The Lamp April 2014

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 71 No.3 APRIL 2014

Not-for-profit aged care campaign kicks off +

MAKING MEDICARE

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TAX JUSTICE

NURSES NEED THEIR OWN MEDICINE

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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.3 APRIL 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

COVER STORY

12 | Get ready to campaign for pay and conditions The way forward to better pay and conditions in the not-for-profit aged care sector lies with enterprise bargaining.

Christine Spangler, AiN PHOTOGRAPH: SHARON HICKEY

REGULARS

5 6 8 33 37 39 43 44 47 48 50

Editorial Your letters News in brief Ask Judith Obituary Social media Crossword Nursing research online Books Movies of the month Diary dates

YOUR HEALTH

NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258 FOR ALL EDITORIAL ENQUIRIES, LETTERS AND DIARY DATES: T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au

TAX JUSTICE

18 | Robin Hood demands tax justice

A small levy on risky transactions made by big business would yield billions more for health care and other public services.

SAVE OUR MEDICARE

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

20 | Nurses need their own medicine

24 | Making Medicare

A new book about the history of Medicare reminds us of the pivotal role that the union movement played in its introduction.

COMPETITION

8 | Win a luxurious stay at Hunter Valley

PRIVATISATION

30 | Stockton public meeting

Over three hundred members of the community gathered with nurses and family members at Newcastle Panthers last month.

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 APRIL 2014 | 3

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

We will not let the Abbott Government silence your voice A royal commission into unions is a blatant attempt to discredit the union movement and undermine our capacity to improve the lives of working people. But by sticking together and doing what we’ve always done well, we can still win a better life for nurses, midwives and other working people.

It is only six months since the federal election took place but it seems that, as a union, we are operating in a totally different world.

Our collective strength gives us the capacity to defend our achievements and forge new ones.

Wins that were hard fought have been rolled back or put under threat and unions are operating in an environment of intimidation.

One of the first acts of the Abbott Government on gaining office was to roll back the Aged Care Supplement (page 12). The supplement was a fantastic achievement by aged care workers, extracted from the previous Labor government.

It guaranteed that government funding for aged care would be translated into fair wage increases for some of the lowest paid workers in the country.

There are other longer established social gains achieved through the sacrifice of trade union members, over a long period of time, that are now under threat.

One of the most historic and proud achievements of Australian trade unionism – our universal health care system, Medicare – faces daunting challenges as the Abbott Government flags changes that would undermine its foundations of equity and access.

It is easy to forget that the important and iconic institution that is Medicare was not always there, and that its existence is owed to the commitment and resolute activism of millions of trade union members. In this month’s Lamp (pages 25-29) we revisit that history and look at the pivotal role of unions in the birth and survival of Medicare, in the face of fierce resistance from the medical profession and the Liberal Party.

He recently told the ACTU Organising Conference that “allegations of corruption and other misbehaviour can be as damaging to reputations as the reality. The royal commission will unfold at the same time as a long Productivity Commission inquiry which amounts to a trial regarding the nature and scope of the industrial relations system. The aim is to present the ‘end’ of unions as a good thing and reduced rights at work as an economic necessity (and both as inevitable).”

Tim Lyons is right to say that the royal commission into unions is an attempt to destroy your voice, the Productivity Commission inquiry an attempt to destroy your rights at work and reduce wages, an Audit Commission an attempt to destroy parts of the social wage, and a tax inquiry an attempt to shift tax away from corporations and onto households.

That’s the Abbott Government agenda. The federal government is essentially saying that your living standards need to fall. For nurses and midwives the clear attack on penalty rates could bring that home in a very real way. No one should think that workers in retail and hospitality are the only workers in the sight of government and business.

We will not submit meekly to this agenda.

Our collective strength gives us the capacity to defend our achievements and forge new ones.

A unionised workplace with a collective agreement remains a powerful force for good.

It has changed millions of workers lives for the better and it still can.

We will make that work everywhere we can.

We will not be ignored.

ACTU Assistant Secretary Tim Lyons describes the royal commission into unions, announced by the federal government, as “a trial about the legitimacy of trade unionism”.

THE LAMP APRIL 2014 | 5

YOUR LETTERS

LETTER OF THE MONTH

Stockton is gold standard I am a third year Bachelor of Nursing student who had the absolute privilege of undertaking a clinical placement at Stockton Residences.

I must say that not only was it an incredibly rewarding experience, and the staff were amazing, but the level of person-centred care that the clients are given is second to none.

In fact, instead of closing it down, downsizing and/or shifting responsibility entirely to NGOs, the government should view the Stockton Residences as the gold standard of disability care and services.

I do not believe for one second that any change to the provision of care for long-term clients, especially those with severe intellectual and physical disabilities, is in the interest of the clients.

Especially if their already gold-standard, person-centred care and services are decentralised, staff displaced and (just putting it out there) the now prime real estate upon which Stockton Residences is built, sold off.

The government must remember that Stockton Residences is not just a name on a Treasury spreadsheet; it is the home of many. In some cases the only home clients have known, with staff that have known them since babes (20 plus years in some cases), where families of past generations were given education, support and services, historically not available in the wider community.

Stockton Residences is more than just a facility. It is a community.

My wish is that Tony Abbott and his ministers would personally take the time to meet this community, to meet the clients who call it home and be open to discussion from staff and families of clients, without bias for their own agenda. Or at the very least for common sense to prevail and the political plague of change for change’s sake ceased and the health systems that actually do work, left alone.

Kind regards Nicole Barnes, 3rd year student and AiN, Greenacre

letter of the

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6 | THE LAMP APRIL 2014

Driving the message For many nurses who cannot attend rallies, is it feasible for us to have something we can hang in our cars, about the social issues on health we are fighting for? I believe many nurses would love this idea of being able to relay to the public what’s going on.

Our cars just go everywhere. Hence, a good avenue for public information and gaining more support. Thanks for the notification about the Medicare rally. More power!

Maria Helena Liceralde, Carlton NSWNMA RESPONDS Dear Maria, The Association often produces bumper stickers and other materials for our campaigns as a way to publicise an issue.We currently have a bumper sticker for our privatisation campaign. Please contact your organiser at the Association to receive one.

Fantastic website Major kudos to whoever produced your new web page at www.nswnma.asn.au Very well done, much better than previous offerings.

Good impact, easy to navigate: 9.3/10 Sincerely Joseph Cidoni RN, Gosford Inspiring scholarship Thanks you so much for making the NIDA filmmaking workshop scholarship possible.

It was a great opportunity to learn about film and filmmaking. The workshop is an inspiring experience where you meet professional actors and skilled technicians in a class of wonderful nurses from a diverse range of specialities and locations. I would recommend it to anyone wanting to get creative, begin making that film, and gain so much in regards to personal development.

Again, thank you to the NSWNMA for this and many other opportunities and support you provide to nurses.

Yours faithfully Christopher Blyton, Glebe

SAY SOMETHING 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.

YOUR LETTERS

Stand up for human rights The NSWNMA, my union, does a sterling job of defending the pay and conditions of nurses and midwives. As someone not a member of a branch, I would like to know that it is taking a stand and acting to defend the rights – or rather regain the rights – of asylum seekers.

The killing of Reza Barati at the Manus Island detention centre is beyond disgraceful. And scores of others were injured. Article 14 of the UN Declaration of Human Rights says that everyone has the right to seek and enjoy in other countries asylum from persecution. The 1951 UN Refugee Convention says that the contracting state (that’s us) shall not expel a refugee lawfully in their territory save on grounds of national security or public order (Article 32). There are many other parts of the Convention we, both our major parties, have violated.

The physical attack on asylum seekers on Manus Island is the outcome of the policy of persecution by detention we have had since 1994, since, in effect, imprisonment without charge or trial. The Nazis found the Jews to persecute and both our major parties have found people arriving here by boat, fleeing persecution.

Ironic that we are about the only European-colonised country not to have a treaty with the first inhabitants, acting with such outrage at a few people arriving here, seeking our protection.

The attack on the unions by Abbott and company is part of a larger attack on civil society. The time has come for our wider solidarity; solidarity with each other and with the truly vulnerable.

It will mean telling Labor as much as the Coalition that the Intervention must end and that the detention of those seeking asylum must end. Time to stand up for human rights while we still can.

In solidarity Stephen Langford, Paddington

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NEWS IN BRIEF

COMPETITION

Switzerland

Bacteria laden stethoscopes The stethoscope should be regarded as an extension of a clinician’s hands and disinfected after every patient contact, according to a new study.

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Researchers at the University of Geneva say stethoscopes carry as many bacteria as the palms of a doctor’s hands. It found the hands of healthcare workers were still the main source of bacterial transmission in hospitals, but stethoscopes also appeared to have a major impact.

Dr Didier Pittet, director of the infection control programme at the University of Geneva Hospital, told the BBC the instruments were transmitters of bacteria.

“By considering that stethoscopes are used repeatedly over the course of a day, come directly into contact with patient skin and may harbour several thousand bacteria [including Methicillin-resistant Staphylococcus aureus] collected during a previous physical examination, we consider them as potentially significant vectors of transmission,” he said.

“From infection control and patient safety perspectives, the stethoscope should be regarded as an extension of the physician’s hands and be disinfected after every patient contact.”

The study said further research was needed to understand how stethoscopes could best be disinfected.

More work was also required on how long bacteria survive on stethoscopes and how they are transmitted to a person’s skin.

NOTICE

NSWNMA survey: have your say This year we will be facing challenges on many fronts and in all sectors where we represent members. In anticipation of that we will be conducting a survey of all members to identify issues that matter most to nurses and midwives in NSW and ensure you have a voice in the delivery of health services and patient care in your workplace.

From April 2nd to April 30th we will be emailing a survey to all members to get your feedback on the industrial issues that are important to you.

Please keep an eye out in your email inbox. If you have not yet updated your details, please go to www.nswnma.asn.au so you don’t miss out.

NEWS IN BRIEF

United States

Older dad, greater mental health risk

Brian D’Onofrio

Children born to fathers over the age of 45 are at greater risk of developing psychiatric problems and more likely to struggle at school, according to the findings of a large-scale study.

According to the study the children of fathers aged 45 and over were 3.5 times as likely to have autism, had more than twice the risk of psychotic disorders, suicidal behaviour and drug abuse, and had a 13-fold greater risk of ADHD. They also reported more drug abuse and suicide attempts.

Less than 1% of children born to fathers younger than 45 had bipolar disorder, a figure that rose to about 14% in their siblings when fathers were 45 or older. In many cases, the risk of each disorder rose steadily with the father’s age. The children’s difficulties seemed to affect school performance, leading to worse grades and fewer years in education overall.

Researchers at Indiana University and the Karolinska Institute in Stockholm studied medical and educational records of more than 2.6 million babies born to 1.4 million men.

The group amounted to nearly 90% of births in Sweden between 1973 and 2001.

Using the records the scientists added up the diagnoses for psychiatric disorders and educational achievements and compared the figures for children born to fathers of different ages.

Lead author Brian D’Onofrio said: “While the findings do not indicate that every child born to an older father will have these problems, they add to a growing body of research indicating that advancing paternal age is associated with increased risk for serious problems.”

Some experts questioned the analysis because important factors that could otherwise be to blame were not ruled out.

Europe

More nurses, bettereducated, lower mortality A new study published in the British medical journal The Lancet, has found that cuts to nurse staffing levels to save money might adversely affect patient outcomes. It also found that an increased emphasis on degree level education for nurses could reduce preventable hospital deaths.

The observational study looked at discharge data for 422,730 patients, aged 50 years or older, that underwent common surgeries in 300 hospitals in nine European countries.

Surveys of 26,516 nurses practicing in study hospitals were used to measure staffing and education levels.

An increase in nurse workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7%, and every 10% increase in bachelor degree nurses was associated with a 7% decrease in this likelihood.

The researchers say the implication is that patients in hospitals in which 60% of nurses had bachelor degrees, and where nurses cared for an average of six patients, would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor degrees and nurses cared for an average of eight patients.

AN INCREASE IN NURSE WORKLOAD BY ONE PATIENT INCREASED THE LIKELIHOOD OF AN INPATIENT DYING WITHIN 30 DAYS OF ADMISSION BY 7%.

THE LAMP APRIL 2014 | 9

NEWS IN BRIEF

Australia

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Joe Hockey and Tony Abbott have been relentless in their assertions that Australia can no longer sustain its spending on Medicare, welfare and education. “We will either have to have a massive increase in taxes – and that means fewer jobs at the end of the day – or we are going to have to look at ways that we can restructure the system to make it sustainable,� Joe Hockey told the Age recently.

Offering an alternate view, Warwick Smith, a research economist at the University of Melbourne, argued in the Sydney Morning Herald that there are alternative sources of revenue readily available to the government to help pay for Medicare. “If we look at the 20 countries with the highest GDP per capita, quite a few have much higher rates of tax as a proportion of GDP. Sweden, for example, has similar GDP per capita to Australia and takes 54% of GDP in tax (compared with 31% in Australia)� he said.

THERE ARE ALTERNATIVE SOURCES OF REVENUE READILY AVAILABLE TO THE GOVERNMENT TO HELP PAY FOR MEDICARE. “Most of these high taxing, high GDP per capita countries have low unemployment, low inflation and score very well on various measures of life satisfaction and wellbeing. Their existence and their success prove Abbott and Hockey wrong and demonstrate that there is another path to prosperity, one that also leads to less inequality while maintaining very high living standards for the overwhelming majority.�

Smith quotes Treasury forecasts which estimate that in the next financial year Australia will spend more than $45 billion on superannuation tax concessions, around $17 billion of which will go to the top 10% of income earners. The country also spends more than $8 billion a year giving concessional treatment to capital gains earnings and allowing negative gearing; money that mostly goes to more wealthy Australians.

