Lamp June 2014

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 71 No.5 JUNE 2014

NURSES AND MIDWIVES

A force for change

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IT’S WAR ON YOUR LIVING STANDARDS

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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.5 JUNE 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 | A force for change As workers and their unions celebrated the achievements of working people, PM Tony Abbott celebrated May Day by releasing his Commission of Audit report – a blueprint for decimating Medicare.

Ciaran McCloughan, EN, Fiona Deegan, CNS PHOTOGRAPH: SHARON HICKEY

REGULARS

5 6 8 33 39 43 45 47 48 50

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

COMMISSION OF AUDIT

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

BUDGET 2014

18 | Health the casualty in a liar’s budget

There were enough bombs in the budget to blow our public health system out of the water.

Editorial Committee • Brett Holmes, NSWNMA General Secretary • Judith Kiejda, NSWNMA Assistant General Secretary • Coral Levett, NSWNMA President • 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

PENALTY RATES The Lamp ISSN: 0047-3936

22 | It’s war! On your living standards

27| PM’s next target: your rights

Tony Abbott has asked the Productivity Commission to review workplace laws.

HEALTH

CAB

AUDIT 04/2013– 03/2014 Average net distribution

60,303

30 | Nurses and midwives on the toxic front line Attendees at a recent NSWNMA seminar heard grim statistics on the potential effect of workplace chemicals on health professionals.

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 JUNE 2014 | 3

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

A disastrous budget for health Medicare as a universal health care system will be finished if Tony Abbott gets his way.

The attack on Medicare and the public health system will inevitably have an impact on nurses and midwives …

Tony Abbott’s prescription for health, as set out in his government’s first budget, is a textbook example of what not to do if you want an efficient and fair public health system.

The most generous reading of the government’s agenda would be to say that it reveals a profound ignorance about health.

Without doubt the biggest losers will be patients. Taking an axe to Medicare will force Australians to put their capacity to pay before their clinical needs. Not only will it cost patients more – financially and in terms of their health – ultimately it will cost the country more.

Nurses and midwives understand well that delaying or avoiding GP consultations, diagnostics or pathology tests can lead to catastrophic outcomes, and increased costs of care, for the most vulnerable in our community.

Either Tony Abbott and Joe Hockey do not understand these fundamentals of preventative health or they are being cruelly indifferent.

NOT EVERYONE IS BEING ASKED TO DO THE HEAVY LIFTING The Abbott government has used the Commission of Audit and the budget to weave a narrative that says Australia has a severe budgetary crisis and that “we are all in this together”.

Neither is true.

Australia’s economy is fundamentally sound and any budgetary problems we have are surmountable without taking to Medicare, our education system and our safety net with a chainsaw.

When it comes to health expenditure and health outcomes Australia has an efficient and enviable public health system.

Health spending in Australia comes to 9% of Gross Domestic Product (GDP) compared to 18% in the United States. A significant amount of that 9% already comes out of the pockets of patients. Government spending on health only comes to 6% of GDP.

Bloomberg, the influential American business media company, rated Australia’s health system the seventh most efficient in the world. The US system – which appears to be the favoured model of the Abbott government – came 46th.

Ultimately, embracing a user-pays model doesn’t save money it merely shifts the costs on to the community through co-payments and means testing.

There is no budgetary or economic crisis in Australia that even remotely justifies the savage attack on our health system and our living standards that this Abbott/Hockey budget sets out.

These attacks are not about economics, they are about power and ideology. There are a lot of losers in the budget but there is one group of very significant winners – big business interests in mining and finance.

The government is committed to cutting company tax by 1.5%. It is also axing the carbon tax and the mining tax in response to well-funded campaigns by big business. These corporations are not only being absolved of their responsibility to pay their fair share of tax, but their generous subsidies, financed by the public purse, are being maintained.

COMMISSION OF AUDIT IS LONG–TERM BLUEPRINT The severity and the intent of the budget is a wake up call. The attack on Medicare and the public health system will inevitably have an impact on nurses and midwives and a move to a user pays system will diminish the care we are able to give.

But the budget is likely to be just the first stage in the government’s agenda. The Commission of Audit is the long-term blueprint for what will follow (see page 20). Here, pay, penalty rates, overtime and allowances – all the staple targets of WorkChoices – will come into play again.

ONE HONEST LIBERAL? We welcome a post-budget commitment by New South Wales Health Minister, Jillian Skinner, to put patients first and promise no cuts to hospital services and no co-payments for emergency department patients, despite the budget measure of lifting restrictions to do so.

We can only hope Minister Skinner is better at keeping promises than Prime Minister Abbott.

THE LAMP JUNE 2014 | 5

YOUR LETTERS

LETTER OF THE MONTH

Hockey makes history of health In my opinion the Hockey budget and Medicare co-payment are the most regressive health care policies ever put forward. I work in the Transitional Care Program (TCP), a 12-week program that transitions elderly clients from hospital to home.

Our team has an upfront view of how elderly Australians are coping. We are one of the few TCPs to operate without a co-payment.

TCP encourages the involvement of local GPs, most of whom bulk bill pensioners. A large number of our clients would be significantly disadvantaged by the GP co-payment, to the point they would reconsider attending their GP appointments. But this is only the thin end of the wedge: 1. Petrol tax: Transport to the GP, increased cost passed on to taxis, service providers and community transport or personal fuel cost if the pensioner is lucky enough to have a car.

2. GP co-payment: $7 3. Blood tests and X-ray: $7 each 4. Prescriptions: 80c per script increase. Most people are on at least three medications.

So the government will take away the aged care supplement of between $876-$1320 a year, hit them with the fuel excise that will flow on to all goods and services, then charge them on an average GP visit with an x-ray, blood test and three prescription medications, $23.40.

Add to this the change in the asset test on July 1 this year to access services such as community age care packages, which up to now have seen people receive care in their home with subsidies provided by government.

So Joe Hockey, the age of entitlement is over.

Entitlement to a decent standard of living. Entitlement to access appropriate health care. Entitlement to receive appropriate services to continue to live in one’s own home. Entitlement to live in a society that values its old people.

You’re a history maker all right.

Zoe-Anne Guinea, RN CNS, Burringbar

HAVEYOURSAY 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.

6 | THE LAMP OCTOBER 2013

Disgust at attack on Medicare I am writing to express my disgust at the 2014 Budget and the attack this government has made against Medicare. The introduction of the co-payment is going to destroy what universal, free at point-of-service health care we have left.

Early last year in America a middle-aged man presented to an emergency department with symptoms of bowel obstruction and spent his family’s life savings, re-mortgaged his home only to learn he had inoperable metastatic bowel cancer he could not afford to have treated. One year earlier, he had symptoms but these had not been investigated because he could not afford the tests. We hear these horror stories about the US and think perhaps this wouldn’t happen in Australia.

But with the recent budget announcements that favour privatisation, moving in this direction is a very real possibility.

The inequalities that already exist in Australia are highlighted by the following: an Australian Bureau of Statistics survey found that about 10% of adults referred to a specialist delayed or didn’t keep the appointment because of cost. The same survey found 9% of adults delayed or failed to fill prescriptions because they couldn’t afford to do so. This rose to over 12% in the most socio-economically disadvantaged population.

And now, with this $7 co-payment, if you have four children all sharing a bug and all needing to see the GP, that’s $28, which is nearly two hours of our minimum wage – why should anyone have to work for two hours to have their family seen by a doctor? Especially while we still pay a Medicare levy. And more importantly, how many people would go without medical attention and end up sicker than they would have been with early intervention, therefore putting more pressure on our health system?

It is easy to assume that $7 is just the beginning and horrific to think about what that cost will be in five, 10 or 20 years.

I say shame on the Liberal government. This attack on Medicare is only one aspect of this federal budget that blatantly attacks our way of life.

Frances Usherwood, RN CNS, Coogee Burnt out in neonatal I took part in your last film about ratios in neonatal nursing. Our situation is getting worse. We are overworked and very understaffed. Ultimately our tiny patients are being put at risk. I came into neonatal nursing as it was my passion and I thoroughly enjoy educating new mothers and dads.

Now we have barely enough time to do the bare minimum. Most shifts I go home thinking “gee, have I done everything?” And I hate feeling that way. I used to hop out of bed every morning excited to start my day in the NICU. Now every day is a struggle to get out of bed knowing what we nurses have to put up with and knowing I won’t be able to give the best care possible to my tiny patients.

The health system is in dire straits and it’s only going to get worse.

We are burnt out, which is sad to say as I’m only an eighth year RN. Tamara Macdonald, RN, Spring Farm

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

YOUR LETTERS

Greener practices The NSWNMA environmental health seminar (14 March) was great, so interesting. It brought home the very small changes we can make in our nursing and midwifery practice to help the environment. Also how vulnerable we are in our profession – we are one of the highest industries with environmental asthma and breathing disorders due to the use of cleaning products, i.e. hand washing solution, the many other chemicals we are exposed to in our daily work practices.

I was so inspired, as was my colleague, that we have joined the environmental planning committee and intend to make it far greener.

This would be a great topic to bring in at annual conference in the future. Well done NSWNMA. Jacqui Myers, RM RN, Avoca Beach Find all NSWNMA seminar podcasts at www.nswnma.asn.au/podcasts Cuts, cuts and more cuts Is this the end to universal healthcare in Australia? This was a budget we all knew was coming but was it one we were ready for?

Announced was the introduction of a Medicare co-payment, a co-payment for pathology and radiological services, the slashing of $80 billion of health and education funding to the states and the removal of provisions that once stopped the states from charging those who present to emergency departments.

Who does this Budget really affect? It’s the vulnerable – the sick and aged, children and those requiring government support. As we continued to watch the budget being delivered we saw cuts, cuts and more cuts.

These changes raise many questions, which we as Australians, and more importantly as health care professionals, should think about.

With cuts to social services and changes flagged for the pension, how is a Medicare, radiological or pathology co-payment to be made – do they go without dinner that night? $7 may not seem much to you or me but for some it’s the difference between an evening meal or not.

With such drastic cuts to funding, how will the states continue to fund essential public hospital services? Will this mean the introduction of a hospital co-payment in the future? Will nurses be forced to means test or decide how to administer a co-payment?

What happens to the chronically ill – those with respiratory, renal or cardiac issues – changes to the PBS means extra costs for their medications will be passed on to the consumer – our patients.

I’m proud to be a member of this union. We all should be. A union that is standing up for the sick, injured and those who need help standing up for themselves.

We put patients before profits.

Ciaran McCloughan, EN, Meadowbank

letter of the

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

“Whatever your next purchase, remember Union Shopper.

After all, who can think of a reason NOT to save.”

