0422 418 255 Joanne.mcloughlin@sesiahs.health.nsw.gov.au The deteriorating patient – clinical decision making for RNs, ENs 4-5 March Coffs Harbour • www.acn.edu.au NSWNMA Environmental Health Seminar 14 March Waterloo Janet Roden 8595 1234 jroden@nswnma.asn.au Inflammatory Arthritis Clinical Update Day 15 March Sydney Jenny 02 9857 3300 or jly@arthritisnsw.org.au www.arthritisnsw.org.au 6th Annual NSW Health and Ambulance Darts Tournament 6 April Revesby Workers Club Paul Sillato 0424 705 778 paul.sillato@swsahs.nsw.gov.au Palliative Care Nurses Australia Conference 2014 6-7 April Sydney www.pcna.org.au/conference Turning the Tide on Continence 14 June Port Macquarie Ann 0413 992 468 jca43356@bigpond.net.au

Cr osswor d solution

Through These Lines – a play about Australian Army nurses in WW1 24 July-5 August Fort Scratchley Tunnels Newcastle www.civictheatrenewcastle.com.au Paediatric Perioperative Seminar 13 September Westmead claudia.watson@health.nsw.gov.au georgina.whitney@health.nsw.gov.au

G Y N A E C O M A S T I A

A S E U M I S S Y U N T D H E I T I C C L B A L P

ACT Infection prevention and control for RNs, ENs 25–26 March Canberra www.acn.edu.au

INTERSTATE 18th National Otorhinolaryngology Nurses’ Conference 29 March-1 April Brisbane www.ohnng.com.au/national_conference.html No 2 Bullying 2014 Conference 7-8 April Noosa www.no2bullying.org.au Personalised Pain Management – Quest for the Holy Grail Australian Pain Society’s 34th Annual Scientific Meeting 13-16 April Hobart www.dcconferences.com.au/aps2014/ National Eating Disorders and Obesity Conference 26-27 May Gold Coast eatingdisordersaustralia.org.au Cultural Diversity in Ageing 2014 Conference: Shaping Inclusive Services 12-13 June Melbourne www.culturaldiversity.com.au/conference-2014 (03) 8823 7979 Nursing Informatics Australia 2014 Conference 11 August Melbourne www.hisa.org.au/page/hic2014nia 15th International Mental Health Conference 25- 26 August Surfers Paradise www.anzmh.asn.au/conference conference@anzmh.asn.au

OVERSEAS Epidemiology and Social Psychiatry Meeting 2014 21-24 May Germany www.epa2014ulm.eu 3rd World Congress of Clinical Safety 10-12 September Spain www.iarmm.org/3WCCS/ 4th International Conference on Violence in the Health Sector 22-24 October 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

Quality legal advice for NSWNMA members c c c c c c c c c

Compensation and negligence claims Employment and Industrial Law Workplace Health and Safety Anti-Discrimination Criminal Law Free standard Wills for members Probate / Estates Public Notary Discounted rates for members including First Free Consultations for members on all matters. Offices in Sydney and Newcastle with visiting offices in regional areas (by appointment).

Call the NSWNMA on 1300 367 962 and find out how you can access this great service. 50 | THE LAMP FEBRUARY 2014

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

E S C L P E R L O P A R O A T E R I O N S F P E

T I N E U R A T R C K A L A T I S I L I N M G A A C N E N S I

A L A B E S G E L V E M S E N U T R E D O N

$15 per person includes food Colin Campbell or Warren Martin (02) 9489 5907; 0428 727 384 warrenjmartin@hotmail.com Sydney Hospital Group 791 35-year reunion breakfast 23 February Milson Point Jenny Cohen 0408 740 004 Mona Vale Hospital Golden Jubilee Reunion dinner 21 February 2014 Mona Vale Ian and Colleen Lee 02 9918 2900 iccp@arrowtech.com.au NEC Prince Henry/POW Hospitals Oct 1972-75 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



Calling all

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