United States

Polio-like illness in California About 20 cases of a polio-like syndrome have been identified in Californian children over the past 18 months, according to CNN. Neurologists at Stanford University said they had identified five patients who developed paralysis in one or more of their limbs between August 2012 and July 2013. All five children had been vaccinated against the poliovirus. Treatment did not seem to help the children regain their motor function.

Dr Keith Van Haren, a paediatric neurologist at Lucile Packard Children’s Hospital, Stanford, said although they had found five cases there had been “preliminary reports of several more.� “We want to temper the concern because, at the moment, it does not appear to represent a major epidemic but only a very rare phenomenon,� he said.

Dr Van Haren said similar outbreaks had been seen across the world.

The poliovirus has been eradicated in the United States for more than 30 years. Only three countries in the world are not free of the disease: Afghanistan, Pakistan and Nigeria, according to the World Health Organisation.

NEWS IN BRIEF

Australia

NSWNMA advocates for EN/TAFE funding The NSWNMA has told the federal government that funding for NSW TAFE needs to be adequate to maintain a sustainable EN workforce in New South Wales and to ensure appropriate skill mix in workforce planning.

“We believe that TAFE NSW should remain at the forefront and retain majority control of EN education through the provision of increased government funding arrangements,” the Association argued in a submission to the Senate Education and Employment Committees.

“The decline of ENs needs to be reversed so that adequate EN staff can continue to take their place alongside RNs, particularly in principal metropolitan referral hospitals.

We urge the Committee to ensure that ENs are a highly qualified and valuable asset to any nursing team.”

The submission pointed out that, despite the importance of ENs to a rich skill mix, the numbers of ENs in NSW are declining: • In July 2012 there were 264 EN vacancies across NSW (a 50% increase since 2010).

• The proportion of ENs to RNs in NSW is among the lowest in Australia (AHPRA figures).

Ministry of Health modelling showed that from 2012 to 2026, 1400-1600 commencing EN training places were needed each year to ensure a balance of supply/demand by 2026. This was a far cry from the 1049 EN enrolments at TAFE NSW for 2012 and the 1177 new EN registrations for the May 2011 to September 2012 period.

This means that the number of training places for ENs would have to increase to around 2100 or approximately 65% per year.

Britain

Ratios breakthrough Wales Online reports that a proposed law to introduce a legal minimum staffing level for nurses in Wales overcame its first parliamentary hurdle, after MPs voted in favour of progressing it to public consultation.

The Private Member’s Bill proposed by Welsh Liberal Democrat leader Kirsty Williams (pictured), would see an independent assessment of appropriate staffing levels in Welsh hospitals, following in the footsteps of policies introduced in New South Wales,Victoria and California.

The bill attracted cross-party support from Labour backbenchers, Welsh Conservatives and Plaid Cymru (the Welsh nationalist party), with the Welsh government abstaining from the vote, and passed with 39 votes in favour and 12 abstentions.

Ms Williams told the parliament that minimum staffing level laws in California and Australia had boosted recruitment and led to better standards of care, and that a minimum staffing level could help avoid issues associated with the Mid-Staffordshire NHS Trust care scandal (see Lamp May 2013).

“Our nurses in Wales are under huge pressure, with more patients to care for, per nurse, than any other part of the United Kingdom, with an average of 10.5 patients per nurse compared to 8.5 in England or 7.2 in Northern Ireland,” she said.

Tina Donnelly, director of the Royal College of Nursing in Wales, gave full backing to the bill.

“The RCN believes there can be no compromise on the need for mandated minimum registered nurse staffing levels,” she said.

Australia

Nominations open for HESTA Aged Care awards Nominations have opened for the 2014 HESTA Aged Care awards. Winners of the awards, which aim to find aged care professionals who demonstrate excellence, leadership and innovation, will share in a $30,000 prize pool, provided by long-term HESTA Awards supporter, ME Bank.

HESTA CEO Anne-Marie Corboy said: “People working in this sector provide emotional support to their clients and families, as well as delivering services in innovative ways to help preserve the independence and dignity of older Australians.

“We are keen to hear about the work of outstanding individuals as well as the work of health teams and organisations that have found new ways to deliver services that enhance the wellbeing of older Australians.”

Finalists will be announced on 15 July 2014, with interstate finalists flown to Melbourne for an awards dinner on Tuesday, 5 August 2014.

Nominations are open until Friday 30 May 2014. To make a nomination or learn more about the awards visit hestaawards.com.au

THE LAMP APRIL 2014 | 11

COVER STORY

Get ready to campaign for pay and conditions Immediately on gaining office the Abbott government abolished the Aged Care Supplement guaranteeing increased wages. The way forward to better pay and conditions now lies with enterprise bargaining.

T HE NSWNMA WILL SOON ENGAGE employers in the charitable, religious or not-for-profit residential aged care sector to bargain for a new enterprise agreement.

We have written to Aged and Community Services (ACS) Australia – the organisation representing employers in the sector – to confirm their willingness to negotiate a new agreement.

The goal is to establish a new template enterprise agreement to take effect from July 2014. The current agreement expires at the end of June 2014.

NSWNMA General Secretary Brett Holmes says the decision by the Abbott government to abolish the aged care supplement was a “kick in the guts” for aged care workers and their residents.

Now, the way forward to better wages and conditions, that will keep trained staff in the sector, is via a new enterprise agreement, he says.

“Putting the Workforce Supplement into enterprise agreements guaranteed that government funding flowed straight into workers’ pockets, thereby helping the sector retain and attract staff,” Brett said.

“We are now working in a more hostile environment where we can expect the federal government and employers will oppose improvements in workers’ pay and conditions.

Under the previous Labor government, the $1.2 billion Workforce Supplement was allocated to wage rises of 1% per annum, over and above any other increases negotiated with employers.

Brett says aged care workers are going to have to show the same passion they have for resident care to the campaign for improved pay and conditions in the notfor-profit aged care sector.

“Enterprise bargaining still provides us with the opportunity to get pay rises and improve our conditions, if we are organised and committed to the campaign,” he said.

12 | THE LAMP APRIL 2014

Have your say Brett says the NSWNMA is setting up a Bargaining Organising Committee with representatives made up from not-for-profit aged care facilities as a vehicle for greater consultation with members.

“Every facility can get involved in consultation and activities. To be successful we need to build networks and build strength. Firstly, that involves getting as many people as possible to join the Association.

“To achieve a good outcome, to improve pay and conditions, so the sector is an attractive place that will retain staff, we need you to put your hand up and participate in the campaign.”

NSWNMA organisers have already begun making visits to members to talk about the issues. Early indication is that members are looking for pay increases to value their work and measures to enhance resident care through skills mix and career paths.

It is anticipated that negotiations on the new agreement will begin this month, with the aim to have a new agreement to put to the ballot of members and take effect in July 2014.

THE DECISION

BY THE ABBOTT GOVERNMENT TO ABOLISH THE AGED CARE SUPPLEMENT IS A “KICK IN THE GUTS.”

The not-for-profit aged care template • The first template agreement in the sector was negotiated with Aged and Community Services Australia in 2007 after WorkChoices legislation removed aged care from the NSW Award system.

• The current agreement expires on 30 June 2014.

• The current agreement covers 176 residential aged care facilities in New South Wales. The template also influences the outcomes in a significant number of other agreements.

• It is available for employers in the not-for-profit sector to adopt.

Unpaid overtime and heavy workloads The NSWNMA has been conducting various surveys as part of the consultation process leading into the campaign to achieve a new template for the not-for-profit aged care sector.

According to the Association’s research unpaid overtime is widespread in the aged care sector, with 56% of respondents saying they regularly work more than their contracted hours.

Workloads and staff shortages were frequently blamed for members having to work back beyond their normal shift hours.

This impacted on the care that nurses were able to provide to residents.

“I really need extra staff to watch the residents so I can finish my work or I just stay back until it’s finished,” said one RN. “It would be good to see staff have enough time to interact with residents rather than a frantic rush to get the basic jobs completed in the allotted time,” said another.

“Dementia residents are often physically aggressive towards staff, especially at night where there is less staff on duty. Priority is given to resident safety as is required, but in most cases staff are left to their own devices. The main advice is to walk away, which in some cases is difficult to do,” said one respondent.

“Violence in the workplace is usually dismissed. There is no formal education of de-escalating situations with residents when they have cognitive impairment and they become aggressive towards staff,” said another nurse.

Sixty-nine per cent of respondents said they worked on a set roster.

For those without a set roster more than 41% had to deal with unpredictable shifts.

Two thirds of the respondents had permanent part time jobs while 22% had permanent full time jobs.

“Stop ALL unpaid overtime: it is unacceptable that essential tasks have to be completed in our own time, as overtime must be pre-approved,” said another respondent.

The research shows that bullying and violence from residents are perennial problems for staff in the sector. Fifty-seven per cent of respondents said they had experienced violence from residents in the past year.

While most people were satisfied that the issue was dealt with appropriately by management, over a third indicated that the issue was not managed appropriately.

Glenys Roelfsema, RN, and Christine Spangler, AiN.

THE LAMP APRIL 2014 | 13

COVER STORY

Vital issues Two nurses from the not-for-profit aged care sector talk to The Lamp about the issues that are important for them and their colleagues in enterprise bargaining.

Christine Spangler, AiN CHRISTINE BELIEVES THAT WORKLOADS AND PAY RISES ARE the key issues for not-for-profit aged care nurses in the upcoming round of enterprise agreements.

She says achieving a good result in bargaining is very important now that the Abbott government has axed the Aged Care Supplement that would have guaranteed government funding for the sector was used for fair wage increases.

“We were very, very disappointed about the supplement. Now we are going to get nothing from that, we have to fight for everything again.

Now we have to go back to the bargaining table to get anything through an agreement,” she said. “I’m very angry and disappointed with the federal government that we could be treated in that way. I told my colleagues, what you are going to get depends on who you vote for and that proved right. Tony Abbott got in to power and we got nothing.”

Christine says aged care nurses will have to fight to be paid what they are worth.

“Enterprise bargaining is not easy. Employers always quote the funding bucket. ‘We can’t do this because of the funding bucket’, ‘there’s only so much money in the funding bucket’.”

“They’ll try any way they can to avoid giving us wage increases. It’s shocking. Aged care nurses are the lowest paid in any nursing sector and the work we do is highly demanding.”

Christine says workloads and lack of time to deliver ideal care are also issues that need to be dealt with in aged care.

“You just haven’t got time for residents. They need us but there isn’t enough time.”

“LOSE PENALTY RATES AND YOU’LL LOSE PEOPLE. THEY’LL GO TO THE PUBLIC HOSPITAL UP THE ROAD OR GO WORK IN A SUPERMARKET.”

14 | THE LAMP APRIL 2014

PENALTY RATES VITAL Christine is very concerned that the federal government has flagged the rolling back of penalty rates.

“Lose penalty rates and you will lose people.We don’t get paid enough even when we get penalty rates. People will come in on the weekend knowing that they’ll get penalty rates. In Broken Hill, where you are working in an isolated area, you can’t call on agencies when you are short staffed.

We haven’t got a giant casual pool to draw on.

“If they take penalty rates away people are going to walk from aged care. They’ll go to the public hospital up the road or go work in a supermarket.”

Glenys Roelfsema, RN GLENYS SAYS AGED CARE NURSES WILL HAVE TO STICK together to improve pay and conditions in their next enterprise bargaining agreement (EBA).

“We were pretty gutted by the loss of the aged care supplement.To think we were not valued enough to be given that. It was pretty demoralising to say the least. It now means we need a new EBA,” she says.

Glenys works night shift part time at her facility and has been innovative in getting information to her colleagues and collecting their feedback.

“I think there has to be good collaboration among the staff. There are staff members on most shifts who are able to disseminate the information quite well. I rely on that.”

“I put a box in the staff rooms for staff to put their questions in if they can’t come to the NSWNMA’s information sessions about the EBA. That way people can have some input and they don’t necessarily have to put their name on it. People thought that was non threatening.”

“WE WANT TO RETAIN OUR GREAT NURSING STAFF, SO WE HOPE THEY WILL BE RESPECTED WITH DECENT WAGES AND CONDITIONS.”

A REASONABLE INCREASE Glenys says there are a number of issues for the enterprise agreement that are important to her and her colleagues.

“We want a reasonable increase in wages each year. Our dream of course is to have parity with the Public Health System (PHS). We’ve got 30 high dependent residents so we’re not just babysitting elderly people.

“We want to retain our great nursing staff, so we hope they will be respected with decent wages and conditions.

Many experienced people are leaving the aged care sector to work in the public sector or private enterprise. Present aged care wages and conditions are not attracting the new grads that we need to replace the aging, experienced workers.

“Something that I would like included in a new agreement is paid union leave, which we only need about four times a year anyway. I can’t afford to take a day off to go to an Association meeting.The PHS has it but we don’t have it yet.”

Glenys says that maintaining penalty rates is essential.