Hold on to your registration I am an Enrolled Nurse and a member of the Queensland Nurses Union. I am in my final year of studying a nursing degree at university. With the proposal last year by the Australian Health Practitioner Regulation Agency (AHPRA) to end dual/concurrent registration for nurses by end-of-May 2014, my university saw significant numbers opt to drop the Bachelor of Nursing degree with the decision to stay as an Enrolled Nurse.

We have been hard hit in Queensland by cuts to nursing positions across the state by the Liberal/National government, so now more than ever, many ENs upgrading to RN are looking at an uncertain future with regard to employment upon graduation. I have personally heard claims of new graduate registered nurses being registered for up to two years and not having gained any type of nursing employment, despite ongoing, fruitless applications for positions. The situation is deplorable. Letting your EN registration go for possible unemployment as a new graduate RN would be foolish to say the least in the current environment.

Some employers have also demanded that ENs choose only the RN registration once they graduate, with the employee finding out later that the employer had no opportunities for them to gain a place on a graduate program or employment. This left ENs in an unsatisfactory situation, with no EN registration, no job, an RN registration and still no job!

There are other reasons I thought AHPRA should not force an EN to surrender their registration based on my belief that the individual has done the training and holds the title and should not be forced to surrender it. After all, an RN can’t just go and be an EN – they must do the training, which as we have always been told is different! If you can prove you are competent and have undertaken the Continuing Professional Development points then why should you be forced to give up your registration?

I’ve had clarification from AHPRA in April 2014 that a nurse under national law is able to hold dual concurrent registration as an Enrolled and Registered Nurse. The formal AHPRA policy that was to take effect in May 2014 is currently being reviewed.

Wayne Wheeler, EN, Queensland NSWNMA RESPONDS Well said Wayne. As far as we are aware the NSWNMA was a lone voice in arguing against the Nursing and Midwifery Board of Australia’s position, from the very beginning of the consultation on the matter. We did not accept the widespread view that holding concurrent registration was somehow a threat to patient safety and we stood firm in our belief that it was fundamentally unjust to force someone to surrender their registration based on such spurious grounds. This is a win for fairness and common sense. We have recently written to AHPRA to urge them to write to those affected to notify them of the change. We would certainly like to hear from any NSWNMA members who are unhappy that they were forced to drop one of their registrations on the basis of this now abandoned position. Please contact Angela Garvey, Professional Officer on agarvey@nswnma.asn.au

unionshopper.com.au • 1300 368 117 THE LAMP JUNE 2014 | 7

COMPETITION

Win a set of chic suitcases

NEWS IN BRIEF

Italy

From PM to aged care worker Silvio Berlusconi, the former Italian prime minister and media mogul, has been convicted of tax fraud and sentenced to work parttime in a home for the elderly.

The 77-year-old will work in a home outside Milan run by the Sacred Family Foundation (Fondazione Sacra Famiglia), according to the Guardian.

Judge Pasquale Nobile de Santis ordered Berlusconi to carry out volunteer work in the home “once a week and for a period of no less than four consecutive hours”.

Berlusconi’s lawyers welcomed the ruling as “balanced and satisfactory”.

The former prime minister was handed a four-year sentence – commuted to a year – for tax fraud at his Mediaset television empire last year. He has also been barred from holding public office for two years and was expelled from the Italian senate.

Sweden

www.americantourister.com.au

Less hours more productivity Council staff members in the Swedish city of Gothenburg will trial a six-hour workday, according to SBS.

American Tourister Prismo Competition 50 O’Dea Avenue, Waterloo, NSW 2017

“WE HOPE TO GET THE STAFF MEMBERS TAKING FEWER SICK DAYS AND FEELING BETTER MENTALLY AND PHYSICALLY AFTER THEY’VE WORKED SHORTER DAYS.” The workplace experiment aims to reduce sick leave, increase productivity, create more jobs, and save the country money in the long term.

Mats Pilhem, deputy mayor of Gothenburg said, “we think it’s time to give this a real shot in Sweden”.

Pilhem pointed to a Gothenburg car factory that recently tested a six-hour workday with positive results. He believes inefficiency in the workplace is created by longer shifts, particularly relevant in the aged care sector.

“We hope to get the staff members taking fewer sick days and feeling better mentally and physically after they’ve worked shorter days,” he said.

Several parts of Sweden have been experimenting with the shorter workday model since 1990. Recent OECD (Organisation for Economic Co-Operation and Development) data suggests shorter working hours equal greater productivity.

NEWS IN BRIEF

Britain

Midwife shortage link to infant deaths?

Britain’s leading obstetrician says it is legitimate to ask whether understaffing of maternity wards is contributing to Britain’s high rates of infant death and brain damage.

Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists, raised his concern that nearly 300 babies a year are dying during or soon after birth in England, with a further 1200 suffering brain damage or other serious health problems.

“We need to look at the possibility that understaffing, labour wards that are under pressure and busy, and stretched facilities may be a factor in some of these poor outcomes,” he told the Guardian.

The UK had the third-worst stillbirth rate among 35 high-income countries, according to a study published in the medical journal The Lancet in 2011.

Richmond said it was “a legitimate question to ask” whether the lack of resources was contributing to the tragic toll, adding there “are still a lot of mums in the 21st century that are losing their babies unnecessarily”.

Cathy Warwick

“FAILURE TO FILL MIDWIFERY VACANCIES WAS A RECIPE FOR DISASTER THAT COULD ONLY HAVE A DISASTROUS IMPACT ON STAFF MORALE, BURNOUT AND SICKNESS RATES.”

While there has been a 22% increase in births in the UK in the past decade, that has not been matched with an equivalent increase in midwife and doctor numbers.

Four out of five English hospitals have too few midwives according to official NHS figures.

The National Audit Office says the NHS needs 2300 more midwives, although the Royal College of Midwives (RCM) puts the figure at 4800.

Cathy Warwick, the RCM’s chief executive, told the Guardian that the failure to fill midwifery vacancies was “a recipe for disaster” that could “only have a disastrous impact on staff morale, burnout and sickness rates, which only make maternity services even more short-staffed.”

Australia

Getting rich off the aged Aged care workers are used to their employers crying poor but players in financial markets are finding aged care companies a lucrative source of profits.

“MAKING A PROFIT IS ALWAYS GOING TO TRUMP QUALITY OF CARE.” — Charmaine Crowe, Combined Pensioners and Superannuants Association Recently, Japara Healthcare, the first pure aged care company to be listed on the stock exchange, was publicly floated with a value of $450 million. The company was initially floated at $2 a share but after one day’s trading its value had ballooned by 35% to close at $2.70 a share.

Online news site Crikey said “… it is easy to be bullish about aged care. We all know about the ageing population. The government forecasts we need another 74,000 nursing home places (on top of the existing 186,000) by 2022”.

Crikey says investors are attracted to aged care companies by the profitability of accommodation bonds.

“It is effectively free money: providers can charge whatever bond they think the market can bear, relative to local house prices given most residents sell their homes to raise the bond. Bonds were not expected to exceed $100,000 originally but are averaging about $275,000,” it said.

Japara is forecasting revenue from bonds will rise from $9 million in 2012-13 to $25 million in 2013-14 and triple to $77 million the year after.

Not everyone shares the exuberance of the market about the profits to be made in aged care.

Charmaine Crowe from the Combined Pensioners and Superannuants Association told Crikey there was an inherent conflict of interest between for-profit companies with their obligations to shareholders and care for the aged.

“Making a profit is always going to trump quality of care,” she said. “We believe the current regulation around care quality is failing and doesn’t ensure resident health and welfare is upheld.”

THE LAMP JUNE 2014 | 9

NEWS IN BRIEF

World

Australia

IMF: inequality slows growth

Public believes alcohol abuse will worsen

A recent discussion paper from the International Monetary Fund says that countries with high levels of inequality suffer lower growth than nations that distribute incomes more evenly.

The paper also warned that inequality could make growth more volatile and create the unstable conditions for a sudden slowdown in Growth Domestic Product.

The paper was written by Jonathan Ostry, deputy head of the IMF’s research department with economists Andrew Berg and Charalambos Tsangarides.

The authors said “… we find that higher inequality seems to lower growth. Redistribution, in contrast, has a tiny and statistically insignificant effect.”

The new study comes 18 months after the IMF published its analysis that government cuts to public-sector spending were having a detrimental impact on economies.

The public believes Australia has a drinking problem that is getting worse, according to an annual poll commissioned by the Foundation for Alcohol Research and Education.

United States

Last abortion clinic faces closure Mississippi could become the first state in the United States without a single abortion clinic, thanks to a legal challenge by opponents.

63%

HAVE ENGAGED IN NEGATIVE BEHAVIOUR AFTER DRINKING ALCOHOL

Mississippi did have 14 different facilities that offered abortions but that number has dwindled to just one due to harsh legal procedures known as TRAP laws (Targeted Regulation of Abortion Providers), which allow states to indirectly limit a woman’s access to legal abortion.

The American College of Obstetricians and Gynecologists opposes these laws.

According to the online news site Think Progress, only two doctors provide abortion care in Mississippi and they fly in from out of state to serve their patients. These doctors haven’t been able to get hospitals to agree to the new legal procedures, so the future of their work is in doubt.

“The devastating impact of this unconstitutional law couldn’t be clearer,” Julie Rikelman from the Centre for Reproductive Rights said.

Ms Rikelman, who is an attorney representing Mississippi’s last clinic, the Jackson Women’s Health Organisation clinic, said, “If it is allowed to take effect, Mississippi will become the first state since Roe v.Wade without a single clinic offering safe, legal abortion care.

“Women across the state will be plunged back into the dark days of back-alley procedures that Roe was supposed to end.”

10 | THE LAMP OCTOBER 2013

Consistent with previous years, the poll found that the majority of Australians (78%) believe Australia has a problem with excess drinking or alcohol abuse, and 76% believe that alcohol-related problems in Australia will get worse or remain the same over the next five to 10 years.

The majority (79%) of Australians also believe that more needs to be done to address alcohol-related harms, with people believing that governments, alcohol companies, and clubs and pubs are not doing enough to address alcohol-related harms.

The poll revealed that in the previous 12 months, 24% of Australian drinkers had not been able to stop drinking once they started, 22% could not remember what had happened the night before, and 31% had a feeling of guilt or remorse after drinking. Gen Y is most likely to report all three of these behaviours (31%, 28% and 45% respectively).

Drinkers were asked for the first time about the behaviours they engage in after consuming alcohol. Almost two-thirds of drinkers (63%) have engaged in negative behaviour after drinking alcohol (including vomiting, having an argument or driving a car), with 30% having done so in the previous 12 months.

More than one-third (37%) of Australians have been affected by alcohol-related violence, and 70% have been negatively affected by someone else’s drinking in some way (including property damage and physical abuse).

NEWS IN BRIEF

Australia

Short story and poetry winners announced Arch Sirondom has won the inaugural Nurses and Midwives Short Story and Poetry Competition for his story Her Smile.

Arch, who is in his last year of undergraduate nursing studies at Sydney University, wins a prize of $2000 donated by First State Super.

The two runners-up in the competition, which was held to celebrate International Nurses/Midwives Day, were Kathleen Wurth with her story The Ambulance and Mary Perry with her story Those Were the Days. They each win $500, also generously donated by First State Super.

Ariane Blom won a Readers’ Choice award, with her story Serendipity, which was voted for by visitors to the NSWNMA website. Ariane wins a prize of $500 donated by the NSWNMA. More than 60 stories and poems from members and associate members were entered into the competition.

Judges Mary Chiarella, a former NSW Chief Nursing Officer and Dr Debra Adelaide, a writer and academic at UTS, said they found the entries to be of a very high standard.

NSWNMA General Secretary Brett Holmes says the level of creativity revealed in the entries was exciting.

“The competition has been a great success and we will be running it again next year,” he said.

All entries can be found on the NSWNMA website: www.nswnma.asn.au

NOTICE

Notification to members regarding tax receipts

As of 1 July 2014, the Association tax has ceased mailing out member statements for membership fees.

These statements are now available online by simply visiting our website at www.nswnma.asn.au and logging in to the NSWNMA Members Only section.

THE LAMP JUNE 2014 | 11

COVER STORY

MAY DAY MARCH

A force for change As nurses and other workers and their unions celebrated the achievements of working people, Prime Minister Tony Abbott celebrated May Day by releasing his Commission of Audit report – a blueprint for decimating Medicare, the minimum wage, penalty rates and our industrial relations system.

AFTER SPENDING THE PAST THREE YEARS wandering from worksite to worksite in a hi-vis vest, pretending to be a friend of the worker, Tony Abbott has at last shown his true colours.

His hand picked Commission of Audit, dominated by representatives of big business, has produced a blueprint for change that will kill Medicare and destroy workers’ rights well beyond the ambitions of WorkChoices.

On a bright sunny day that belied this grim future thousands of trade unionists and supporters gathered to celebrate the annual May Day march in central Sydney.

A large contingent of nurses were there to present their own blueprint for change: better ratios for safer patient care, defending Medicare, opposing privatisation of public services, defending our rights at work including penalty rates, and advocating a “Robin Hood” tax to fund improvements in health.

NSWNMA General Secretary Brett 12 | THE LAMP JUNE 2014

Holmes said the challenges were clear and formidable but nurses had proven before that they could be a positive force for change.

“On May Day 2014 we face more fights and battles than you could imagine.

We face a battle as a society and as a union movement and as progressive people in our country to maintain the integrity of our universal healthcare system, Medicare,” he said.

“Previously you wouldn’t have imagined the sort of attacks that are now being faced by Medicare.

“The threat against universality. The threat that people will be co-paying every time they go to see a doctor. The threat that those people who are considered richer will somehow be forced to go off Medicare and only rely on private health insurance.There is the threat that Medicare will only become a safety net for the poor.”

Brett says the challenge cannot be limited to holding on to what we have

got. It is also about improving our health system and society.

“We still have the battle for safe patient care and members across our public health system are gearing up for a fight to extend and improve nurse-to-patient ratios,” he said.

Brett says the NSWNMA, along with other unions, will stand up for those within our society who don’t have a voice.

“We have to stand up for those people and send a message to our state and federal governments that are hell bent on ruining the social systems of this country, and who are completely focused on privatisation and handing money over to their lobbyist mates.We have to tell them that enough is enough.

“Nurses and midwives are a force for change.We need to be talking to our friends, relatives, our communities and the wider Australian society.We have a credible voice and we are calling on nurses and midwives to stand up and have their voices heard.”

What May Day speakers said “EVERYTHING BUILT

BY WORKING PEOPLE IN THIS COUNTRY …

TONY ABBOTT HOLDS IN CONTEMPT.”

“THE ABBOTT GOVERNMENT’S COMMISSION OF AUDIT THINKS AUSTRALIA’S LOWEST PAID WORKERS ALREADY EARN TOO MUCH.” LINA CABAERO-PONNAMBALAM, from Asian Women at Work, a community organisation that represents migrant women workers, spoke about threats to the low paid.

“Do you know, under this government, rules that helped ensure Australia’s garment makers did not use sweatshop labour were needlessly discarded as part of its so-called red tape cuts?

“Mr Abbott’s government did just that and its ultimate intention is to dismantle the current protections for outworkers who are some of the lowest paid and most vulnerable workers in the country.

“This government governs for the wealthy and will not think twice about disadvantaging those who are already doing it tough such as migrant women workers in low paid employment and their families. Just look at the Abbott government’s Commission of Audit report. It thinks Australia’s lowest paid workers already earn too much.

“This is why May Day 2014 is very important, for we have to commit – now more than ever – to work together to prevent this government from robbing us of a decent future.”

SALLY MCMANUS, Secretary of the Australian Services Union Services Branch told May Day marchers we face a federal government that holds Australians and Australia in a deep and lasting contempt.

“If we needed any further proof it came in this week’s Commission of Audit, which represents – and let’s not mince words – the most comprehensive and savage attack on Australian workers, their living standards, their health care, their services, and the wages ever dared by a conservative government.

“Everything built by working people in this country – everything – Tony Abbott holds in contempt.

“Our union movement, our public institutions, our hospitals, our schools, our universities, even our childcare centres, Medicare, the pension, and now the minimum wage.

“All gains made by working people through their unions: women and men who have believed in and fought for a more decent and more equal Australia.

“Tony Abbott does not even believe in the weekend for working people, which is why he is planning the aggressive abolition of penalty rates.

“He has abolished nearly every expert advisory committee.

I mean, why do you need this when you have corporate lobbyists who will pay to tell you what to do?

“It is our job – and our duty – to stop this wrecker.

“We have done it before and we can do it again.”

“IF WE STAY TRUE TO OUR VALUES …

WE WILL PREVAIL.” MARK LENNON, Secretary of Unions NSW, says the conservative blueprint set out by the Commission of Audit is an affront to union values.

“We are standing up for working people, minorities and the oppressed here and everywhere. Everyone in this country can be treated with dignity and respect because unions stood up for it.

“We had free education because unions fought for it. We have decent wages and conditions because unions fought for it. And we have a universal health care system because unions fought for it.

“Under the conservative agenda mapped out in the Commission of Audit, the rights and conditions of working people will be gone.

“But if we stay true to our values of social justice, equity and solidarity we will prevail. These are the values of working people.”

THE LAMP JUNE 2014 | 13

COVER STORY

MAY DAY MARCH

“HEADING DOWN THE AMERICAN HEALTH CARE PATH.” — Kylie Tastula, Royal Prince Alfred Hospital

“IF THERE WERE NO PENALTY RATES WHY WOULD YOU CONTINUE TO GIVE UP YOUR WEEKENDS?” — Kim Lee and Jim Lin, Peninsular Nursing Home Calls by employer organisations and federal government MPs to reduce or eliminate penalty rates must be resisted, says Kim Lee, a registered nurse at Peninsular Nursing Home in Mona Vale.

“I’m definitely against any move to cut penalty rates. I think the present federal government is trying to take penalty rates away from everyone,” Kim, who regularly works night and weekend shifts, said.

“Most people do not want to do the graveyard shift because it’s not natural to be working at night and it’s hard for the body to adjust to shift work. We should be compensated for that sort of disruption to our lives and our health.

“If they took penalty rates away my money would be slashed.

If there were no penalty rates why would you continue to give up your weekends and public holidays and miss out on family activities?”

Kim’s husband Jim Lin, RN, works afternoons and nights at the same nursing home. He estimates night penalty rates add about 30% to his hourly rate.

“Housing, food and transport are so expensive in Sydney, especially the northern beaches area. Without penalty rates not many nurses could survive,” he said. “AiNs in particular rely on penalty rates.

“If we are not compensated with better money for working at night, not many people would choose to do that. They would leave the profession and that would make the nurse shortage even worse.”

14 | THE LAMP JUNE 2014

The Abbott government’s decision to hit Australians with a fee whenever they visit a GP is a move towards an American-style healthcare system that will penalise chronically ill and injured people, Kylie Tastula, a clinical nurse consultant at Royal Prince Alfred Hospital, believes.

“It is very much heading down the American path with health care based on user pays rather than the right of people to get adequate care through the Medicare system,” Kylie said.

“YOUR POSTCODE SHOULD NOT DETERMINE YOUR LEVEL OF CARE.” — Ciaran McCloughan, Ryde Hospital

“It is widening the divide between those who can afford to pay and those who can’t, at a time when the government is cutting welfare payments and trying to reduce the minimum wage. It will especially hurt large families and people with chronic illnesses.”

Kylie says the erosion of Medicare would put a greater burden on the public health system.

“More people will use emergency departments instead of going to their doctor. And some people with chronic diseases will stop going to the GP. They will end up sicker and needing more expensive care in public hospitals.”

Nurses must continue to campaign against a government staffing policy that discriminates against patients according to hospital size and postcode, believes Ciaran McCloughan, an enrolled nurse in the general medical ward at Ryde Hospital.

Ryde, where Ciaran is NSWNMA branch secretary, is one of just three Sydney metropolitan hospitals classified in Peer Group C by NSW Health.

“That means Ryde patients get only five nursing-hours-per-patient-day (NHPPD) – the same as many country hospitals – while up the road Royal North Shore receives six NHPPD,” Ciaran said.

“As nurses we always try to put our patients first and the only way to do that

is to ensure safe patient care is enshrined in adequate ratios throughout New South Wales.

“With our current staff numbers based on five NHPPD we struggle to meet basic care needs.

“A patient with pneumonia at North Shore gets one hour of care per day more than a patient with pneumonia at my hospital. It’s just not fair that your postcode should determine the level of care you receive.”

Ciaran says the Ryde Hospital and Community Health Service branch was active in campaigning for ratios last year “and we are ready for another year of campaigning ahead.”

THE LAMP JUNE 2014 | 15

COVER STORY

MAY DAY MARCH

“IT SEEMS RIDICULOUS PUBLIC MONEY WILL SUPPORT A PRIVATE HOSPITAL.” — Fiona Deegan, Mona Vale Hospital The need to deliver profits to shareholders will take priority over patient care at Sydney’s new, privatised northern beaches hospital, fears Mona Vale Hospital theatre nurse Fiona Deegan.

The state government says Mona Vale Hospital will be downgraded and Manly Hospital closed when the new facility opens at Frenchs Forest in 2018.

“The minute you bring shareholders into the picture the dynamics of health care change,” said Fiona, a clinical nurse specialist.

“The owners of the new hospital – whoever they are probably will be investing borrowed money and will need a certain return in order to repay the debt.

“They will look for ways to cut costs. Who is going to guarantee that conditions such as nurse-to-patient ratios will be protected in the interests of patients?”