“I couldn’t afford to work in aged care without penalty rates. I wouldn’t work in aged care if penalty rates went. But it’s not so easy for our staff members with mortgages, particularly because there aren’t many other opportunities around here to work in a nursing environment. Working the hours others are not prepared to work, like afternoons, nights and weekends, should be compensated.

“There is a lot of discussion among staff members about workloads. Staff have complained about patient safety and staff safety being at risk. It can be pretty demanding at night with 30 residents but we’ve been told there is no more staff for nights, despite an increase of staff for other shifts due to the workload increase.”

THE LAMP APRIL 2014 | 15

COVER STORY

Bullying widespread A survey conducted of NSWNMA members in the not-for-profit sector of aged care found a stunning 77% of respondents had witnessed bullying in their workplace.

E V E N M O R E S T U N N I N G WA S T H E frequency that bullying took place: nearly 20% of respondents witnessed bullying more than once a day and another 27% witnessed bullying every one or two days.

Six per cent witnessed bullying once per fortnight, the same number once per month and 13% less than once per month.

The survey covered members who work in an aged care facility that was covered by an Aged and Community Services template agreement; which includes the great majority of facilities run by not-for-profit, charitable, or religious organisations.

Under new national anti-bullying laws, which came into force from January this year, the Fair Work Commission has the power to order that bullying must stop.

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

The NSWNMA research found a relatively high awareness among aged care employees of these new legal powers at the Fair Work Commission’s disposal: 57% of respondents said they were aware of them.

NSWNMA General Secretary Brett Holmes says the level of bullying revealed in the survey is alarming and unacceptable.

“Even worse, we know that bullying can increase during bargaining as the less reputable employers try to pressure their employees.

“We will not stand by and let that happen. We hear the message from the workplace about bullying and we will stand by aged care workers.

“First off, the Association intends to run free workshops on bullying for aged care workers in this sector starting in April,” he said.

16 | THE LAMP APRIL 2014

Have you seen bullying happen in your workplace?

If so how often does it occur in your workplace?

13.76%

22.70%

19.27%

6.42% 6.42%

77.30%

26.61%

27.52%

Yes

More than once per day

No

Once every one or two days Once per week Once per fortnight

Did you know that the Fair Work Commission has new legal powers to deal with issues of bullying in your workplace?

once per month Less than once per month

7.41%

35.55%

Yes No

57.04%

I don’t know what the Fair Work Commission is

“WE HEAR THE MESSAGE FROM THE WORKPLACE ABOUT BULLYING AND WE WILL STAND BY AGED CARE WORKERS.” — BRETT HOLMES

What to do if you are being bullied

Abbott wants rid of penalty rates

• If you can, tell the bully that their behaviour is

When asked about abolishing penalty rates, at a private meeting of the Liberal faithful last year, Prime Minister Tony Abbott said he believed the only way to bring this about would be for a federal government to pressure the independent umpire to strip back penalty rates.

unreasonable and inappropriate, and that you want it to stop.

• Keep a written record of all bullying incidents including dates, times and witnesses to the behaviour.

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

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

• If you are having trouble making a complaint to someone in authority in your workplace, or are afraid to do so, contact the NSWNMA for advice.

• You can also get more information about new national anti-bullying laws at the Fair Work Commission website: www.fwc.gov.au

New powers to act Under new national anti-bullying laws that came into force at the beginning of this year the Fair Work Commission has the power to order that bullying must stop.

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

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

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

“I am confident that if the government were to back, for argument’s sake, applications to the Fair Work Commission for adjustments in this area, it may well be successful.”

Abbott’s plan to roll back penalty rates, couched in such cautious language before the federal election, is now gaining momentum.

The Fair Work Commission has begun a review of awards. The review will allow the commission to make decisions on whether minimum pay and conditions should be varied across the 122 modern awards that cover most Australian employees.

The Abbott government has asked the review to consider whether minimum terms and conditions, including penalty rates, are “appropriate in a particular industry”. The government’s submission acknowledged the review may lead to “significant changes” to the modern award system.

Before the election the Coalition promised not to make any legislative changes to the Fair Work Act, but this submission comes as a further sign that the federal government is prepared to back a push by business to reduce operating costs via penalty rates.

Labor workplace relations spokesman Brendan O’Connor says the submission exposes the Coalition’s true agenda to bring back WorkChoices.

“Everything suggests WorkChoices was merely sedated, not cremated, as Tony Abbott promised,” he said.

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

“EVERYTHING SUGGESTS WORKCHOICES WAS MERELY SEDATED, NOT CREMATED.” — BRENDAN O’CONNOR

THE LAMP APRIL 2014 | 17

FINANCIAL TRANSACTION TAX

Robin Hood demands tax justice A small levy on risky transactions made by big business would yield billions more for health care and other public services.

A MERRIE BAND OF NURSES TOOK THE NSWNMA’s call for a “Robin Hood Tax” to the top end of town during a recent meeting of world finance ministers.

Wearing scrubs and green Robin Hood caps, the nurses took street theatre to Circular Quay to highlight the need to raise revenue for important public services like health care – without extracting more money from the pockets of Australian workers.

The Financial Transaction Tax (FTT) – or Robin Hood Tax as it is being referred to around the world – is a proposed 0.05% levy on the kinds of high-risk financial transactions that contributed to the global financial crisis.

The international aid organisation Oxfam estimates that a tax of just 0.05% on foreign exchange transactions, derivatives and share deals by banks, hedge funds and other finance institutions, could raise hundreds of billions of dollars globally every year.

A group of nine European countries including France, Germany and Spain, has already agreed to implement a FTT. It is estimated the tax could raise £26.8 billion (approx. AUD$49 billion) a year.

In Sydney, our Robin Hood nurses bailed up three corporate-looking characters – one with a money sack representing bankers and two wearing Tony Abbott and Joe Hockey face masks – to ask why big business and the Abbott Government are looking to raise the taxes and charges paid by ordinary people, such as a possible increase in the GST and the introduction of a $6 Medicare GP co-payment fee.

Meeting at a luxury hotel a short walk away were the G20 finance ministers and Central Bank governors, representing more than 75% of global trade and two-thirds of the world’s population.

The nurses handed out NSWNMA leaflets headed “Bring the Robin Hood Tax to Australia”.

Registered nurse Michelle Cashman 18 | THE LAMP APRIL 2014

“LET’S GET BIG BUSINESS TO PAY THEIR FAIR SHARE INSTEAD OF INCREASING TAXES ON ORDINARY PEOPLE.” — MICHELLE CASHMAN RN

said not one person she spoke to at Circular Quay had heard of the FTT. “There was a look of horror on most people’s faces when they first heard the word ‘tax’,” Michelle, a NSWNMA delegate at Long Jetty Continuing Care on the Central Coast, said.

“Once we explained it to people they saw the logic of raising billions of dollars from a tiny tax on certain transactions by the finance industry.

“Our message was, let’s get big business to pay their fair share instead of increasing taxes on ordinary people,” Michelle said.

“The public are starting to realise this government is going to make them pay more for Medicare and health services generally.Why not let an FTT pay for it?”

NSWNMA Assistant General Secretary Judith Kiejda said the FTT would be levied on very specific financial transactions, not on the everyday consumer.

“An FTT would give Australia many billions of dollars more each year to properly fund public services like health and aged care and schools,” Judith said.

“If governments can tax transactions between a nurse and their electrician or plumber at 10% through the GST, then they can tax big businesses carrying out certain financial transactions at less than 0.05%.”

NSWNMA Nurses stand strong on Robin Hood Tax

GET INVOLVED If you would like to get involved in the Robin Hood Tax campaign, or want more information about an FTT, visit our website and look for “Tax Justice” under the “Get Involved” tab. www.nswnma.asn.au

Trading away our health Secret trade negotiations could affect the health care of every Australian.

TAKE ACTION If you want to take action around Tax Justice and Fair Trade email gensec@nswnma.asn.au to find out how.

For more information on the Trans-Pacific Partnership Agreement go to http://aftinet.org.au/cms/

AUSTRALIANS COULD BE PAYING A LOT more for medicine under an international trade agreement being negotiated in secret – and it’s time to let the public in on the secret deal.

Two NSWNMA delegates on the New South Wales north coast delivered this message to their local member of parliament with a warning that the Trans-Pacific Partnership Agreement (TPP) could undermine the Pharmaceutical Benefits Scheme (PBS).

American drug companies see the PBS as a barrier to increased profits and the Australian government seems to be listening to them, putting profits before the health interest of Australians.

Charmaine Murphy RN, delegate for the NSWNMA at Lismore Base Hospital, and Kyogle Hospital NSWNMA branch official, Gail Jenkins, took their concerns about the TPP to the federal member for Page, Kevin Hogan.

Australia, the US, Japan and nine other countries are involved in the TPP. The NSWNMA has joined with organisations such as consumer advocacy group Choice, in calling on the government to release the contents of the TPP so we know what is being traded.

Choice says that while the public is being kept in the dark,“a group comprising industry lobbyists from the United States have had access to full drafts of the TPP.” Médecins Sans Frontières (Doctors Without Borders) says the TPP includes some of the most harsh provisions against access to medicines ever included in a trade agreement.

A group of about 50 academics with expertise in public health and medicine wrote to federal health minister Peter Dutton asking him “not to sell out to commercial interests Australia’s sovereign rights to protect health”.

Charmaine Murphy and Gail Jenkins told MP Kevin Hogan they were concerned that the TPP could result in

“A FREE TRADE AGREEMENT SOUNDS INNOCUOUS BUT THE SECRECY MEANS WE DON’T KNOW WHAT’S IN THE AGREEMENT.” — CHARMAINE MURPHY RN

Australians having to wait longer for generic versions of drugs, with implications for the old and chronically ill in particular.

“We explained that international drug companies saw our PBS as a threat to profits. Kevin Hogan was quite interested in what we had to say,” Charmaine said.

“He was particularly interested in reading ministerial responses to the material sent to them by the NSWNMA. “A free trade agreement sounds innocuous but the secrecy means we don’t know what’s in the agreement.”

Reports suggest the TPP may extend the life of pharmaceutical patents, and allow companies to gain new patents on existing drugs, by making small changes to their formulation such as changing the dosage or even changing from a tablet to a capsule.

This could mean cheaper generic versions of medications take a lot longer to reach the market.

Charmaine said she was also concerned that the TPP would give foreign companies the right to sue Australian governments if they introduced laws to protect public health – such as plain packaging of cigarettes or laws to protect the environment.

“This could threaten laws and regulations to limit coal seam gas mining.This is a big issue in Lismore where residents voted 87% ‘No’ against CSG mining.

“Kevin Hogan spoke a lot about CSG threats to the environment in his maiden speech to parliament and we raised the implications of the TPP in the context of his speech,” Charmaine said.

THE LAMP APRIL 2014 | 19

YOUR HEALTH

Nurses need their own medicine A nationwide survey has found that workplace stress is having a devastating effect on the overall health and wellbeing of Australia’s nurses.

MANY NURSES IDENTIFIED STRESS AS THE biggest contributing factor to obesity, hypertension, respiratory diseases and the risk of developing Type 2 diabetes.

The most reported chronic disease was musculoskeletal, which may be a reflection of the age of the nursing population, many who trained before the no-lift policy was introduced.

The results from an online survey by Kay Ross and Dr Jennieffer Barr of Southern Cross University’s School of Health and Human Science, will be used to develop strategies to address the prevention and management of chronic illnesses in nurses and midwives.

“Nurses told us that workplace stress is a huge issue,” Kay Ross said. They talked about things causing stress such as workloads, bed closures, job losses, bullying, shiftwork and being expected to do more with less. Many of them said if they had some way of dealing with their stress they’re sure their health would improve.”

A third of nurses who had a chronic illness needed to take time off in the previous 12 months. Ms Ross says that while the survey focused on nurses, the largest workforce in the health sector, it was also a snapshot of the wider health community.

“The whole health system has to realise that the most important commodity it has is the people that work for it. By looking after all staff, including nurses, we can have happier and healthier workplaces.

“We would probably find that any group of health professionals would have similar results, with many also not being as healthy as they would like. Most of us know what to do; however we need support to be able to do it.

“We’ve had a lot of health promotion messages, from Norm’s Life Be In It back in the seventies to recent campaigns including Measure Up and Swap it, Don’t Stop it. But we have to go the next steps, which include 20 | THE LAMP APRIL 2014

motivation, sustainability and support.”

Ms Ross says some hospitals in the United States have developed staff wellness programs, but she is not aware of anything similar in Australia.

Steps to better health could be as simple as providing “chill out” rooms where employees can take a break, relax and maybe have a cup of tea or coffee before going back to work.

With 35% of registered nurses in Australia aged over 50, and an average age of 45, chronic illness is a major concern.

“Forty per cent of nurses are looking at retiring during the next 10 or 15 years and we don’t have the numbers of experienced nurses to replace them,” Kay said.

“The reality at the moment is that nurses are expected to be working very hard, very quickly with very little support, because everyone is so flat chat.”

With a captive workforce 24/7, the issue of providing healthy food also needs to be addressed.

“There has to be an option for staff who are working in the middle of the night or on weekends to have something healthy available to eat rather than a soft drink or a chocolate from a vending machine,” Kay said. “Even if staff take food from home to work, there’s often nowhere to put it because the staff room is where you do handover, write your notes and catch up on paperwork.

“If you bring your lunch to work there often isn’t a quiet place where you can eat it. In some hospitals the only comfortable place to sit is in the main foyer where patients wait to be picked up to go home.”