Fiona suspects the private owners will seek to limit the access of public patients to certain types of surgery, in favour of private patients.

“At Mona Vale we try to give all patients the best possible care, as economically as we can. There is no guarantee that’s going to be the case in the new hospital.

“It seems ridiculous that public money will go to support a private hospital.”

Fiona says almost all Mona Vale nurses she has spoken to do not want to work in a private hospital.

“The government has said we can keep our existing conditions for a two-year transition period. After that there are no guarantees for conditions like rates of pay, patient ratios, and leave entitlements.

“No one knows what the structure of the new hospital will be. We are all very much in the dark about the government’s intentions.”

16 | THE LAMP JUNE 2014

“THE GOVERNMENT SHOULD STOP COMPANIES SHIFTING PROFITS OVERSEAS.” — Maria Burrow, Sutherland Hospital The federal government should raise money by joining the global push for a “Robin Hood” tax, instead of charging Australians more to visit the doctor, believes Sutherland Hospital nurse Maria Burrow.

Maria, a clinical nurse educator, cites Oxfam’s estimate that a Financial Transaction Tax (FTT) – commonly known as a Robin Hood tax – of 0.05% on certain transactions such as derivatives and foreign exchange dealings, could raise up to $18 billion annually in Australia.

Nine European countries have already agreed to implement a FTT. “An 0.05% tax is small change for the investment banks, hedge funds and other financial speculators who caused the recent global financial crisis. Most ordinary Australians would not be affected by a FTT,” she said.

Maria says the global financial crisis showed that the huge volume of international financial transactions creates instability while enriching the finance industry at the expense of the general economy.

She says the government should also crack down on companies that shift profits overseas to avoid paying tax in Australia. As much as $60 billion was shunted off to foreign tax havens in 2012, the Sydney Morning Herald has reported.

“Instead of making people wait longer for the pension, the government should look at stopping companies from shifting profits overseas,” Maria said.

Media reports suggest technology companies are among the worst offenders. In the past decade Apple appears to have shifted almost $9 billion in Australian earnings via Singapore to Ireland where it pays less than 0.01% tax.

Google’s annual advertising revenue in Australia is as high as $2 billion but it paid just $466,802 tax last year, after shifting profits to lower tax jurisdictions.

THE LAMP JUNE 2014 | 17

BUDGET 2014

Health the casualty in a liar’s budget There were enough bombs in the budget to blow our public health system out of the water.

O N T H E E V E O F T H E 2013 F E D E R A L election Tony Abbott promised “no cuts to education, health, or the ABC and SBS, and no changes to pensions”. He also said “we are not shutting any Medicare Locals” and “no one’s personal tax will go up”.

In its first budget less than six months after coming to office, Tony Abbott’s government has delivered an $80 billion cut to health and education over the next decade. All 61 Medicare Locals will be scrapped and replaced with local health networks.

Age and disability pensions will fall behind wages growth from 2017 when they will be linked to inflation. The retirement age will rise to 70.

There will be $43.5 million in cuts over four years to ABC and SBS budgets.

The government has introduced a deficit levy – read tax.

MEDICARE ON THE EDGE Tony Abbott spent years telling Australians that the Liberal Party was “Medicare’s best 18 | THE LAMP JUNE 2014

friend”. His health minister Peter Dutton has repeatedly told us over the past year that the government would “strengthen Medicare”.

This budget has put lie to that.

There are numerous measures in the budget that attack the universality and viability of Medicare. Co-payments are to be introduced for GP visits and states will

be able to introduce them for emergency department visits.

There are increased co-payments for prescriptions on the Pharmaceutical Benefits Scheme (PBS) and federal funding to the states will be drastically reduced.

The body responsible for programs in preventative health has been scrapped and the body for health workforce

The white anting of Medicare The budget contains a series of measures and cuts that will effectively destroy Medicare: • The government will introduce a $7 co-contribution payment for GP consultations and out-of-hospital pathology. Concession cardholders and children will also pay the fee, capped to the first 10 services.

• Patients will pay an extra $5 towards the cost of each PBS prescription from July next year. Concession cardholders will pay an extra 80 cents.

• Federal health funding to the states will be reduced by $1.5 billion.

• The government will abolish Health Workforce Australia, which is responsible for ensuring the health workforce has appropriate skills and training.

• The National Preventative Health Agency will be abolished.

“RARELY DO YOU SEE AS CLEAR AN EXAMPLE OF A GOVERNMENT BEING CRUEL TO ONE GROUP OF PEOPLE — LOWER-MIDDLE INCOME EARNERS — PURELY BECAUSE IT KNOWS THEY HAVE NO POLITICAL POWER.”

What economists had to say “The $7 patient co-payment for GP visits and tests is certainly likely to discourage visits – more by the poor than the rest of us – but if it dissuades people from seeking help until their medical problems are acute it may end up costing the taxpayer more than it saves.”

— Ross Gittins, economics editor Sydney Morning Herald “Rarely do you see as clear an example of a government being cruel to one group of people – lower-middle income earners – purely because it knows they have no political power. In the cold light of the day it is hard to go past the view that this is an unnecessarily malicious budget that leads Australia towards a much more divided nation.”

— Greg Jericho, economics commentator, The Guardian

“The scale of this vindictive and ideological destruction of public institutions has yet to be fully comprehended by the leaders of corporate Australia, who are deluding themselves if they believe that very many businesses outside the mining and finance sectors are likely to be the beneficiaries of this budget.”

— Roy Green, Dean of the UTS Business School, University of Technology, Sydney “This budget is a clear victory for Australia’s 1%. The fact that our structural problems can only be addressed if the 1% contribute more and receive less from the government has been ignored yet again.”

— John Quiggin, Australian laureate fellow in economics, University of Queensland

What health experts had to say The impact on the health system overall “Bulk billing is gone, health reform agreed by all states and territories is demolished, funding to the states is slashed and promises are broken.”

— Stephen Duckett, Professor of Health Policy, La Trobe University

On Medicare Co-payments

education and skills development has also been abolished.

NSWNMA General Secretary Brett Holmes says the undermining of Medicare and the assault on the less well off is unconscionable.

“This budget is underpinned by two assertions made by Tony Abbott: that we have an alarming budgetary crisis and that we are all in this together. Both are demonstrably wrong,” he said.

“Australia’s economy is sound and any problems that we have are surmountable without destroying our world class Medicare and education systems and our safety net.

“Secondly, this budget is demanding that the poor, the sick, young people and pensioners bear the burden while, for the big end of town, it’s business as usual.

“Tony Abbott has always been the master of fear and this budget shows that when you strip away the grandstanding and the scaremongering what stands behind is cruelty and extremism.”

“The co-payment proposal has been widely criticised by many in the health sector because out-of-pocket costs in Australia are already relatively high by world standards. There are concerns that increasing them further will: • Reduce necessary use of GP visits (for preventive services such as immunisations, for instance, or cancer screening); and • be an unfair burden on people with lower incomes, who tend to be in poorer health and are most likely to defer visits to the GP because of cost.

These concerns are justified based on international evidence where co-payments for health care have already been trialed.”

— Anne-marie Boxall, Director, Deeble Institute for Health Policy Research

On preventative health “It’s a dark day for Australia’s health and health services, and especially for prevention. Nobody can doubt our health services and future health are the big losers. The crazy part of all this is that it’s preventive programs that ultimately save the system money.”

— Mike Daube, Professor of Public Health Policy, Curtin University

On co-payments for PBS medicines “Clearly, it is consumers, particularly those with chronic diseases, rather than the pharmaceutical industry or pharmacists, that will feel the pain from these budget measures.”

— Philip Clarke, Professor of Public Health, Melbourne University

On Medicare Locals “Medicare Locals will be replaced by Primary Health Networks, which will be set up through open tender and encouraged to partner with private health insurers – a major policy change. This is a retrograde step for the Australian health system.”

— Fran Baum and Sara Javanparast, Southgate Institute for Health, Society and Equity at Flinders University. (from The Conversation) THE LAMP JUNE 2014 | 19

BUDGET 2014

“THE BUDGET EXTENDS PRESSURE ON PEOPLE WHO CAN LEAST AFFORD IT.” — Maureen Buckley, CNC, Blacktown Hospital “As a nurse in a western Sydney public hospital and a local resident I have grave concerns about what this budget will do to the local population,” said Maureen Buckley, a clinical nurse consultant in the aged care services emergency team and a NSWNMA branch delegate.

“A lot of people around here struggle financially and the $7 co-payment will be problematic for them, regardless of the fact that it is limited to 10 GP visits per year.

“The patients I see – aged people in emergency – are usually on multiple medications. They will bear the brunt when prescription drugs go up 80c for concession holders and pensioners, and $5 for others.

“It’s a double hit because while

medical care will cost more, pensions won’t be indexed to wage rises and in time they will fall further behind.”

Blacktown Hospital services one of the poorest areas of Sydney with many disadvantaged elderly pensioners, a high level of youth unemployment, a large Aboriginal population and a large refugee and immigrant non-English speaking population.

Maureen says the budget increase in petrol excise will also hurt western Sydney workers, who drive long distances to get to their jobs and already pay high road tolls.

“We are already disadvantaged here in the west in numerous ways so the budget just extends the pressure on disadvantaged and marginalised people who can least afford it.”

“WE ALREADY HAVE FEWER RESOURCES AND STAFFING LEVELS.” — Tania Gleeson, CNS, Wagga Wagga Base Hospital Wagga Wagga clinical nurse specialist Tania Gleeson fears rural and remote health facilities will fall further behind metropolitan hospitals as a result of the budget’s cut to federal funding of state health services.

The NSWNMA is campaigning to end the anomaly under which non-metropolitan hospitals such as Wagga Wagga Base Hospital are funded for fewer NHPPD (nursing hours per patient day) than their big city counterparts.

“We already have fewer resources and staffing levels so cutting the health budget will only further erode services to rural communities,” said Tania, an ICU liaison nurse and NSWNMA delegate and council member.

“We need ratios brought into areas not included in our last agreement, like HDUs, EDs, ICUs and paediatrics. But this budget 20 | THE LAMP JUNE 2014

means it will be harder to catch up with metro hospitals.”

Tania expects a surge of patients into the already-busy emergency department once the GP co-payment is introduced from July 2016.

“Is Mr Abbot going to fund more staff to manage an influx of patients?” she asked.

“The co-payment starts at $7 but they will put it up and up and before you know it, we’ve got a Americanised health care system.

“There is no way this country would want to end up with a disgraceful system like that, where if you can’t pay you don’t get treated.

“This country can’t lower it’s standard and think that’s okay.

Medicare was supposed to guarantee access to health care for everyone regardless of their income level.”