Kay says the next step is to develop strategies to deal with the health issues that the survey revealed.

“We’re not saying there has to be a lot of money spent, but we

have to put some thought into this, we need to talk to nurses and get more input on what’s going to work for them.

“Online wellness coaching is one strategy that we have talked about but we need to find out what nurses think will work best for them. We now have the evidence that nurses are not as healthy as they would like; the next step is to do something about it!

Survey results will be published in a report “Primary Health Care for Nurses: Developing strategies for the prevention of chronic illness in nurses.”The (former) Department of Health and Ageing under the Chronic Disease Prevention and Service Improvement Fund provided funding for the survey.

Work bans at Parklea prison One of the toughest jobs in nursing just got a whole lot tougher, thanks to the introduction of some hard to understand “efficiencies”.

ACCORDING TO PARKLEA CORRECTIONAL Centre, NSWNMA branch spokesman, Steve Sullivan, the main result of new “efficiencies” introduced by the Justice Health and Forensic Mental Health Network, has been a decline in the health and wellbeing of nursing staff.

Unhappy with the changes that they see impacting negatively on their ability to provide the best possible patient care, nurses at Parklea are responding in the only way they can, by ending flexible work practices.

There has been particular outrage at a decision to overturn a longstanding condition for Justice Health nurses to have paid meal breaks. The prison canteen is open only a few hours a day on weekdays.

Outside those hours the only available food is from vending machines.

“We’re in a jail for Christ’s sake,” Steve said.“We have to pass through seven locked gates to get out of the place.

“To get to a canteen outside the main gate can take 15 to 20 minutes sometimes and same to get back in. Most times, if there’s not a big line of people, it will take five to six minutes each way and that’s the best you could do because you have to go through all the security process each time you come into the jail, such as the x-ray scanner, take off all your belts, your shoes.

That’s protocol and we put up with that.”

In a longstanding goodwill gesture, nurses on the 7am to 3pm shift have not taken the regulated 20-minute morning tea break, preferring to work through and have a half hour paid lunch break on site, meaning they are still available for emergencies and handovers.

“That’s been a local agreement and we’ve been happy to do that to provide the service we have to provide,” Steve said. “That will no longer happen, we will insist on our right to our 20-minute morning break.

“We’re also going to insist we leave the site for a half hour for lunch. Most nurses will be leaving the centre for their

“PATIENT CARE WILL BE THE SAME, BUT THERE’LL BE LESS OF IT.” —STEVE SULLIVAN unpaid meal break and if it takes longer than five minutes to get back into the centre, so be it.”

Steve, a drug and alcohol clinical nurse specialist, joined the prison service to treat disadvantaged drug users. Seventy five per cent of the New South Wales prison population has a drug or alcohol problem and he says there is a waiting list for methadone treatment.

“If you are HIV positive you’ll get on fairly quickly. If not you’ll wait 8-10 months.All those I’ve assessed since August last year are still not on the methadone program and they’re telling me ‘I’m using drugs in jail, I’m sharing needles in jail.’

“And I can do nothing,” Steve lamented.

Under new management “efficiencies”, nurses will follow management’s stated zero tolerance policy toward abuse, which could mean filling in between 30 and 40 forms a day.

Under regulations covering mass flu

vaccinations, nurses must individually deliver and then document each patient’s flu shot, meaning it could take three or four days to vaccinate 100 people, in a community of 900, when previously a team could vaccinate as many as 100 in a 90-minute clinic.

“We feel we are not respected by upper management at all. We have 100% support from local management, but they’re treated as mushrooms as much as we are,” Steve said.

Nurses only have access to patients in clinics from 9am to 11am and from 12.30 till 3pm. Traditionally nurses have worked through morning tea to fit in all the services required.

“That won’t happen now. It’s all going to have to be done in the time we have access to patients. Patient care will be the same, but there’ll be less of it. “Over the past few years I’m getting less and less job satisfaction and most of our nurses are saying the same thing,” Steve said.

THE LAMP APRIL 2014 | 21

COMMUNITY NURSES

Work bans get vacancies filled A campaign by Albury community nurses to improve service delivery and cover annual leave is getting results.

“IT IS QUITE AN ACHIEVEMENT FOR A SMALL BRANCH TO BE CONFIDENT ENOUGH TO TAKE ACTION.” — PETRA SMYTH

ACTION BY COMMUNITY MENTAL HEALTH nurses in Albury has succeeded in easing a staff shortage with management finally agreeing to fill four vacancies.

Nurses banned a range of administrative and other tasks last September, following Murrumbidgee Local Health District management’s failure to co-operate with nurses to solve serious staffing issues, including failure to backfill annual leave despite funding being provided.

This forced nurses to cancel hundreds of client appointments and diminished the range of services and quality of patient care.

The Albury Community and Mental Health Nurses Branch of the NSWNMA lifted the work bans in stages as management acted to fill each vacancy.

Branch president Petra Smyth said filling the vacancies meant there was now enough staff to cover annual leave.

“Nurses are quite pleased with the result and feel better able to deal with the workloads.And it’s now easier for people to access leave.”

She said the work bans were carefully targeted so as not to impact on clients because “the whole point of our action was to improve the quality of the service.”

“It is quite an achievement for a small branch to be confident enough to take action. It reinforced to us that we did have a voice – something we were not confident about beforehand.

“At first we felt disempowered and didn’t believe there was much we could do.

However by using the reasonable workloads process we realised we could take steps to improve the workload and patient care.”

The actions taken by the nurses prompted the Health Services Union to form a local branch and join the campaign.

This meant the entire multidisciplinary community health service was united on the issue.

Petra said the campaign also encouraged new members to join the NSWNMA. Branch secretary Margaret Traill said the NSWNMA branch had stayed united on the issue and the result was a boost for morale.

Failure to backfill annual leave is a breach of the 2011 nurses award, which says “funded / budgeted FTE (full time equivalent) must include no less than four weeks (20 days) of annual leave relief per productive FTE.Where staff are required to

work shift work or weekends then no less than six weeks (30 days) should be included.”

The award adds that managers are responsible for scheduling annual leave so as to “prevent unreasonable increased workload for remaining employees arising from the taking of leave.”

Margaret said this award provision was not being implemented at Albury Community Mental Health.

“However since our action nurses are being replaced when going on leave providing that suitably qualified people are available to step in,” she said.

In a separate dispute the branch succeeded in blocking an attempt to downgrade the full time community nurse manager position by splitting the funding between a 0.6 FTE nurse manager position and a 0.4 FTE allied health manager position.

The nurse manager position had been left vacant for several months, requiring team leaders to take over nurse manager roles, leading to a loss of clinical time.

In a letter to management Margaret said the proposal would have “a significant and negative impact” on patient care, workplace health and safety, the professional responsibilities of nurses, and human resource processes.

She said a reduction in nurse manager hours would weaken many aspects of the service leading to reduced efficiency, reduced management of critical incidents and reduced clinical advocacy for patients at meetings.

Sustained pressure from the branch resulted in management agreeing to recruit a full time permanent nurse manager.

Margaret said both campaigns had definitely been worthwhile: “I would love other branches around the state to realise that if they do stick together they can get a positive outcome.

“The clear lesson from our disputes was that the push needs to come from the members.

“The Association officers were terrific support and advocates but they need clear instructions from members to act on their behalf.They were very helpful in taking our resolutions to management and negotiating on our behalf.

“If you show the Association you are serious about an issue and are prepared to take action they will support you.”

“THE CLEAR LESSON FROM OUR DISPUTES WAS THAT THE PUSH NEEDS TO COME FROM THE MEMBERS.” — MARGARET TRAILL

22 | THE LAMP APRIL 2014

Call for action on obesity Warning that obesity and poor nutrition contribute to chronic illnesses, experts call for food labelling website to be relaunched.

PUBLIC HEALTH EXPERTS HAVE called for urgent action to reduce obesity following the Abbott Government’s decision to scrap a healthy-food star rating system.

The website for the food rating system was online for just a few hours before being taken down under instruction from the office of Assistant Health Minister Fiona Nash.

The assistant minister’s then chief of staff, Alastair Furnival, was later forced to resign after it was revealed he held shares in a company that had done lobbying for the junk food industry.

Some 66 health professors co-signed a letter to state and territory food ministers calling on them to take urgent action to reinstate the star rating system.

The professors warned that obesity and poor nutrition were contributing to chronic illnesses such as diabetes, cardiovascular disease, kidney disease and cancer.

The Front of Pack food labelling website took two years to develop and had been approved by all state and territory health ministers.

The consumer advocacy group Choice said the star rating system gave consumers information they could use to make healthier choices at-a-glance.

One of Australia’s foremost cancer experts, the University of Sydney’s Bruce Armstrong, says he signed the letter in because getting better information to the public is crucial.

“Obesity is shaping up as one of the major drivers of cancer rates into the future,” he told the Sydney Morning

A screenshot of the mobile view of the Health Star Rating website.

“YOU HAVE TO GIVE CONSUMERS ADEQUATE INFORMATION SO THEY CAN MAKE INFORMED DECISIONS.” — DR LESLEY RUSSELL

Herald. “As a consumer myself I see how extracting from the label the information you want to find out … is really quite difficult.”

Dr Lesley Russell, a senior research fellow at the Australian National University’s College of Medicine, Biology and Environment, is also an honorary research associate at the Menzies Centre for Health Policy.

Dr Russell told The Lamp it was “clearly a political decision” to take the website down.

“We need a concerted and

multifaceted effort to tackle obesity in Australia. One way of doing that is to have a website that provides information about obesity and nutrition,” she said.

“Such a website would be a key initiative allowing us to move forward on a major public health issue.”

Dr Russell rejected the argument that governments had no business trying to influence eating habits, because they were a matter of personal responsibility.

She said the government should play a role in combating

obesity if only because obesity costs taxpayers money in terms of increasing health expenditure and lost productivity.

“If you are going to argue for personal responsibility then you have to give consumers adequate information so they can make informed decisions.

“Giving people adequate nutritional information on websites and on food packaging is one of the ways you can contribute to personal responsibility.”

Alastair Furnival was a shareholder of lobby group Australian Public Affairs (APA), which once represented multinational food giant Mondelez International.

The consumer watchdog Choice decided to take a closer look at Mondelez after it attacked the rating system as “ill-founded, unscientific and confusing”.

The main element of the food rating website was a calculator, which generated a star rating for packaged food depending on how healthy it was. Choice used the calculator to compare Mondelez brands, such as Kraft, Cadbury, Oreo and Nabisco, with the offerings of its leading competitors.

Choice campaigns manager, Angela Cartwright said that in all three comparisons undertaken, the Health Star Rating “shot down the Mondelez product each time”.

“Choice questions whether the real reason Mondelez doesn’t like the system is that it would show consumers that some of their products are less healthy than the alternatives,” Ms Cartwright said.

THE LAMP APRIL 2014 | 23

SAVE OUR MEDICARE

RPAH Sydney march, October 1983

Making Medicare A new book about the history of Medicare reminds us of the pivotal role that the union movement played in its introduction.

MEDICARE IS 30 YEARS OLD AND A REVERED Australian institution – but a revisit of its tortuous creation, and new rumblings from the federal government about more user pays in health, suggests we shouldn’t be complacent about its survival as a universal health care system.

24 | THE LAMP APRIL 2014

In Making Medicare two authors, AnneMarie Boxall from the Deeble Institute and James Gillespie from the Menzies Centre for Health Policy, chart what they describe as the “contentious history of health reform in Australia”.

From 1969, when Gough Whitlam first

took Medibank to an election as a central ALP policy, until 2003 when the Coalition “begrudgingly accepted Labor’s reforms and announced they were Medicare’s greatest friend”, a universal health system has generated intense political conflict.

From the beginning there were four

MEDICARE WAS NOT A GIFT— WORKERS GAVE UP DESERVED WAGE INCREASES IN RETURN FOR A UNIVERSAL HEALTH CARE SYSTEM.

significant opponents to Medibank (Medicare’s first incarnation): • The medical profession (represented by the AMA and the General Practitioners Society of Australia) • the states • the private insurance funds, and • the Liberal Party.

All were vociferous opponents when Gough Whitlam attempted to introduce his version of universal health insurance – Medibank.

From 1972 to 1984 Australia became the first developed country to introduce a universal health care system (under Whitlam), then discard it (under Fraser). In those 12 years Australia attempted, on five separate occasions, to find a way of balancing public and private insurance schemes.

Finally, in 1984, the Hawke Government reintroduced a universal health care system, Medicare.

A fair and efficient system Medicare had two fundamental pillars — a concern for equity i.e. equal access to equal care for rich and poor alike; and it was efficient by controlling health care costs. Medicare’s key characteristics, which made it a winner, were: • It was simple — every Australian would be covered.

• It was affordable — everyone contributed according to his or her ability to pay.

• It restored the principle of universality.

• It was efficient — by shifting to a single government payer system, health insurance would not have to bear the overheads of a multiplicity of private funds, nor would vast resources be wasted on checking eligibility.

THE PIVOTAL ROLE OF UNIONS Medibank, the universal health care system introduced by the Whitlam Government, was eventually discarded by the Fraser Government after years of tinkering, and replaced with a system of private health insurance with public subsidies.

But from 1975, when the Whitlam Government lost office, through the years of the Fraser Government, till the ALP returned to power with Bob Hawke at the helm, the union movement championed the dream of a universal health care system.

The union movement had its own plan for universal health insurance based around a “health charter”.

Boxall and Gillespie say the support of the trade union movement proved crucial.

“The ACTU and many of its powerful members had been campaigning for the restoration of universal health insurance since 1976. They made sure it was a core part of Labor’s program in the successful 1983 election and it remained on the government’s agenda,” they said.

Medicare was not a gift – workers throughout the country gave up deserved wage increases in return for a universal health care system. And it has never been free – workers pay a levy based on ability to pay to finance the system.

“The main reason Labor in government implemented Medicare was pragmatic. Labor needed union support

for wage restraint, and that support was contingent on the restoration of universal health insurance in Australia,” say Boxall and Gillespie.

Medicare was introduced as a key element of the historic “Income and Prices Accord”. Its appeal to the union movement was that it included non-wage elements – the “social wage” – that would improve the standard of living. High on the list of priorities was the provision of universal health insurance, which later became known as Medicare.

The Accord was an agreement on economic reform, negotiated between the opposition Labor Party and the ACTU in 1982. Its aim, from Labor’s view, was to secure union cooperation on wage restraint, so that productivity growth did not drive up inflation and unemployment.

“The social wage, therefore, would preserve real living standards but it was one of the mechanisms through which the government could achieve wage restraint and provide incentives for employers to create jobs.”

Despite initial public scepticism to Medicare when Labor first mooted it: “Medicare became overwhelmingly popular after it was implemented,” say Boxall and Gillespie.

Labor’s decision to make Medicare part of the social wage was vital to the success of the Income and Prices Accord.

HEALTHCARE “GAME-CHANGER” In his introduction to Making Medicare Professor Stephen Leeder, Professor of Public Health and Community Medicine at the University of Sydney, describes the introduction of Medicare as a “thunderclap” and a “game-changer”.

“Medicare is an example of that rare thing in health care policy in Australia: a radical change,” he wrote.

Professor Leeder says Medicare needs to retain its core fundamentals into the future.

“In my view the real test of Medicare is its ability to survive as a universal health insurance system – paid for by everyone, accessible by everyone. If the changes and additions and subtractions lead to it being called a safety net, it is lost. If the central purpose can be maintained then it will continue to be a strong expression of a society that cares for all its members, sick or well, rich or poor.”

THE LAMP APRIL 2014 | 25

SAVE OUR MEDICARE

Medical madness and Liberal resistance The road to Medicare was long and rocky due to relentless resistance by the medical profession and the Liberal Party.

THE BATTLE OVER MEDICARE WAS A conflict between individual or collective responsibility for healthcare and reflected deep divisions in Australian politics.

The medical profession fought a vicious and personal war with the Labor government of Gough Whitlam and his health minister Bill Hayden over Medibank. Its opposition was clearly ideological In 1973, when Medibank was on the point of been implemented, the Australian Medical Association (AMA) voiced total opposition to the scheme claiming it was “a cleverly devised plan for the ultimate nationalisation of all medical and hospital services and a first major step to achieve socialisation of the Australian community in accordance with the socialist objectives of the ALP.” Such bizarre logic was shared by the General Practitioners’ Society of Australia (GPSA) which claimed “the control of our country has fallen into the hands of socialists … the fight that GPs in Australia are spearheading is basically a fight for freedom – not just freedom for doctors – but freedom for you, your children and for all people in the country.”

The GPSA also distributed controversial posters featuring Bill Hayden dressed in a Nazi uniform standing in front of a picture of Whitlam, with the inscription ”Heil wHITLAm”.

This extreme position alienated many progressive doctors who, through the Doctors Reform Society, advocated strongly for Medibank and criticised the AMA and the GPSA for their highly political, selfinterested and money-grabbing position.

Although doctors gained a temporary victory when Medibank was dismantled under the Liberal government of Malcolm Fraser, their self-interested campaign, weakened by divisions within the profession, led to them being a much diminished opposition group when the Hawke Labor government reintroduced universal healthcare under the new name of Medicare in 1983.

The rise and fall of Medibank and the divisions it engendered changed medical politics in Australia.

26 | THE LAMP APRIL 2014

Medibank is “a first major step to achieve socialisation of the Australian community in accordance with the socialist objectives of the ALP.” – AMA (1973)

In a survey of its own members in 1980, respondents said “the AMA had a conservative outlook and was self interested and ineffective.” Many doctors complained that the AMA put too much emphasis on protecting its members and not enough on demonstrating its concern for public health and community welfare.

Ironically, when Medicare was finally opened for business in 1984, the benefits for many doctors were obvious. Bulk billing had a major impact on GPs and many swallowed their other objections as Medibank guaranteed their incomes. For doctors working in poorer areas, bulk billing ending the problem of bad debts because it meant they were always paid for their services.

THE LIBERAL PARTY’S CONSISTENT OPPOSITION TO MEDICARE After initial scepticism Medibank was able to engender deep community support. But for two decades following Gough Whitlam’s first attempt to implement a universal health system, the Liberal Party remained staunchly opposed to it.

Making Medicare – a timeline ALP WHITLAM GOVERNMENT

1969 Labor takes a national health insurance scheme to the federal electorate but loses the election.

LIBERALNATIONAL FRASER GOVERNMENT

ALP HAWKE GOVERNMENT

LIBERAL- NATIONAL HOWARD GOVERNMENT

1984

1996-97

1981

Medicare begins 1 February.

Medibank abolished, return to private health insurance with public subsidies

1991

Co-payments for pharmaceutical benefits increased, medical benefits frozen and benefits for pathology services reduced.

1972

Co-payments for GP visits introduced.

1993

Whitlam government elected.

Co-payments for GP visits abolished.

Subsidies for private insurance withdrawn.

1975 Medibank (the precursor of Medicare) begins.

“In a society as wealthy as ours there should not be people putting off treatment because they cannot afford the bills. Basic healthcare should be the right of every Australian.”

— Gough Whitlam

Upon his election in 1975, Prime Minister Malcolm Fraser said:“We will not dismantle Medibank”. Yet over the next seven years the Fraser Government would tinker ceaselessly with Medibank, introducing Medibank II in 1976, Medibank III in 1978 and Medibank IV in 1979, before finally abolishing Medibank in 1989 and returning to private health insurance with public subsidies.

In 1987, John Howard was in his first incarnation as Liberal leader. Howard saw Medicare as a wasteful program that would be cut to make way for tax cuts.

“Australia’s healthcare system is in a shambles.The real villain is Labor’s doctrinaire commitment to a universal government health insurance system, Medicare.

Our policy will confront these questions, reduce the role of government in the provision of health insurance and restore effective choice,” stated Howard’s election manifesto for 1987, Future Directions.

Howard lost the 1987 election.

In the 1990 election the Liberals, now led by Andrew Peacock, were low key in their health announcements, but a year before the shadow health minister Peter Shack

“We will not dismantle Medibank.”

— Malcolm Fraser, November 1975.

Over the next seven years his government dismantled it.

1997 Medicare Levy Surcharge introduced to encourage higher income earners to take out private health insurance.

1999 Private health insurance rebate introduced.

2000 Lifetime Health Cover introduced, imposing financial penalties on people aged over 30 without private health insurance.

2003 Incentive payments introduced for GPs who bulk bill; co-payments for GP visits increased.

said Medicare would move towards a meanstested safety net. All those above a certain income would be obliged to take out private health insurance or face a tax penalty.

In the 1993 election Liberal leader John Hewson’s election manifesto Fightback promised an end to Medicare and a return to means tested subsidies to private health insurance. Bulk billing was to be abolished and restraints on medical incomes would be removed as “a blatant rewarding of political support.”

This attack on Medicare was vigorously supported by the Private Hospitals Association, which ran a direct mail campaign in 10 marginal seats, and by the AMA, which called for an anti-Labour vote and launched a campaign in 23 marginal seats.

Liberal defeat in these elections led to much soul searching by the party and finally, in 1996, public attachment to universal health led to bipartisan support for Medicare.

Leading up to the 1996 election John Howard, back as Liberal leader, said: “Australians want Medicare kept and the Coalition is fully committed to that”.

Consensus on Medicare had finally arrived.

THE LAMP APRIL 2014 | 27

SAVE OUR MEDICARE

The evolution of Medicare The Lamp spoke to Anne-Marie Boxall, co-author of Making Medicare, about the challenges facing our iconic public health system.

What was the Australian health system like before we had Medibank/Medicare?

It worked well for some people but a lot of average people didn’t get the necessary health benefits. There was a built in degree of inequity in the system. Some people didn’t go to health services at all – to GPs or avoided hospitals. Obviously that had a terrible impact on their health or it may have delayed their accessing care. When they did eventually go they were in much poorer health. Some people couldn’t avoid going and it ended up costing them a lot of money. One of the people I interviewed for the book told me it was not uncommon in inner city Sydney to see the medical debt collector driving around knocking on people’s doors and taking away furniture to pay for medical debts. I was surprised to hear that the cost of medical care could actually bankrupt people back then.

It was not uncommon. We hear of things like that happening in the United States but back then it was not uncommon in inner Sydney either.

factor in why we got Medicare. Medicare was one of the pay offs for the Income and Prices Accord. It was the centerpiece of the social wage.

How important was the union movement to the creation of Medicare?

The union movement was pivotal, absolutely critical, to getting Medicare.

And the reason was that although the Labor Party fought hard to get their Medibank proposal up and running, it was prepared to consider other options in the period between the Whitlam Government and the Hawke Government. The union movement was adamant that the Medibank system be returned. They didn’t care what the name was but they wanted a universal taxfunded insurance scheme in Australia and they never gave up fighting for it. Because they didn’t give up it became a critical

What impact would co-payments for GP or ED visits have on the universal nature of Medicare?

We already have a lot of co-payments in our health system – for example with pharmaceuticals and a whole range of other services and products. Public hospitals don’t have co-payments and that is an important feature of Medicare. Bulk billing is an important aspect of Medicare – access to GP services. So although copayments for GP visits are an option for raising revenue for the government they do undermine the basic principle of Medicare. The World Health Organisation has pointed out that a co-payment as a mechanism for financing public health systems is the least equitable. There are

“THE UNION MOVEMENT WAS PIVOTAL, ABSOLUTELY CRITICAL TO GETTING MEDICARE” 28 | THE LAMP APRIL 2014

many other ways to finance health care.

We already pay higher co-payments compared with other countries. It’s not a sensible option because of the signal it sends about our system but also because it is not very effective.

“THE PRINCIPALS OF MEDICARE WE MUST REMAIN FIRM ON. IT MUST PROVIDE UNIVERSAL ACCESS AND IT MUST BE EQUITABLE.”

What other changes could a government introduce to undermine its universal status?

One of the principals of Medicare is that it is universal. So anybody who is a citizen is included in the system. I think that if you change that, by making Medicare means tested for example, it is really difficult to argue that it is the same system. I think if bulk billing was grossly undermined, and it was by far and away the minority of people who were bulk billed, that would start to raise questions about the universality of Medicare. We must remain firm on the principals of Medicare. It must provide universal access and it must be equitable. Co-payments aren’t that. I think a $6 co-payment in itself is not the end of the world, it’s just not a good policy idea.

When the Fraser Government tried to tinker with Medibank it eventually fell apart. Do you harbour fears that the same could happen with Medicare?

My concern is that we don’t think of our health system in a big picture way very often, so the damage to our Medicare system will come from people not being willing to stand back and do the analysis.

Most governments don’t have that level of strategy. That’s more the risk – ignoring it or not seeing the big picture and trying to solve things by tinkering here or tweaking there.

Australia spends a lot of money on subsidising private health insurance.

Is this an efficient use of resources?

Treasury has said that it is not an efficient use of our resources. Private health insurance has always been government subsidised in some way or form in

Australia and when it hasn’t been it has nearly collapsed. That’s the reality of it. It was the ALP that gradually took away the subsidies and then had to rush to reinstall them to boost private health membership again. So instead of focusing on the rebate what we need to do is look at the structure of our health system and tackle some of the underlying problems. We need to be thinking about what the role of private health insurance should be in the context of Medicare. The subsidy is a symptom of the problem and we need to tackle the problem.

The health needs of the community have changed since Medicare was introduced. What changes are needed for the system to adapt?

The funding under the fee-for-service is an obvious one because people need ongoing care during their lifetime, whereas when Medicare was designed it was for one-off sporadic visits to a healthcare provider.The way we fund Medicare makes it very difficult for health care providers to deliver coordinated care. In the United States they haven’t moved completely away from fee-for-service but there is more openness now to considering alternative payment models like bundled payments where, for example, a provider gets a certain amount of money to look after a diabetes patient for a year.We need to be more creative with the way we fund health care in Australia.

How would that impact on nurses?

I think a different funding model with bundled payments would be more flexible and would allow nurses to take a prominent role in primary health care. If there was a different payment system there would be an incentive for doctors to have more nurses to treat patients where it was appropriate. It would create more opportunities for nurses to be involved in primary care. It makes economic sense because it is more efficient and it would make use of our health workforce more effectively as well.

THE LAMP APRIL 2014 | 29

PRIVATISATION

Hundreds

meet to talk Stockton More than 300 members of the community gathered with nurses and family members to discuss the privatisation of all public disability services in New South Wales by 2018, under the guise of the National Disability Insurance Scheme. The Lamp reports the views of some of the speakers at Newcastle Panthers.