“THE GOVERNMENT DID NOT THINK THIS THROUGH.” — Jackie Holmes, CNS, Blacktown Hospital Jackie Holmes, a clinical midwifery specialist at Blacktown Hospital’s birthing unit, described the budget as “a quick money-grubbing venture” that will impose a huge long-term cost on the public health system.

She predicts the $7 GP co-payment will force many disadvantaged people to delay seeking medical attention.

“For many local people the $7 GP co-payment will be devastating. It will make the difference between attending for medical care early or presenting when they’re extremely ill and require admission to hospital with more expensive tests and treatments,” said Jackie, the hospital’s

NSWNMA branch secretary.

“It will be a huge additional cost to the public health system. It seems the government did not think this through, they just saw it as a quick moneygrubbing exercise.

“The budget seems to be aimed at a large proportion of people in the western suburbs and I think it’s really unfair.

This government is siding with big business and with people at the high end of the socioeconomic scale.

“Pensioners who’ve paid taxes all their lives still can’t relax. Aged people should not be in that position at this stage of their lives.”

“WHY ARE THEY ATTACKING HEALTH?” — Ursula Hollmann, RN, Campbelltown Hospital The Abbott government’s assault on health care affordability could have worse consequences for future generations than a budget deficit, says Ursula Hollmann, a registered nurse at Campbelltown Hospital’s Waratah adult mental health unit.

“I think all the government’s talk about a budget emergency is just an excuse to do things that will increase the gap between rich and poor,” said Ursula, delegate for the Macarthur mental health branch of the NSWNMA. “Continually running down the public health system and making it more expensive for patients will have a greater impact on future generations than the budget deficit.”

Ursula says Australia has one of the worlds best performing economies with relatively low government debt as a percentage of Gross Domestic Product (33.7% compared to 109%

in the UK and USA, according to the OECD).

“We have low public debt, a triple A credit rating, low inflation and fairly low unemployment relative to most other countries.

“So why are they attacking health in this budget?”

Ursula says the Liberals promised no cuts to health spending and deceived voters by doing the opposite.

She welcomed the NSWNMA’s stance in helping to lead a public campaign to defend Medicare and the public health system generally.

“We still have one of the best public health systems in the world and the Association needs to do what’s best for the members and best for the public in regards to defending our health care. We don’t want to go down the same track as America.”

THE LAMP JUNE 2014 | 21

COMMISION OF AUDIT

IT’S WAR!

On your living standards The Abbott government’s Commission of Audit has come up with a raft of extreme recommendations that would unravel Australia’s social fabric.

DESPITE ITS CHAIRMAN COUNTRY’S economy is in

ADMITTING

THAT

THE

relatively good health, the Commission of Audit has recommended cutting benefits for the unemployed, the sick and widows and reducing funding for affordable housing.

Perhaps the Commission’s most incredible recommendation, which wasn’t even part of its terms of reference, was to allow the minimum wage to fall by $136 a week, a massive wage cut for the low paid.

Others recommendations include a $15 Medicare co-payment, a charge for access to public hospitals, increased co-payments for pharmaceuticals and increasing the pension age.

The Commission also urges the Abbott government to cut wage subsidies for the long-term unemployed and abolish vocational education programs.

The ACTU came out strongly against the attack on the minimum wage arguing that it would impact on all award workers, not just the low paid.

“The Commission of Audit’s aim is to lower Australia’s real wage floor. All award-reliant workers would therefore be affected if the recommendations were implemented,” it says in a published analysis Paying the Price.

The ACTU also pointed out the sham nature of the Commission’s “consultations” and described its recommendations as “an ambush on low paid workers”.

“None of the Audit Commissioners publicly mentioned that these large real wage cuts were under consideration. None of the Audit Commissioners raised the issue when they met privately with the ACTU. Unions and workers were not given a chance to defend the current wage-setting arrangements or point out the many flaws in the Commission’s proposed scheme.”

Professor David Peetz, Professor of Employment Relations at Griffith University, says lowering the minimum wage will negatively impact all award workers, including nurses.

“With minimum wage fixing transformed in this way, the setting of award wages for all workers on classifications above the minimum wage would also be

22 | THE LAMP JUNE 2014

affected, as award wage relativities are integrally related to minimum wages,” he said.

Peetz says the Commission gave only one reason for abandoning independent minimum wage fixing — that cutting minimum wages would reduce unemployment.

“Yet Australia has one of the lowest unemployment rates among developed countries — and the lowest among the six countries in the Commission’s selected comparison group. Australia’s youth unemployment rate is also the lowest of the six,” he said.

“The USA, with the lowest minimum wage, had the second highest unemployment rate among the six.

There, more than 600 economists, including seven Nobel laureates, have petitioned for an increase in minimum wages.”

COMMISSION FOR BIG BUSINESS The Commission of Audit has been criticised as a who’s who of Australian big business. Commission chairman Tony Shepherd is president of the Business Council of Australia, which has long railed against minimum wages and was an enthusiastic supporter of WorkChoices.

Peter Crone, also from the Business Council of Australia, headed the Commission’s secretariat.

Fellow Commissioner Amanda Vanstone was a Liberal federal minister in the Howard government.The remaining commissioners, Peter Boxall, Tony Cole and Robert Fisher, are all conservative economists.

The radical nature of the Commission’s findings are at odds with previous comments by its chair Tony Shepherd, who conceded that the Australian economy was in good shape, when he fronted a senate inquiry in January: “We recognise that our fiscal situation, while deteriorating, is not bad by OECD standards and we have a relatively well-educated, healthy and happy society,” he said.

Shepherd also outlined to the senate committee the Commission’s methodology, which stands in stark contrast to its findings.

He said his team would be guided by “the importance of fairness”, which he said was “important for the country and for our ability to work effectively together”.

“Anyone recommending our health system follows the US really should not cut paper without supervision, let alone give advice on how to cut the budget. Bloomberg in 2013 rated our health system the seventh most efficient in the world; the US came 46th.”

— Greg Jericho, economics commentator, The Guardian “The Commission of Audit recommendations were entirely predictable: this is what happens when you write the script and choose the actors.”

— Richard di Natale, the Greens

“This is a report written by big business for big business and it shows.”

— Bill Shorten, leader of the Opposition

“It is difficult to see an independent industrial relations tribunal surviving such change. Other aspects of pay, such as penalty rates, overtime and allowances – previously the target of the WorkChoices legislation – would eventually be in the hands of government wage setters.”

— David Peetz, Professor of Employment Relations, Griffith University

“I’m going to be able to look people in the eye … and say we are all in this together, we are all doing our bit.”

— Tony Abbott, Prime Minister

“We recognise that our fiscal situation, while deteriorating, is not bad by OECD standards and we have a relatively well-educated, healthy and happy society.”

— Tony Shepherd, Chair of the Commission of Audit

THE LAMP JUNE 2014 | 23

COMMISION OF AUDIT

Commission of Audit wishes ill on Medicare An important part of the Commission of Audit’s brief from the government was to look at reducing the size of government and its expenditure on public services. It is no surprise that health was a prime target.

ITS RECOMMENDATIONS INCLUDE A $15 co-payment for all Medicare-funded services, a co-payment for visits to emergency departments if the patient could have seen a GP, and a rise in co-payments for pharmaceuticals.

It also recommended that private health insurers play a greater role in Australia’s health system.

Stephen Duckett, director of the Health Program at Grattan Institute told the theconversation.com.au, that the proposal to abolish bulk billing and introduce a government-mandated co-payment was “a danger” and merely “cost shifting”.

“This will have a big impact on poorer people and save little money relative to other policy options,” he said. “The recommendation to end Medicare’s universality is another backward step. The Commission says higher income earners should be forced into private health 24 | THE LAMP JUNE 2014

insurance and excluded from Medicare coverage.This is the start of a slippery slope to Medicare becoming a second-class scheme for the poor.”

Anthony Harris, director of the Centre for Health Economics at Monash University, was also highly critical of the recommendation to reintroduce a private health insurance market for primary care and having mandatory private insurance instead of Medicare for the better off.

“The aim appears to be to reduce government spending rather than the cost of the health system – as it is far from clear how these proposed reforms would do anything other than increase total expenditure on health,” he said.

“What is missing in the Commission’s rationale is the recognition (widespread among economic analysts) that private health insurance markets are inherently inefficient, and that government provision

of insurance is both cheaper and fairer.”

Harris was dismissive of the Commission’s conclusion that allowing health funds to expand their coverage to primary care would improve the health of Australians at lower cost than public funding of Medicare.

“No evidence is provided for this.The proposal runs counter to the basic principle of Medicare and similar public health care systems: that we want the poor to have the same high quality care and attention as the rich, paid for in a fair way,” he said.

“A private insurance system will inevitably be more expensive; even if it reduces out-of-pocket costs for care, it will result in more, not less, service use and expenditure.

“It might reduce government expenditure, but it will increase total expenditure on health as a proportion of GDP at a time when hysteria about that ratio seems to have reached fever pitch.”

Crisis?

What crisis?

Debt crisis a fabrication The Commission of Audit and the federal government have been loud in their claims of a debt and deficit crisis to justify their slash and burn approach to health and other social expenditure.

GOVERNMENT DEBT PERCENTAGE OF GDP (SOURCE OECD, 2013) 227.15

110.29

106.99

104.09 86.06

34.39

JAPAN

OECD AVERAGE

UK

I N FACT, FAR FROM BEING IN CRISIS, Australia’s economy is the envy of the developed world.

Australia’s debt-to-Gross Domestic Product (GDP) ratio – a key indicator of how well a country can pay back existing debt without incurring more debt – is significantly lower than the OECD average and much lower than countries such as Japan.

BBC journalist Andrew Neil recently quizzed treasurer Joe Hockey on the relative strength of Australia’s economy.

Neil asked Hockey if he could name a single country in the G20 in such a strong economic position, with a national debt of 23%, a 3% fiscal deficit, 3% annual growth, 22 years of continuous growth, an unemployment rate of less than 6%, a strong currency and massive mineral resources.

Hockey’s response was a surly: “No”.

Greens spokesperson Richard di

USA

GERMANY

AUSTRALIA

Natale described the Abbott government’s political strategy as “theatre”.

“In their Greek tragedy the Liberals are the heroes rescuing our sinking economy from the clutches of the incompetent former government, preventing us from meeting the fate of modern Greece.

“Privatisation, cuts to services and the transfer of wealth to the big end of town are a necessary evil because the villains – read: Labor – have bankrupted the country.

“Australia’s debt crisis is a fabrication and our level of public debt is amongst the lowest in the OECD. Far from being in crisis, we are the envy of most other governments.

“Government spending is low by world standards and commensurate with the level of services Australians expect.

“Australia’s tax take as a percentage of our overall economy is low by world standards – and well below the OECD average.”