“WHERE IS THE REAL CHOICE?” Brett Holmes — General Secretary NSWNMA “Over the past few months it is with unfolding horror that we’ve realised that a scheme [National Disability Insurance Scheme] that was to be celebrated has become a point of major concern for nurses who work in the disability sector.

By fully privatising the disability sector without stakeholder and community input, this government has clearly stated the intention to drown out the voices of the most vulnerable citizens and their spokespeople.

Where is the choice for those currently in ageing and disability home care facilities, who are happy with the choice of public provision? How are the disabled with serious disabilities or challenging behaviours able to make an informed choice? Where is the choice for the nurses and others who want to remain in the public system, but instead are being coerced into a private entity?

Shouldn’t the real choice be the choice between public provision and a private entity, between highly qualified nursing care and a care setting that might not even include qualified nurses? What would we choose if we have the choice?

They don’t have a position or a decent plan for how they are going to address the really big issues that we are facing industrially. They are not fulfilling their obligations.”

“WE CANNOT ALLOW POLITICIANS TO DO THIS TO OUR PEOPLE.” Wendy Cuneo — vice president, Stockton Centre Welfare Association “Some of the residents at Stockton are blind, some of them are deaf and blind some of them can’t move at all and they can’t talk.

It’s outrageous to think you can just uproot them and move them.

We cannot allow politicians to do this to our people.”

30 | THE LAMP APRIL 2014

“FORGET COLLECTIVE BARGAINING RIGHTS — NOT EVEN INDIVIDUAL BARGAINING RIGHTS ARE ALLOWED.” Kate Washington — legal partner at Catherine Henry Partners “The state government is acting inconsistently with the NDIS principles of independence, inclusion and choice. I don’t think there is anyone in this room that would dispute the fact that who we are talking about tonight are the most vulnerable people in our community and for the workers providing the care to those vulnerable people.

It also runs contrary to every fundamental legal principal whereby we are all autonomous individuals who have the right to make decisions affecting our lives, including who we choose to work for and on what terms.

Forget collective bargaining rights – not even individual bargaining rights are allowed on this occasion.”

“YOU HAVEN’T GOT A PLAN!” Lynne Warner — sister of Kanangra resident of 40 years “We are all prepared to negotiate if we are given something to consider and if we are given information – but we’re not given anything and that’s why the fear is within us. At a meeting I said to Minister Ajaka, ‘Could you tell me what the plan is?’ and he said ‘it would be negotiated’ and he said ‘there is a 20-year plan to close Morrissett, Stockton and Tomaree’. Now you’re telling me you haven’t got a plan!”

“I WAS STUNNED AT HIS IGNORANCE.” Dr Gillian Evans — GP, Stockton Centre “I’m one of the five doctors at Stockton Centre and this is the first time I’ve spoken publicly. I know all the doctors are very concerned. When I asked John Ryan [Executive Director ADHC] about some very basic information about his plans and his management and what he would be measuring for the medical care of these people in the community he couldn’t answer my questions at all, basically.

“I was stunned by his ignorance. Absolutely stunned by his own admission.

John Ryan says he didn’t really get his head around how complex this situation was. I offered a compromise model – I said what if this goes ahead and these people are relocated in the community: can we keep the medical model in terms of the clinics and the allied health and the doctors, all this expertise that has taken decades and decades? These nurses who have known most of these people from when they were babies. They know what the twinkle in their eye means. I rely on these nurses for their diagnostic skills. Without them I couldn’t do my job.”

THE LAMP APRIL 2014 | 31

PRIVATISATION

Make Metford public Nurses and midwives held a silent vigil last month, outside a community forum to discuss the new Maitland Hospital development.

THE MEETING, RUN BY THE HUNTER NEW England Local Health District, was a tightly controlled affair for which attendants needed to pre-register.

NSWNMA General Secretary Brett Holmes said the nurses and midwives at the vigil were determined to send a message to participants to keep the hospital in public hands.

“They want the new Maitland Hospital to be a publicly run and staffed facility that will offer equitable access to everyone in the community,” he said.

Brett says a lack of information about the new hospital has led to concerns among nurses, midwives and the broader community.

“We need the O’Farrell Government to come clean about its plans for the new Maitland Hospital at Metford,” he said.

“This vital infrastructure will help meet current and future demands of the growing population and, as taxpayers, local residents deserve to know what options are being explored by the government.

“We have a right to know if the government intends to continue shirking its responsibility to provide public health services, favouring profits over patients and a universal health system.”

Since announcing the proposed 40hectare Crown land site in August 2013, the O’Farrell Government has been tightlipped on how it plans to fund and operate the new facility.

The local member for Maitland, Robyn Parker, seems unclear about the government’s intentions.According to local media

reports she confirmed the facility would be publicly – not privately – funded. But within 24 hours a spokesperson for NSW Health Minister Jillian Skinner clarified that the funding model had not been decided and would continue to offer public services.

Nurses line up outside Metford Hospital Meeting.

32 | THE LAMP APRIL 2014

ASK JUDITH Additional days off I work in the public sector and understand we are only able to accrue three ADOs, and that if we accrue more we lose them. Is this true?

The change in policy surrounding Additional Days Off (ADOs) took effect in July 2008.

The Public Health System Nurses’ and Midwives’ (State) Award 2011 clause 4 (vii) currently provides that: vii) (a) Where an employee and her/his local nursing management agree, an employee’s additional days off duty (ADOs) may be accumulated up to a total of three. This limit on accumulation means that any employee who has already accumulated three ADOs must take the next ADO accruing to her/him when it falls due, in accordance with the roster.

Employees who have accrued more than three ADOs should take them as soon as practicable. Management should be flexible in allowing affected staff to take their ADOs and should not unreasonably refuse these requests.You should not lose this entitlement.

your additional annual leave. For further information refer to the NSW Health Information Bulletin IB2011_051 Nurses & Midwives’ Cashing Out Additional Accrued Annual Leave.

Paid for a public holiday?

I am an RN working in a public hospital, permanent part time, Wednesday, Thursday and Friday. I took Leave Without Pay from a Tuesday for two weeks and a public holiday fell on the first Friday. As this is a day that I regularly work I expected to be paid for the public holiday but I wasn’t. Was this correct?

Yes, as set out in NSW Health policy Leave Without Pay, PD2006_091, dated 7 November 2006, a public holiday will not be paid when it falls during in a period of leave without pay: “Where a public holiday or proclaimed local holiday occurs during an employee’s period of absence on leave without pay, the employee shall not be credited with the holiday.�

Cashing out annual leave

Easter leave loading

I am an AiN working in the public sector and have accrued eight weeks annual leave. Am I able to cash out any of this accrued leave?

The Public Health System Nurses’ and Midwives’ (State) Award 2011 clause 30 sub clause (xi) states: (b) An employee entitled to additional annual leave under subclauses 30 (i) (a), 30 (xi) (a) or 17 (ii) can elect at any time to be paid an amount equivalent to the value of accrued additional annual leave in lieu of taking the additional leave, provided also that salary for the period of additional leave paid out will be calculated as if the period of leave paid was actually taken.

This means that if you are an employee contracted to work on a seven-day basis and accrue six weeks annual leave, or if you have accrued this leave for working on Sundays and public holidays, you are able to cash out

I am an RN working in the public health system and have been rostered over Easter. Would you please advise the public holidays for this period and what penalties I am entitled to receive?

The gazetted Easter holidays this year are Friday 18, Saturday 19, Sunday 20 and Monday 21 April. As per clause 30, Annual Leave, of the Public Health System Nurses’ and Midwives’ (State) Award 2011, the penalty rate paid for working on a public holiday will vary depending on your annual leave entitlements and the options you may take.

For example, if you are an employee entitled to four weeks annual leave, you have an option in respect to being paid for or accruing additional annual leave; if you elect (election to be made each anniversary date) to be paid, then you will receive a loading of time-and-a-half (150%) additional pay for that pay period. If you have elected to accrue your additional leave then you will receive an

Rafflee 2014

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

additional 50% loading in your pay for that pay period, as well as having a full day added to your annual leave entitlement. (Note: If you elect to accrue your annual leave you need to understand that when you take the leave you will not receive annual leave loading on this component).

For those employees with six weeks annual leave per year, the loading paid will be 50%.

The additional leave for public holidays (that is, those public holidays named in the award) has in effect already been added to your annual leave on the basis that you work on a seven-day rotating shift basis.

Compassionate leave replaced I am an EN working in the public sector and have taken leave due to a death in the family. I have exhausted my FACs leave entitlements. Can I access compassionate leave?

Family and Community Services Leave (FACS) now replaces Compassionate Leave, so if all FACS leave has been exhausted you must apply for additional FACS leave for bereavement purposes, as per clause 32, Family and Community Services Leave and Personal/Careers’ Leave, Part A, sub clause (viii) of the Public Health System Nurses & Midwives (State) Award 2011. “(viii) Additional FACS leave for bereavement purposes Where FACS leave has been exhausted, additional FACS leave of up to two days for bereavement may be granted on a discrete, “per occasion� basis to an employee on the death of a relative or member of a household as defined in sub clause (iv)(a) of this clause. (iv) FACS leave – general (a) For the purpose of this clause relating to FACS Leave: “relative� means a person related by blood, marriage or affinity; “affinity� means a relationship that one spouse, because of marriage, has to blood relatives of the other; and “household� means a family group living in the same domestic dwelling.�

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VA L E

Bonnie Gail Pereira 17 October 1944 — 13 January 2014

[e\ Bonnie Pereira (nee Graham) was born in Grafton on 17 October 1944. She commenced her general nursing training in 1968 at Concord Repat Hospital and met her husband, David during her early training days.

Bonnie left before completing her training and married David and they moved to Wingham, where they had two children, Jane, born 1970, and Ian, born 1971.

Tragically, Ian died as a result of a motor vehicle accident in August 1994.

Bonnie remained passionate about becoming a nurse and was able to complete her general nursing training at Taree, Maitland and Newcastle. In 1975, Bonnie and her family returned to Erskineville, Sydney, and later settled at Concord. While her children were young, Bonnie worked casual night shifts at Hunters Hill Nursing Home. She also worked at Katingal, Concord Hospital and, after completing an Occupational Health and Safety certificate, worked for the railways as an OH&S nurse.

She completed her psychiatric nursing training at Ryde Hospital in 1982. Bonnie always had a strong desire to work in the area of psychogeriatric nursing and it was in this field of work that her professionalism, knowledge and skills were outstanding. She worked in the community at Croydon Health Centre, before being appointed as Nursing Unit Manager of the Psychogeriatric Ward at Westmead Hospital.

Eventually she returned to community nursing, working at Merrylands Community Health prior to her retirement in 2009. She was an active member of the Psychogeriatric Nurses Association.

Bonnie was known and respected as a true psych nurse who always advocated for her patients, ensuring that they received the best possible care and ensuring that their rights were maintained. Bonnie also spent much time assisting her generally trained colleagues on the best ways to manage some very challenging situations.

Bonnie was an active member of the NSWNMA Westmead Branch and a branch delegate for a number of years.

Following her retirement Bonnie continued to care for elderly mental health patients and volunteered weekly at the Auburn Day Centre until November 2013.

To her friends, Bonnie was kind and giving, a true friend, often inviting those who would be on their own during holiday times to join her family. She loved going to the theatre and her Canasta card group was a treat to join!

Ordinary people are capable of greatness and Bonnie would have described herself as an ordinary woman – but her friends and family saw her as an amazing woman who did extraordinary things.

Bonnie passed away after a short illness on January 13, 2014.

She was survived by her husband David and her daughter Jane, and will be missed by both, as well as her extended family and many friends.

THE LAMP APRIL 2014 | 37

It’s time

to scrub up for 2014!

To order, fax the order form to Glen Ginty, (02) 9662 1414, post to: NSWNMA, 50 O’Dea Avenue, Waterloo NSW 2017 or email gensec@nswnma.asn.au

Order your NSWNMA campaign scrub unifor uniforms ms for conference and rally times, and make an impression!

Merchandise order forms also available on

www www.nswnma.asn.au .nswnma.asn.au

With every purchase of a Scrub Top, you receive this campaign T-Shirt for

SCRUB CRUB P PANTS A ANTS

SCRUB TOP

FREE! HURRY! This Offer Ends 30 April 2014 Size (cm)

XS

S

M

L

XL

2XL

Half Chest Circumference

53

56

59

62

66

69

73

77

81

Half Hem Circumference

54

57

60

63

67

70

74

78

82

10/12

12/14

14/16

16/18

18/20

20/22

22/24

24/26

General Guide for Female 8/10

3XL

4XL

5XL

Half Waist (Relaxed)

29

33

37

40.5

43.5

46.5

50.5

54.5

58.5

Half Waist (Stretched)

47

51

55

58.5

61.5

64.5

68.5

72.5

76.5

Half Hip

55

59

63

66

69

72

76

80

84

Out Seam Length

103

105

107

109

111

112

113

114

115

ORDER FORM NSWNMA Scrub top $20. Quantity: Size: XS S M L XL 2XL 3XL 4XL 5XL NSWNMA Scrub pant $20.. Quantity: S M L Size: XS 2XL 3XL 4XL 5XL XL Total o cost of order $ Please include postage and handling of $5 per order.

Name Address

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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? nurse uncut is written by everyday nurses and midwives.

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

Finn’s new grad diary www.nurseuncut.com.au/rushed-into-the-emergency-dept-of-a-new-grad-year

Meet Finn, who will be sharing the ups and downs of her new grad year with Nurse Uncut throughout 2014.