Tony Abbott and Joe Hockey, backed by their hand picked Commission of Audit, have repeatedly asserted that Australia has a budgetary crisis that justifies their swingeing cuts to health, education, pensions and social programs in the budget.

The facts suggest otherwise.

Here are some of the reasons our economy is the envy of the world: •Australia is one of only 10 countries in the world given an AAA credit rating with a stable outlook from all three global credit agencies.

•We have one of the lowest levels of debt in the world of GDP according to the International Monetary Fund.

•Australia has 3% annual growth and has had 22 continuous years of growth.

•Our unemployment rate is less than 6%, we have a strong currency and massive mineral resources.

When it comes to health expenditure and health outcomes Australia has an efficient and enviable public health system.

WE HAVE ONE OF THE LOWEST LEVELS OF DEBT IN THE WORLD OF GDP ACCORDING TO THE INTERNATIONAL MONETARY FUND.

Health spending in Australia comes to 9% of GDP compared to 18% in the United States. A significant amount of that 9% already comes out of the pockets of patients.

Government spending on health only comes to 6% of GDP. Bloomberg, the influential American business media company, rated Australia’s health system the seventh most efficient in the world. In contrast, the American system – which appears to be the favoured model of the Abbott government – came 46th.

THE LAMP JUNE 2014 | 25

PENALTY RATES

Penalty rates reflect Australian values The Lamp looks at the long history of penalty rates in Australian society.

WE ALL LOVE OUR WEEKENDS AND IT IS easy to forget that those two days of family and leisure time, of recuperation and release from the rigours of work, have not always been ours by right.

The history of penalty rates is not just a story of the evolution of compensation for unsociable hours; it is also the history of an Australia that recognises the social and community importance of the weekend.

Penalty rates have been an integral part of the Australian Industrial Relations system for nearly a century.Their origin in Australia can be traced to 1919, when the Commonwealth Conciliation and Arbitration Commission agreed that penalty rates for work on Sundays were needed as compensation for unsociable hours.

In 1947 this right was broadened when the same Commonwealth commission found that Saturday work should be compensated at 125% of the base rate and Sunday work should be increased to twice the base rate.

FUNDAMENTAL TO THE WEEKEND In 1950 the link between penalty rates and the weekend as an Australian value was enshrined in law by a decision of the Industrial Relations Commission of New South Wales. It held that employers must compensate employees for “the disturbance to family and social life and religious observance that weekend work brings”.

The Commission clearly spelt out that “penalty rates exist to discourage employers from working employees on weekends”.

This decision gave the concept of the weekend the full respect of Australian law: not only is special compensation required for working on a weekend, there is a deliberate attempt to discourage weekend work.

Underpinning penalty rates is the concept that family, social and leisure time are important factors in a person’s life, that they contribute to improved health and wellbeing and that this time must be compensated for financially if it is to be restricted.

26 | THE LAMP JUNE 2014

“WHY WOULD WE WORK WEEKENDS ANYMORE?” — Gail Hayes, RN, aged care.

“I used to work evenings and missed out on many things with my children and grandchildren. I used to miss out on birthdays and functions. I missed out on a lot of time with my children.

Now I work every Sunday evening and otherwise I work during the week.

I brought up four children on penalty rates. That’s how I could afford it.

Some of the nurses at my work have six or seven children and they’re working Saturdays or Sundays. They are missing out on spending time with their children. Of course they have to get paid more.

Nurses at my facility are starting to get very worried. There is a lot of talk that we will be losing penalty rates. They are saying ‘why would we work weekends anymore?’.

Most of the younger people I’m working with are just living from pay-to-pay. They don’t get paid very much. A lot of them are just surviving. If they lost their penalty rates they would have to cut down on their basic necessities, not luxuries.”

PM’s next target: your rights Tony Abbott created his “independent” Commission of Audit to prepare the groundwork for swingeing cuts in the budget.

He has also asked the Productivity Commission to perform a “comprehensive” review of workplace laws.

THE DRAFT TERMS OF REFERENCE FOR the Productivity Commission review were leaked to Fairfax Media and show that they cover penalty rates, pay and conditions, unfair dismissal, enterprise bargaining flexibility and union militancy.

Abbott has asked the Productivity Commission to review the performance of the Fair Work Act and “identify future options to improve the laws”.

The review’s terms of reference direct the Commission to bear in mind “the need for business to be able to grow, prosper and employ, and the need to reduce unnecessary and excessive regulation”.

EMPLOYER OPPOSITION TO PENALTY RATES Unions believe employers will use the review’ to continue their crusade to weaken or get rid of penalty rates.

Last year employers made 20 applications, as part of the two-year review of Modern Awards, to vary the penalty rate provisions in the fast food, retail, food and beverage, hospitality and hair and beauty awards.

Among the changes they sought were a 50% reduction in Sunday penalty rates for retail, the removal of the 25% penalty rate for retail workers rostered at night, and a complete abolition of weekend penalty rates for fast food workers.

The Fair Work Commission rejected their arguments. A full bench of the Fair Work Commission did not mince its words, saying there was “a significant ‘evidentiary gap’ in the cases put” and that the employers’ case was “far from compelling”.

AUSTRALIANS SUPPORT PENALTY RATES A poll conducted for the ACTU last year showed that eight-in-10 Australians support higher rates of pay for people who work outside normal hours on night shifts, weekends or public holidays. Only 13% were opposed.

Respondents rejected claims by business groups that cutting penalties rates would save jobs.

Of those polled 64% agreed that the main outcome of abolishing penalty rates would be that company profits would increase, and only 18% agreed that companies would employ more workers.

Twice as many people (57%) thought abolishing penalty rates would be bad for the economy because workers would have less to spend, than thought it would be good for the economy because it would create more jobs (22%).

The ACTU has estimated that 4.6 million workers (48.1% of the workforce) are entitled to penalty rates for a public holiday and 4.2 million (44.2%) for a weekend.

Reasons to value your penalty rates If a registered nurse working in a public hospital lost their penalty rates, each fortnight they would lose: $839.26 on day shift, $1090.95 on evening shift $1,141.40 on night shift

Unsociable hours unhealthy Research has shown that workers such as nurses who work unsociable hours have worse work/life balance than those in industries with more traditional hours of work.

The Australian Work Life Index, created by researchers at the University of Adelaide, found that this interference in work/life balance leads to “poorer health, more use of prescription medications, more stress and more dissatisfaction with close personal relationships. Work-life outcomes are imposing high costs on individuals, families and the broader community”.

One of the researchers, Professor Barbara Pocock, says that cutting weekend penalty rates would erode the time Australians spend on building relationships with friends, family and neighbours.

“As soon as we take that wage premium off we make all time the same and we’ll see a lot more squeezing of that informal social time on Saturday and Sunday,” she said.

The Australian research is backed up by an International Labour Organisation report, which found that: • Employees working at weekends report significantly higher emotional exhaustion, job stress and psychosomatic health problems than those not involved in weekend work.

• Non-standard schedules can have negative outcomes for the quality of marital relationships.

• Shift work has negative impacts on women’s reproductive health.

THE LAMP JUNE 2014 | 27

PENALTY RATES

“PENALTY RATES ARE CALLED PENALTY FOR A REASON.” — Jane Cooper, private hospital.

“I think penalty rates are called penalty for a reason and that’s because of the isolation that shift work can cause with your family or with your social activities.

You can’t see your favourite rock band at midday on a Tuesday when you have got time off. You can’t see your favourite sporting team during the week. You can’t get an accountant at three o’clock in the morning. The idea of a 24/7 society that everyone fits into, or that you aren’t disadvantaged when you work weekends or rotating shifts or night shift, is ludicrous.

I do the rosters where I work. There will be absolutely no one that would put their hand up to work night shift or work weekends without penalty rates. Why would you?

There is no advantage in it. But there are plenty of disadvantages in your personal life.

I don’t play team sports. My hobbies are affected.

In terms of family it obviously impacts on your ability to participate in family activities. You work around the day-to-day stuff but family barbecues or dinners or celebrations you can’t always guarantee that you are going to attend.

I work predominantly night shift and I don’t sleep nearly as well and the research bears that out. Your eating patterns are disrupted. I think that bears out on weight levels that we are seeing in nurses. It impacts on your ability to have a daily routine.”

Are you Are you a registered registered nurse? nurse?

Ha ve you you considered considered a career career in midwifery? midwifery?

Have If y ou answered answered yes yes to to both these questions, questions, read read on... you All applications for postgraduate midwife ery student positions in NSW public hospitals and a small number of not for profit private hospitals fo or 2015 will be processed online through NSW Health.

Applicants are able to select up to six hospitals fo or their clinical lin train ning, and will be interviewed at their first preference hospital.

Applications open on July 1, 2014.

For more info ormation about the application processs, go to http:/ //www.health.nsw.gov.au/nursing/ /e emplo oyment/P m ag ages/MidS ges/MidStAR t T..aspx

28 | THE LAMP JUNE 2014

N43274 3274

Applicants will be required to provide a letter addr a ad essing the selecti selec ion criteria, as part of their application.

“I WOULD BE HORRIFIED IF THEY GOT RID OF PENALTY RATES.” — Shirley Ross-Shurley, AiN, aged care.

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“I think for families and for social life weekends are important. It’s when everybody gets together. It’s when everybody does things together.

If you are out in the single world and you are looking for a partner how else are you going to meet people? You need to socialise, you need to have a certain amount of free time when other people are available.

In aged care people work irregular hours – they work weekends, the evenings and they work split shifts during the day as well.

Working these hours impacts a lot on family life but the penalty rates compensate for that. If I didn’t have the penalties I wouldn’t be working on weekends.

Night shift impacts on your health because your biological clock is out of whack. It affects sleeping patterns. Health wise, it can’t be good for you in the long term.

I would be horrified if they got rid of penalty rates.

Who would want to work on weekends if they were getting the same as they were getting during the week, and missing out being with their partner or friends, or taking the children or grandchildren to sports activities. The people that work on weekends or do night shift have bills and most are struggling now, so how are they going to cope? Will Tony Abbott pick up the difference?

HEALTH

Nurses and midwives on the toxic front line Attendees at a recent NSWNMA seminar heard grim statistics on the potential effect of workplace chemicals on health professionals.

ACCORDING TO LEADING AMERICAN NURSE educator and environmental health researcher, Dr Barbara Sattler, there is a toxic tide engulfing not just health workers and the general population, but babies still in the womb.

Speaking at a recent NSWNMA seminar on environmental health Dr Sattler, of the Alliance of Nurses for Healthy Environments, outlined recent science on the subject.

This included tests by America’s leading environmental health research and advocacy organisation, the Environmental Working Group (EWG), of 10 samples of umbilical cord blood taken by the American Red Cross, which found an average of 287 contaminants including mercury, fire retardants, pesticides and the Teflon chemical PFOA (Perfluorooctanoic acid).

“Of the 287 chemicals we detected in umbilical cord blood, we know that 180 cause cancer in humans or animals, 217 are toxic to the brain and nervous system, and 208 cause birth defects or abnormal development in animal tests,” the EWG report said.

“We are essentially birthing prepolluted babies, which from a midwifery perspective is really unacceptable,” Dr Sattler told the seminar.

“In recent years we’re starting to look specifically at chemicals that are toxic and are never supposed to be on the human body,” she said.

Surveys and testing by nurse organisations and environmental health advocacy groups in the United States have revealed that rates of cancer in nurses exposed to chemotherapy agents are 42% higher than among nurses with little or no exposure.

Of American nurses reporting exposure to anaesthetic gases 36% have been found to have up to seven times higher risk of central nervous system, cardiovascular, genitourinary, and musculoskeletal birth defects in their children.

30 | THE LAMP JUNE 2014

Fifty-two per cent of nurses in the US work with sterilents and disinfectants and those who work with them the most have a 46% higher rate of asthma. Nurses are the second greatest category (after cleaners) of adult onset diagnoses of asthma in the US.Antibiotics, laxatives, antihypertensives and antituberculars are known to cause the ideology of asthma.

“All of us who work with the elderly pulverise their meds when they have difficulty swallowing,” Dr Sattler said.

“These chemicals can be biologically active at parts per billion in the human body. So if in our med rooms we have just a slight powdering of any number of them we’ve been pulverising in the course of a day, that is a significant exposure for nurses.”

In late 2009, Physicians for Social Responsibility in partnership with American Nurses Association and Health Care Without Harm, released a report, Hazardous Chemicals In Health Care, detailing the first ever bio monitoring of chemicals in health professionals.

The study of 12 physicians and eight nurses looked for 62 different chemicals commonly used in hospitals. There were at least 24 found in any given nurse or physician and sometimes more.

All participants had in their bodies, chemicals listed for priority regulation by the American Environmental Protection Agency and associated with chronic illness such as cancer and endocrine disruption (see box “Bad Medicine”).

“These chemicals are affecting our patients but patients come and go,” Barbara said. “Critically we are the ones that stay for hours a day and weeks and years so we are having a more significant exposure.”

In 2003, Charlotte Brody, then aged 54, mother of two and a registered nurse was tested by the Human Toxome Project for 214 industrial compounds, pollutants and other chemicals chosen because there was little in literature about their toxicity.

Of the 87 chemicals in her body that

Dr Barbara Sattler

were not supposed to be there, 54 had the potential to create a developmental delay, 53 were toxic to the immune system, 52 were carcinogenic according to the International Agency for Carcinogens, which determines which chemicals are suspected or known carcinogens.

“While they created a number of different risks, it doesn’t mean Charlotte was going to experience all these,” Dr Sattler noted.

Dr Sattler believes nurses are ideally placed to campaign for a cleaner healthier world.

“The exposures we have in our air and water and the products we use are winding up in everyone’s personal environment.

“As nurses we are working in coalitions on climate change, fracking and pipeline demonstrations and more, because we know human health and the environment are inextricably linked,” she said.

“I really feel if we can work in a more coordinated fashion, if we can learn to use our voices, if we can learn to step up and step out, nurses have huge capacity on these issues.”

You can find all NSWNMA seminar podcasts at www.nswnma.asn.au/podcasts

Bad medicine: toxic substances in everyday products Triclosan a synthetic broad-spectrum antimicrobial agent used in hundreds of products including toothpaste, antibacterial soaps, cosmetics, fabrics, deodorants and plastics. Shown to accumulate in aquatic organisms and human breast milk.

Phthalates, used as plasticisers, found in many items from cosmetics to wood finishes. Low dose exposures affect the development of reproductive organs, potentially causing adverse health effects in foetuses and preterm babies.

Bisphenol A (BPA) used in baby bottles, plastic water bottles, lining metal food and drink containers for coating products and in many devices. BPA is associated with endocrine disruption, which in turn is associated with miscarriage, prostate cancer, altered brain development and behaviour and diabetes.

Polybrominated diphenylethers (PBDEs) flame retardants in mattresses and computers. Toxic at low levels and persistent in the environment. Affect learning, memory and behavior and thyroid hormones.

Perflourinated compounds (PFCs) used in manufacturing non-stick coatings.

Potential risk for developmental and other health effects.

How can you influence environmental health policy?

There are a number of websites nurses and midwives can visit for peer-to-peer learning, evidence-based science and support for campaigns to change environmental policy. Some of the online resources Dr Barbara Sattler recommends include: The ANHE knowledge network at http://envirn.org, a onestop-shop for nurses who are interested in environmental health on behalf of themselves and their patients or who need advice on how they can advocate for change.

Many US hospitals have banned the use of fragrances. This applies not only to products used in hospitals but also to fragrances worn by staff. There are 10,000 chemicals used in personal care products but only 11% of them have been tested for safety. For more information go to the Skin Deep database on safe cosmetics: www.ewg.org/skindeep/ The March issue of the peer-reviewed journal Environmental Health Perspectives has a cover story on chemicals in feminine hygiene products. Among the suspected endocrine disruptors (EDCs) found in some feminine hygiene products are parabens, which are used as preservatives, and fragrance ingredients including diethyl phthalate. Chemicals from plastics may also be of potential concern, given that many feminine hygiene products have applicators. Read the report at ehp.niehs.nih.gov/122-a70/ Health Care Without Harm is an international coalition of hospitals and health care systems, medical professionals,

community groups, health-affected constituencies, unions, environment and environmental health organisations and religious groups. It provides information on medical waste, toxic materials, safer chemicals, green building and energy, healthy food, pharmaceuticals, green purchasing, climate and health, transportation and water.

Go to www.noharm.org For educational materials for practitioners from the National Environmental Education Fund go to www.neefusa.org/ ToxTown is about environmental conditions in different areas of the US. While some issues are unique to America, many, including areas where hydraulic fracturing (fracking) for oil and gas and toxic abandoned mines occur, can be applied to Australia. http://toxtown.nlm.nih.gov/ Household Products Database covers everything from hobby materials to pet care and more. http://householdproducts.nlm.nih.gov/ ToxNet has searchable databases on toxicology, hazardous chemicals and environmental health. http://toxnet.nlm.nih.gov/

THE LAMP JUNE 2014 | 31

NSWNMA NEW HON NE E APP A iPHONE This FREE app is for the use of NSWNMA members. It allows you to: R Record ecord hours and pa patient tient c counts ounts ffor or w weekly eekly spot checks Quickly calculate calculate rrequired equired nursing hours View V iew w wages ages tables V iew NS WNMA View NSWNMA ne ws, alerts and news, c ontact information information contact

Available to download from iTunes store. The android and iPad versions available soon.

Authorised by B.Holmes, General Secretary, NSWNMA

ASK JUDITH Pay deducted without permission I am a nurse working in the public health system. When I received my last pay slip the pay office had deducted a significant amount, leaving me unable to meet my financial commitments. When I rang I was advised I had been overpaid an allowance over a period of 12 months. Is the employer allowed to deduct the money from my pay without my permission?

No. There are two documents that clearly lay out the procedural requirements for recovering overpayments. Firstly, a claim by the employer that you have been overpaid should always be checked. Secondly some overpayments may not be able to be recovered by the employer. Where recovery of an overpayment can occur, the NSW Health policy directive PD 2009_015, and the Public Health System Nurses’ and Midwives” (State) Award 2011, clause 27, “Payment and Particulars of Salaries”, sub clause (v), part (b), provides guidance on the process to be followed.

In brief the details are: You must be notified in writing, detailing circumstances surrounding the overpayment, the amount, and when recovery is to commence.

One off overpayments can be deducted from the next normal pay, except where the employee can demonstrate this would cause undue hardship. Recovery will then be at 10% of the employee’s gross fortnightly base pay.

The maximum rate for recovery of cumulative overpayments is equivalent to 10% of the employee’s gross fortnightly base pay, unless the employee agrees otherwise. The employee can elect to pay higher repayments or a lump sum, however if the employee can demonstrate that undue hardship will occur the 10% may be reduced by agreement.

If an employee resigns or terminates before

the full overpayment is repaid, the balance of monies still owing can be deducted from the employees termination pay.

The Local Health District chief executive or their delegate has discretionary powers in respect to recovery of overpayments.

If you have problems in resolving this issue please contact the Association for assistance.

Roster has insufficient breaks I am employed in a New South Wales public hospital and our nurse manager (NM) interprets the Award so she can roster nursing staff up to a maximum of seven consecutive shifts, regardless of the start and finish times of those shifts. For example, the NM regularly rosters us for a combination four x 10-hour night shifts, followed by three day shifts, without days off in between. This is a regular rostering pattern in our facility. Does this meet with award requirements?

No. Because your nurse manager is not allowing for a 20-hour break between changing from night duty to day duty she cannot put out a roster as you have described. Clause 4, “Hours of Work and Free Time of Employees Other Than Directors of Nursing and Area Managers, Nurse Education”, sub clause (xv) of the Public Health System Nurses’ and Midwives’ (State) Award 2011, states; “… an employee changing from night duty to day duty or from day duty to night duty shall be free from duty during the 20 hours immediately preceding the commencement of the changed duty.”

The award is specific on the rostering requirements in respect to breaks between shifts, and I suggest you and your colleagues read the above clause. If you find your rosters are not conforming to the award requirements you need to urgently bring this to your manager’s attention and, if they will not change the rosters accordingly, contact the Association and speak to one of our Information Officers.

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

Extra work must be approved I am a full-time nurse in the public health system and am thinking of working on a casual or part-time basis at the local nursing home. My manager has told me I need to seek official approval before accepting additional alternate work, is this correct?

Yes this is correct.You must seek the approval of the CEO or his/her delegate before accepting outside employment as per the Code of Conduct; PD2005_626, clause 2.4: “If I work full-time in a Health Service and want to undertake another paid job or participate in other business activities (including a family company or business) I will seek the approval of my Health Service Chief Executive or his or her delegate. If there is any real, potential or perceived conflict of interest, I will put the duties of my Health Service job first or reach an agreement on ways to resolve the conflict.”

Bullying ignored I am a nurse working in the private sector and have made a formal complaint to my employer in regard to bullying behaviour, but my employer has dismissed my complaint without a proper investigation. What can I do?

You should contact the Association who will approach your employer and request them to investigate the complaint via an appropriate bullying complaints process. If you work in the private sector (private hospitals and aged care), the Association can take your bullying issue to Fair Work Australia (FWA). FWA can make an order against your employer to prevent you from being bullied at work. FWA will look at the way your employer has or has not investigated your complaint and must be satisfied any investigation was conducted “rigorously, impartially and independently”.