Life during wartime: nursing on the AIDS ward, parts 1 and 2 www.nurseuncut.com.au/life-during-wartime-nursing-on-the-aids-ward-part-1 www.nurseuncut.com.au/life-during-wartime-nursing-on-the-aids-ward-part-2

Diarrhoea, dementia, pervasive death – nursing on the AIDS ward at St Vincent’s in the 1980s forged a special camaraderie.

Like vaccination, union membership benefits all www.nurseuncut.com.au/like-vaccination-union-membership-benefits-all

Coral Levett argues that, like “herd immunity”, the more nurses and midwives who join our union, the better the outcomes for all.

Enrolled nurses go to conference www.nurseuncut.com.au/enrolled-nurses-go-to-conference

Rebecca Roseby EN recounts the proud history of the Enrolled Nurse Professional Association of New South Wales.

Close the accommodation gap for country patients www.nurseuncut.com.au/close-the-accommodation-gap-for-country-patients

North Coast GP Linda Samera regularly travels to Sydney for vital medical treatment – but where is the affordable, accessible accommodation?

Podcasts on nurses and environmental health www.nurseuncut.com.au/podcasts-on-nurses-and-environmental-health/

Listen to expert speakers on environmentally healthy hospitals, plus fracking, climate change and nurses.

New on SupportNurses YouTube channel don’t privatise our homes!

Families of people with complex disabilities speak out. > youtu.be/F-G8Kw5C9sU a merrie band of nurses Pesky nurses in green caps waylay “Hockey and Abbott”. >youtu.be/FpwwpquTB7I

NSWNMA on Instagram!

Yes, we’re now on Instagram, so share your branch and local action photos with us @nswnma.

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 APRIL 2014 | 39

SOCIAL MEDIA

WHAT

Keep me logged in

Forgot your Password?

NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Workplace violence A study finds that one third of aged care nurses have experienced recent workplace violence.

Not feeling s’well Early results from the 2013 survey of nurse wellbeing show that nurses are not feeling swell.

Ageing workforce Delegate Karin Tilden wants the health department to consider the needs of its ageing nurse workforce.

I am amazed it is only one third. I feel that families of residents are getting more abusive towards staff, but they generally don’t use physical aggression.

Have to say, giving myself permission to be flexible about my priorities, while attempting to deliver person-centred care, does reduce my experience of threats of violence.

Night shift was the reason I got out of hospital and into community.

Shift work is unhealthy and antisocial. Have been a nurse 12 years and am planning on getting out due to the impact on my health.

Yes, but a lot of nurses ignore warnings. Nurses need to be healthy to look after someone else.

I have been on fulltime permanent night duty for 16 years and get frustrated at people who blame shift work for the state of their health. I am healthy and don’t think it comes down to luck. It’s a choice for me. As health professionals we have the information of what is right and see firsthand the results of not looking after your health. Don’t we need to be accountable for ourselves, and not use shift work as an excuse for bad habits?

I hope all nurses over 55 come forth and have their say on this. I am nearly 64 and still working. When we get to this age we have a lot to share and give to nursing students and other staff.

They all know about it but bury their heads in the sand. But wait, the pollies would like us to work until we’re 70!

Once you received service awards for loyal service, now they just want you out!

How lucky we are that this fabulous midwife is one of ours :) Love the cover! Gorgeous! // Nice to see someone smiling on the cover.

Pin-up midwife! // Might even read my copy this month ... ha ha!

Doesn’t she look great! // Candace you look awesome!

Thank goodness you put the lippy on Candace. Cover girl...

Popular front Last month’s Lamp cover was extremely popular

Penalty rates The Australian Nursing and Midwifery Federation fears that penalty rates will be in the firing line as the Productivity Commission reviews the Fair Work Act.

I’m not giving up my family time if I don’t get penalty rates. I’ve done it for years already but without the pay I’m off.

Unfortunately most of us came into the profession because we actually care about our fellow human beings and wanted to make a difference. I would like these politicians to become critically ill or have a family member requiring round the clock care.

I’d love to be home with my family on weekends, nights and not to mention Christmas, but if I have to work I expect to be paid for it.

Working weekends is the pits for social/family time but somebody has to do it. They need to review the penalties as in increase, not decrease.

If they even attempt to interfere with our penalty rates, all nurses should walk.

PHOTO GALLERY

Rydalmere disability nurses oppose the complete privatisation of their service by the NSW government.

US-style credit card rather than Medicare card? This popular Facebook meme delivered a resounding no!

Aged care nurses take part in the Kenna pay negotiations.

Nurses hold a vigil outside an LHD meeting on plans for a new Metford hospital: will it be privately run?

THE LAMP APRIL 2014 | 41

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.

TOGETHER WE’LL BEAT CANCER

Advertise in The Lamp.

Reach over 58,900 nurses and midwives.

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 71 No.2 MARCH 2014

Big win for mothers and midwives

The Lamp is produced 11 times a year and mailed to over 58,946 members. 97.7% are sent to residential addresses. It is uploaded to the NSWNMA website and gets 4,000 hits per month.

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

42 | THE LAMP APRIL 2014

test your

knowledge 1

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Across 1. Counteracting pain, as a posture assumed so as to lessen pain (8) 10. A radioisotope element used in brain diagnostic imaging (9) 11. Originating within the eye (8) 12. A benign tumor derived from smooth muscle, often of uterus (9) 14. Depressions at the part of an organ where vessels and nerves enter (4) 16. To sag (5) 17. To release from or as if from restraint (7) 20. A chronic autoimmune disorder (1.1) 21. Poisoning by toxins formed within the body (16)

32 34

25. A shallow circular glass dish used to hold solid culture media (5.4) 26. To exceed in weight (8) 27. A class of the Arthropoda (9) 28. A system of thought of the interests, needs, and welfare of human beings (8) 29. A message received and understood (4) 30. One of a blood group (1.1) 31. Lowered and raised head (6) 32. Liquid obtained by leaching wood ashes (3) 33. Electroconvulsive therapy (1.1.1) 34. An extrachromosomal replicating unit (7)

Down 2. Japanese martial arts (8) 3. A law of Ampère postulate (8) 4. Intestine (3) 5. A cytotoxic drug used in the treatment of lymphomas and leukemias (16) 6. Small sacs or pouches (8) 7. Fungi with yellowish gelatinous sporophores having convolutions resembling the brain (8) 8. One thousand grams (4) 9. Therapy that uses a local electric current to introduce the ions of a medicine into the tissues (1.1.1.1) 13. Minimally-invasive surgery (1.1.1)

15. The part of the back between the thorax and pelvis (4) 18. Capable of being made acid (11) 19. Characteristic of or suffering from kyphosis (11) 20. A large white blood cell, found primarily in the bloodstream and connective tissue (10) 22. Proof, evidence (9) 23. A section or part between two nodes (9) 24. Waxy; wax-like (9)

THE LAMP APRIL 2014 | 43

NURSING RESEARCH ONLINE

The NSWNMA’s argument for mandated minimum staffing levels has been further strengthened by the publication of more evidence connecting nurse staffing and skill mix with patient outcomes. Nursing Online recently presented current research and discussions linking the issues of staffing, skill mix and safety. results of the Keogh review of 14 hospital trusts in England showed that inadequate nurse staffing was an important factor in persistently high mortality rates. Austerity measures in Ireland and Spain have been described as adversely affecting hospital staffing too.

Research that could potentially guide policies and practices on safe hospital nurse staffing in Europe has been scarce. However, the nascent but growing scientific literature about nursing outcomes in Europe is complemented by research from North America showing that improved hospital nurse staffing is associated with low mortality.

Additionally, growing evidence exists that bachelor degree level education for nurses is associated with low hospital mortality. www.thelancet.com/journals/lancet/article/PIIS01 40-6736(13)62631-8/fulltext#aff1

Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study Prof Linda H Aiken, PhD, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing; and others Constraint of health expenditure growth is an important policy objective in Europe, despite concerns about adverse outcomes for quality and safety of health care. Hospitals are a target for spending reductions. Health-system reforms have shifted resources to provide more care in community settings while shortening hospital length of stay and reducing inpatient beds, resulting in increased care intensity for inpatients.

The possible combination of fewer trained staff in hospitals and intensive patient interventions raises concerns about whether quality of care might worsen. Recent findings of the European Surgical Outcomes Study across 28 countries, showed higher than expected hospital surgical mortality and substantial between-country variation in hospital outcomes.

Nursing is a so-called soft target because savings can be made quickly by reduction of nurse staffing, whereas savings through improved efficiency are difficult to achieve. The consequences of trying to do more with less are shown in England’s Francis Report, which discusses how nurses were criticised for failing to prevent poor care after nurse staffing was reduced to meet financial targets. Similarly, 44 | THE LAMP APRIL 2014

Nurse staffing and education in Europe: if not now, when?

Alvisa Palese, Roger Watson Results of the study by Aiken and colleagues show that the skills of the staff acquired at university create the conditions for safe staffing. The investigators report a 7% reduction in patient mortality for every 10% increase in the number of nurses with bachelor’s degrees. The continuing presence of graduate nurses in the staff (i.e., at least one per shift), able to guarantee surveillance and clinical judgment, creates a protective environment for surgical patients.

Recession has highlighted the cost of graduate education for nurses; therefore, health-care organisations could be attracted to vocationally trained nurses in the belief that costs might be lower and the nurses more effective. Paradoxically, and notwithstanding the support for research (including from the EU’s Seventh Framework Programme), in November 2013 the EU decided to approve two pathways for nursing education: a vocational school or training after 10 years of general education; and a higher education or university pathway after 12 years of education, which is a change from the previous directive that envisioned at least 12 years of general education before nursing education. www.thelancet.com/journals/lancet/article/PIIS01 40-6736(14)60188-4/fulltext

An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions Heather L Tubbs-Cooley, Jeannie P Cimiotti, Jeffrey H Silber, Douglas M Sloane, Linda H Aitken The purpose of this study was to examine associations between hospital nurse staffing ratios and readmission among children admitted for common medical and surgical conditions. We studied common conditions for the purposes of focusing on diagnoses and procedures where a readmission is generally considered undesirable and possibly preventable. We departed from traditional studies of 30-day readmission to analyse readmission in discrete time intervals within the first 30 days after discharge: within 14 days and 15– 30 days. This decision was prompted by clinical observations that re-hospitalisation in the immediate post-discharge period may be more related to the quality of hospital care than rehospitalisations beyond the first two weeks, which may be more influenced by non-hospital characteristics. We hypothesised that better staffing ratios within hospitals (e.g., fewer patients per nurse on average) would be associated with reduced odds of readmission during both time intervals, with the strongest and most significant effects evident within the first 14 days after hospital discharge. qualitysafety.bmj.com/content/early/2013/05/03/b mjqs-2012-001610.full

EDUCATION@NSWNMA

WHAT’S ON APRIL 2013 ——— • ———

Computer Essentials for Nurses and Midwives – 1 day 2 April Prince of Wales Hospital, Randwick 7 May Prince of Wales Hospital, Randwick

Members $85 Non-members $170

10

%

——— • ———

Tools in Managing Conflict and Disagreement – 1 day 3 April NSWNMA Waterloo

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

Are you meeting your CPD requirements? – ½ day 9 April Parramatta • 30 April Ballina 15 May Wagga Wagga • 12 June Newcastle Suitable for all nurses and midwives to learn about CPD requirements.

Members $40 Non-members $85 ——— • ———

Practical, Positive Leadership – 3 days 16 April, 12 May, 9 June, NSWNMA Waterloo Three-day workshop designed to meet the leadership needs of nurses and midwives.

Members $250 Non-members $400 ——— • ———

Legal and Professional Issues for Nurses and Midwives – ½ day 1 May Ballina • 16 May Wagga Wagga 13 June Newcastle Topics covered include Health Practitioner Regulation National Law, potential liability, importance of documentation, role of disciplinary tribunals and writing statements.

Did you know...

HEALnet topics are endorsed by the Australian College of Nursing

Members $40 Non-members $85 ——— • ———

Appropriate Workplace Behaviour – 1 day 14 May Wagga Wagga • 1 June Newcastle Topics include why bullying occurs; anti-discrimination law and NSW Health policies; appropriate behaviour in the workplace; identifying unlawful harassment and bullying; what to do if subjected to unlawful harassment and bullying; how to use workplace grievance procedures; identifying, preventing and resolving bullying.

Members $85 Non-members $170 ——— • ——— To register or for more information go to www.nswnma.asn.au/education or phone Matt West on 1300 367 962 ——— • ———

NSWNMA NEGOTIATION AND ADVOCACY PROGRAM 2014 Negotiation and Advocacy Part 1 (for Delegates/Activists/Members) 21 May • 17 September • 19 November NSWNMA Waterloo 9am – 4pm

160+ topics

Live Chat

Real time support

24/7 Access

Mobile Compatible

er:: ffeeer ff Off ive O clussiv Exclu n iption ed subscrriptio ited hs unlimit months 10% off a12 mont .au// du.au .edu net.e net, visit HEALnet o HEALnet, tto e quote thelamp or call 1300 8233 669 & quot ay 2014 May ffer ends 31st M Offer 414 O 0414 Lamp0 Lamp

Negotiation and Advocacy Part 2 The IRC, FWA, AHPRA and You 21 May • 17 September • 19 November NSWNMA Waterloo 9am – 4pm ——— • ——— For more information, contact Lyn Stevens at the NSWNMA 8595 1234 (Metro) 1300 367 962 (Regional)

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BOOKS

BOOK ME SPECIAL INTEREST The Dictatorship of Capital: The New Corporate World Order Michael Tubbs Boolarong Press www.boolarongpress.com.au RRP $19.95 ISBN 9780987234360 The themes in this book are of crucial importance for everyone as it considers the global financial crisis (GFC) and the global ecological crisis (GEC). It focuses on big companies or corporations and the role they play in shaping government policy and responses to events, and the power they have to shape public opinion. The author shows how the corporations of capital have gained vast power in society, to the detriment of democracy throughout the world. While private corporations have exploited labour and natural resources for their own profit, governments have failed in their duty of care. Corporations continue to hide their profits in tax havens, while ordinary citizens bear the brunt of the GFC and GEC, and no one accepts or apportions blame. Tubbs argues it is time to take action to lift the corporate veil of secrecy and privilege that protects corporations of capital, and to democratise them for the benefit of all.

A Straight Talking Introduction to the Causes of Mental Health Problems John Read and Pete Sanders PCCS Books (via Footprint Books) www.footprint.com.au RRP $25.95 ISBN 9781906254193 This pocket-sized book presents straightforward summaries of the history, theories and research into the various possible causes of mental health. Because there is no single convenient answer to the questions explored in this book, competing viewpoints are presented. Readers are encouraged to focus on what fits best with their own experience and decide what might be most helpful to them.

It is an engaging book that describes current opinion about the causes of mental health problems.

Midwifery Safari: East Africa Mavis Gaff-Smith Triple D Books www.tripledbooks.com.au RRP $30.00 ISBN 9780987522429 This is the author’s fifth book about the history and practice of midwifery around the world. In this book Mavis visits Uganda, Kenya and Tanzania, both as a tourist and as an informed observer of the practices of the Maasai and Pokot tribespeople. She examines the efforts being made in a variety of hospitals and clinics to provide modern medicine to the economically underdeveloped. She comments that she was truly inspired while observing their ingenuity and learned from their ability to earn a living and provide for themselves and their children.

Understanding Clinical Research Renato D. Lopes and Robert A. Harrington McGraw-Hill Education Australia www.mcgraw-hill.com.au RRP $POA ISBN 9780071746786 Understanding Clinical Research is a reference for addressing both the operational challenges of clinical trials and the need for an understanding of methods to interpret the results. An excellent resource for the reader to familiarise themselves with the field’s history, as well as its contemporary structural and operational components, and major research domains.

Nursing Leadership from the Outside In Edited by Greer Glazer and Joyce J. Fitzpatrick Springer Publishing Company www.springerpub.com RRP $28.95 ISBN 9780826108678 This book offers leadership lessons from luminaries in business, medicine, philanthropy, government, academia, research, and health care. The book sets out to prepare aspiring nurse leaders nurses to lead change to advance health.

It offers practical advice, lessons learned, and testimonials as to how nurses can prepare themselves for leadership, in turn helping them to provide exceptional patient care.

Understanding Behaviour in Dementia that Challenges: A Guide to Assessment and Treatment Ian Andrew James Jessica Kingsley Publishers (via Footprint Books) www.footprint.com.au RRP $35.95 ISBN 9781849051088 This book provides theory and practical advice on dealing with challenging behavior in a person with dementia, and suggests that the management of such behaviour should take into account the combined influences of chemical, neurological and physical changes, as well as psychological and social features.

This book is timely and relevant given the confusion regarding the current treatment of challenging behavior, including the use of drugs and the need to develop effective alternatives.

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 Information and Records Management Centre (IRMC). Contact Jeannette Bromfield gensec@nswnma.asn.au or Cathy Matias 8595 2121 cmatias@nswnma.asn.au. All reviews by NSWNMA IRMC Coordinator/Librarian Jeannette Bromfield.

Some books are reviewed using information supplied and have not been independently reviewed.

THE LAMP APRIL 2014 | 47

MOVIES

movies of the month THE INVISIBLE WOMAN An intelligent, absorbing film recreating the little-known personal life of Charles Dickens, writes Anni Cameron.

METRO MEMBER GIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to The Invisble Woman thanks to Hopscotch Films. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

48 | THE LAMP APRIL 2014

This is a fascinating true tale of the celebrated, powerful, middle-aged and very much married, Charles Dickens, and his 13-year affair with a woman of much lower social standing.

The beautiful Nellie Ternan, movingly played by Felicity Jones, is only 18 when the affair begins. The invisible woman of the title could allude not only to the socially unacknowledged Nellie, but also Catherine, his betrayed wife, played to great effect

by Joanna Scanlon.

Nellie’s mother, portrayed by Kristen Scott-Thomas in a powerful cameo role, could also be viewed as invisible. Drawn and haunted, she steps aside to allow the charismatic Dickens pursue Nellie while knowing the implications such a relationship holds for her youngest daughter.

The film opens with Nellie, a married mother and schoolteacher, haunted by her past secret affair with Dickens. Her memories, provoked by remorse and guilt, are used as flashbacks to tell the story of her evolving relationship with Dickens.

Ralph Fiennes, in his dual role as both the film’s director and key character, Dickens, has recreated the social mores of 19th century England. His attention to detail brings Claire Tomalin’s investigative biography of Dickens to life, depicting the costumes, hairstyles, speech, social attitudes, values and sexual repression of the time, as well as the very obvious sexism and double standards.

Fiennes portrays a complex, driven figure: a private and emotionally aloof man behind the charismatic showmanship of his public persona. During this affair Dicken wrote one of his greatest novels, Great Expectations, and it could be surmised that Nellie was the inspiration.

However, his passion for Nellie is frustratingly subdued on screen and so he remains a rather remote, chauvinistic presence.

His inability to connect on an emotional level is also seen in his cruel, dismissive treatment of his wife.

If The Invisible Woman is a tale of repression and emotional abuse, it is also a bittersweet love story, sympathetic to all its characters and subtle in presenting the suffering and humiliation that women of that time must have endured.

Anni Cameron, RN, BHA MEd, is a Teacher of Nursing at St George TAFE, Sydney IN CINEMAS APRIL 17

DVD SPECIAL OFFER

I took my 13-year-old daughter to see this film, writes Sue Miles, and we left the cinema with hearts soaring and spirits uplifted.

Beautifully filmed in rural Victoria, Healing tells the story of a long-term inmate, Viktor Khadem (Don Hany), who is sent to a low security prison farm to serve out the remainder of his sentence.

In this unique environment there is a place for redemption and healing of the spirit. Damaged men are rehabilitated on the farm by taking responsibility for the rehabilitation of injured raptors, birds of prey, beautiful fearsome eagles, falcons and owls.

Hugo Weaving plays Matt Perry, the caseworker responsible for establishing this unique program. He introduces Viktor to the injured Yasmine, a majestic wedge tailed eagle with a two metre wingspan.

The journey of healing an injured spirit, and the discovery of hope in the seemingly beyond help,

unfolds within an Australian bush backdrop complete with the ear piercing shrill of cicadas.

The production of this powerful story was inspired by true events and was filmed at Healesville Sanctuary in the Yarra Valley.

Sue Miles is a Mental Health Nurse at the RPA IN CINEMAS MAY 8

METRO MEMBER GIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to Healing thanks to Pinnacle Films. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

A fictional re-telling of one of the most stunning scandals to rock the United States, American Hustle tells the story of brilliant con man, Irving Rosenfeld (Christian Bale), who along with his equally cunning and seductive British partner Sydney Prosser (Amy Adams), is forced to work for a wild FBI agent, Richie DiMaso (Bradley Cooper).

DiMaso pushes them into a world of Jersey powerbrokers and mafia that’s as dangerous as it is enchanting. Jeremy Renner plays Carmine Polito, a passionate, volatile, New Jersey political operator caught between the con artists and federal agents. Irving’s unpredictable wife Rosalyn (Jennifer Lawrence) could be the one to pull the thread that brings the entire world crashing down.

Like director David O. Russell’s previous films, American Hustle defies genre, hinging on raw emotion, and life and death stakes.

RURAL MEMBER GIVEAWAY Email The Lamp by the 15th of this month to be in the draw to win the dvd of American Hustle. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

THE LAMP APRIL 2014 | 49

DIARY DATES

conferences, seminars, meetings NSW Mountains to the Sea Midwifery Conference 4 April Wollongong Snez or Jo 4253 4275 NSW Orthopaedic Nurses Association Conference – Bones in the City 4 April Sydney aona.com.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 X-ray interpretation for RNs Australian College of Nursing 10 April Burwood 1800 265 534 studentservices@acn.edu.au ACN Nursing and Health Expo NSW 10 May Sydney Town Hall www.acn.edu.au/expos 1800 061 660 events@acn.edu.au Nurses Christian Fellowship workshop: Caring for their families 20 May Sydney www.ncfansw.org Resus at the park 28-30 May Sydney www.resusatthepark.com.au Jayne@eastcoastconferences.com.au Turning the Tide on Continence 14 June Port Macquarie Cost $50, morning tea /lunch provided Keynote speaker Pauline Chiarelli local pharmacist jca43356@bigpond.net.au Ann 0413 992 468

Through These Lines – a play about Australian Army nurses in WW1 24 July-5 August Newcastle www.civictheatrenewcastle.com.au/index.php 14th Rural Critical Care Conference 22-23 August Tweed Heads www.ruralcritalcare.asn.au Jayne@eastcoastconferences.com.au Smart Strokes 2014 10-year anniversary: Are We Fit For The Future?

28-29 August Sydney www.smartstrokes.com.au smartstrokes@theassociationspecialists.com.au 4th Annual NSW Health and Ambulance Bowls Tournament 7 September St. John’s Park Bowling Club Paul 9828 5391 (business hours) Paul.Sillato@swsahs.nsw.gov.au Children’s Hospital at Westmead Paediatric Perioperative Seminar 13 September Westmead claudia.watson@health.nsw.gov.au georgina.whitney@health.nsw.gov.au Enrolled Nurse Conference 18-19 September Tweed Heads 1300 554 249

ACT Australasian Neuroscience Nurses Association Conference 40-year anniversary: yesterday, today, tomorrow 7-9 May Canberra Leigh Arrowsmith 0400 927 022 leigh.arrowsmith@health.nsw.gov.au 3rd Biennial Australian Capital Region Nursing and Midwifery Research Centre Conference 16-17 October Canberra www.rcnmp.com.au

INTERSTATE 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 ACMHN Consultation Liaison and Perinatal and Infant Mental Health annual conference 11-13 June Adelaide Jenni.Bryant@calvarymater.org.au Cultural Diversity in Ageing 2014 Conference: Shaping Inclusive Services 12-13 June Melbourne www.culturaldiversity.com.au/conference2014 03 8823 7979 Nursing Informatics Australia 2014 Conference E-health is changing healthcare: Nurses meeting the challenges 11 August Melbourne www.hisa.org.au/page/hic2014nia hic@hisa.org.au 15th International Mental Health Conference 25-26 August Paradise www.anzmh.asn.au/conference conference@anzmh.asn.au Paramedics Australasia International Conference 18-20 September Gold Coast www.paic.com.au ACMHN 40th International Mental Health Nursing Conference 7-9 October Melbourne www.acmhn2014.com events@acmhn.org 02 6285 1078

OVERSEAS

Cr osswor d solution

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50 | THE LAMP APRIL 2014

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K E E B I U M L D O Y O M A I N E A S H C U C T I O N E D C E T R I D I S H A F B R A C H N I D A E A C A B K N F O U L Y E D P I S O M E U T T R E I C U L X I

7th World Congress for Psychotherapy 25-29 August South Africa wcp2014.com secretariat@wcp2014.com 3rd World Congress of Clinical Safety: Clinical Risk Management 10-12 September Spain www.iarmm.org/3WCCS

Nurses Christian Fellowship International PACEA Conference Compassion: The Cornerstone of Care 10-14 October Fiji pacea-region@gmail.com 4th International Conference on Violence in the Health Sector 22-24 October USA www.oudconsultancy.nl/MiamiSite2014/inde x.html International Conference on Infectious and Tropical Diseases 16 -18 January, 2015 Cambodia ictid.webs.com

REUNIONS Sacred Heart Mercy Hospital Young May 24-25 Joy Cameron 6382 2762 or 0419 822 473 Ann Symons 6382 6334 Tamworth Base Hospital Nurses July 74 -77 group (40-year reunion) 8-9 June Tamworth Bronwyn Johnson (nee Ashworth) 02 9315 7545/0431 446 114 johnsonsbronte@gmail.com St. Vincents Hospital PTS group August 1974 July 12 Sydney Cate Keast (Taylor) 0415 653 221 02 6653 6915 domxav@bigpond.com Mater Graduate Nurses’ Association Annual Reunion 19 October North Sydney Joan Taniane 0401 344 363 joans2458@yahoo.com Prince Henry Hospital PTS Jan 1964 meet-up at annual PHH reunion 25 October Helen Millan (nee Flanagan) helenmillan@bigpond.com NEC Prince Henry/POW Hospitals Oct 1972-75 25-26 October Margret Brignall (Samuel) 0418 646 959 Sonia Keeling (Graf) 0407 221 407 Marcia Jarvis (Fitch) 0438 415 647 Dianne Walkden (Edwards) 0400 621 470 Gill Gillon (Horton) 0401 048 205

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