FULL-TIME, PART-TIME AND CASUAL POSITIONS AVAILABLE WOLPER JEWISH HOSPITAL is a private, 54 bed hospital situated in Woollahra, comprising a 32 bed Rehabilitation Ward and a 22 bed Medical/Palliative Care Ward. We currently have Full-time, Part-time and Casual positions available for RN’s and EEN’s on these wards.

To apply for nursing positions on the Rehabilitation Ward please email your CV to: JodieDominey@wolper.com.au To apply for nursing positions on the Medical/Palliative Care Ward please email your CV to: AndrewDriehuis@wolper.com.au To apply for any of these positions you must be an Australian Citizen or Permanent Resident, or be able to independently and legally live and work in Australia.

For more information please go to: www.immi.gov.au

THE LAMP JUNE 2014 | 33

BRANCHES

Workplaces without NSWNMA Branch representation The following NSWNMA workplace branches have become defunct.

Having a branch at your workplace gives you a voice. It gives you authority to meet, discuss and negotiate with your management under the umbrella of the NSWNMA. As well as being a source of collective power for large issues such as inadequate staffing, hospital closures or occupational health and safety issues, a branch can also take up individual issues on behalf of members.

Members of local NSWNMA branches have the chance to influence state action at the bi-monthly Committee of Delegates, and to set Association policy at our annual conference.

If you and other nurses and midwives in your workplace would like to reform your local branch, please contact the NSWNMA for help with the process.

Alternatively, you can write to the Council of the NSWNMA, care of our Sydney office, to request a transfer to another branch.

Our contact details can be found on the contents page of this issue of The Lamp.

DEFUNCT NSWNMA BRANCHES Anita Villa Nursing Home Australian Red Cross Blood Service Liverpool Australian Red Cross Blood Service Nepean Bathurst Private Hospital Bellingen River District Hospital Calare Residential Aged Care Facility Campbell Hospital Constitution Hill Retirement Village Crown Gardens Residential Aged Care Domain Florence Tower Aged Care Facility Goondee Nursing Home Grafton Aged Care Facility Gunnedah District Hospital Health Department, Commissions and Boards Hills Private Rehabilitation Centre Hornsby Community Mental Health Hunter Valley Private Hospital Imlay District Nursing Home Inner West Community Health Jamison Gardens Jerilderie Multi Purpose Service Justice Health Emu Plains Lingard Private Hospital Lottie Stewart Hospital Lower Clarence Retirement Village Maclean Health Service Macquarie Lodge Nursing Home Maitland Private Hospital

Mater Aged Care Service Mosman Private Hospital Mount Wilga Private Hospital Mudgee Nursing Home Narrandera Nursing Home Newborn and Emergency Transport Service Newcastle Community Mental Health Nurses Nexus Child and Adolescent Mental Health Unit North Shore Ryde Mental Health Nowra Community Health Nurses Nurse Managers’ (Hunter Residences) DADHC Orana Gardens High Care Palm Grove Nursing Home Pioneer House Nursing Home Port Macquarie Private Hospital Redfern Community Health St George Mental Health Strathfield Private Hospital Sydney West Community Mental Health Nurses Tenterfield Community Health Service The Surgery Centre – Hurstville Toronto Private Hospital Weeroona Aged Care Residence Wesley Heights Nursing Home Western Sydney LHD Nurse Managers Westmead Rehabilitation Hospital Whiddon Group (The) Wingham

THE LAMP JUNE 2014 | 35

FINANCIAL

New South Wales Nurses and Midwives’ Association Summary of The Financial Statements for The Year Ended 31 December 2013 The financial statements of the New South Wales Nurses and Midwives’ Association have been audited in accordance with the provisions of the Industrial Relations Act 1991, and the following summary is provided for members in accordance with Section 517(2) of the Act, as applied by section 282(3) of the Industrial Relations Act, 1996.

A copy of the Financial Statements, including the Independent Audit Report, will be supplied free of charge to members upon request. Certificates required to be given under the Act by the Accounting Officer and the Committee of Management have been completed in accordance with the provisions of the Act and contain no qualifications.

SUMMARY OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2013 2013 $

2012 $

Membership revenue

29,449,258

27,621,785

NursePower revenue

3,293,807

3,083,215

Other income

1,421,133

1,664,349

34,164,198

32,369,349

TOTAL INCOME LESS TOTAL EXPENDITURE

(36,022,474) (30,524,519) (1,858,276)

1,844,830

Profit on disposal of assets classified as held for sale

–

3,983,891

Reversal of impairment loss – O’Dea Ave, Waterloo

–

2,097,394

Loss on disposal of available for sale financial assets

–

(897,236)

Share of losses of investment in joint venture operations

–

(340,201)

(1,858,276)

6,688,678

RESULT FOR THE YEAR Net gain on revaluation of financial assets Remeasurement of net defined benefit liability TOTAL COMPREHENSIVE INCOME ATTRIBUTABLE TO MEMBERS

383,714

1,364,388

1,388,239

17,125

(86,323)

8,070,191

BALANCE SHEET AS AT 31 DECEMBER 2013 ACCUMULATED FUNDS

32,041,103

32,127,426

Current assets

13,831,974

14,640,824

Non-current assets

28,692,932

28,722,350

TOTAL ASSETS

42,524,906

43,363,174

Current liabilities

9,068,090

8,629,270

Non-current liabilities

1,415,713

2,606,478

TOTAL LIABILITIES

10,483,803

11,235,748

NET ASSETS

32,041,103

32,127,426

Represented by:

Information to be provided to members or Registrar

In accordance with the requirements of the Industrial Relations Act 1991 [NSW], the attention of members is drawn to the provisions of Sub-sections (1) and (2) of Section 512 which read as follows: (1) A member of an organisation, or the Industrial Registrar, may apply to the organisation for specified information prescribed by the regulations in relation to the organisation.

(2) An organisation must, on the making of such an application, make the specified information available to the member or the Industrial Registrar in the manner, and within the time, prescribed by the regulations.

Auditor’s Certificate

We certify that the above Summary of the Financial Statements is a fair and accurate summary of the Report, Accounts and Statements of the New South Wales Nurses and Midwives’ Association for the year ended 31 December 2013. Our Independent Audit Report to the members dated 6 May 2014 on the Financial Report did not contain any particulars of any deficiency, failure or shortcoming as referred to in the Industrial Relations Act 1991 [NSW], as applied by Section 282(3) of the Industrial Relations Act, 1996.

DALEY & CO Chartered Accountants

Michael Mundt Partner 6 May 2014 Wollongong Liability limited by a scheme approved under Professional Standards Legislation

A copy of the Financial Report, including the Independent Audit Report, may be found on the Members page of the website www.nswnma.asn.au or can be obtained upon written application to: Brett Holmes, General Secretary, New South Wales Nurses and Midwives’ Association, 50 O’Dea Avenue, Waterloo 2017 THE LAMP JUNE 2014 | 37

It’s time

to scrub up for 2014!

To orderr, fax the order form to Glen Gintyy, (02) 9662 1414, post to: NSWNMA, 50 O’Dea Avenue, venu v 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.nswnma.asn.au www.nswnma.asn.au

SCRUB UB P PANTS ANTS A

SCRUB TOP

ORDER FORM Size (cm)

XS

S

M

L

XL

2XL

3XL

4XL

Half Chest Circumference

53

56

59

62

66

69

73

77

Half Hem Circumference

54

57

60

63

67

70

74

78

General Guide for Female

8/10

10/12

12/14

14/16

16/18

18/20

20/22

22/24

Half Waist (Relaxed)

29

33

37

40.5

43.5

46.5

50.5

54.5

Half Waist (Stretched)

47

51

55

58.5

61.5

64.5

68.5

72.5

Half Hip

55

59

63

66

69

72

76

80

Out Seam Length

103

105

107

109

111

112

113

114

NSWNMA Scrub top $20.

Quantity: Size: XS S M L XL 2XL 3XL 4XL NSWNMA Scrub pant $20.

Quantity: Size: XS S M L XL 2XL 3XL 4XL To otal cost of order ord $ Please include postage and handling of $5 per order.

NAME ADDRESS

POSTCODE PHONE (H) (W) (MOB)

METHOD OF PAYMENT Y Cheque Mastercard Bankcard Money Order

Visa

NAME OF CARD HOLDER

CARD NUMBER

SIGNA ATURE T

EXPIR RY Y DA ATE T

/

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

Should RNs perform endoscopies and anaesthetics? www.nurseuncut.com.au/should-rns-do-endoscopies-and-anaesthetics/

Should AiNs do most personal care in hospitals while RNs take on some medical procedures to save money?

Short story: The Ambulance www.nurseuncut.com.au/short-story-the-ambulance/

Palliative care nurse Kathleen Wurth’s moving story was a runner-up in our story and poetry competition.

My first nursing job www.nurseuncut.com.au/my-first-nursing-job/

Ann-Marie was 15 when she got her first job in a nursing home in the 1960s.

She still has fond memories.

How a young nurse changed lives www.nurseuncut.com.au/how-a-young-nurse-changed-thousands-of-lives/

In 1983, Helen McCue had an idea that led to the formation of Union Aid Abroad-APHEDA, the overseas humanitarian aid agency of the ACTU.

Now I can remain an EN and an RN www.nurseuncut.com.au/wayne-i-can-now-remain-an-en-and-rn/

An Enrolled Nurse outlines his arguments against AHPRA’s proposal to do away with dual registration.

My trip with Aussie Bangla Smile www.nurseuncut.com.au/my-trip-with-the-aussie-bangla-smile-team/

Scrub and scout nurse Pia Buckingham went to Bangladesh to help with cleft lip/palate surgery.

New on SupportNurses YouTube channel Save Medicare – a pre-budget protest > youtu.be/2hitogBMy_w global nurses united Have a look at our contribution to International Nurses/Midwives Week. > youtu.be/1-83BSvdJhA

NSWNMA on Instagram!

Yes, we’re on Instagram, so share your local photos with us @nswnma and #NSWNMAforce4change.

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 JUNE 2014 | 39

FIT FOR FOR

LIFE LIFE AND

DEATH DE AT TH

DASHES D A ASH ASHES Claire Wilkinson EMERGENCY EMERGENC CY NU NUR NURSE SE

I’ve I’ve always always enjo enjoyed yed running. I idolised Cathy Cathy Freeman Freeman as a kid and dreamt dreamt of winning gold. gold. But now now running is about more more than fun and fitness. fitness. In one shift I ccan an ccover over mor more e than 6.8km - and that’s that’s on a quiet night. Which is why why The Athlete’s Athlete’s Foot F oot Fit T Technicians echnicians fit fitted fitt ed me with a pair of shoes that are are comfortable comfortable and dur durable. able. Sometimes, a second second can can mean the diff difference erence betw between een life lif e and death. The decisions w we e make make and the speed with which w we e ccarry arry them mak makes es all the diff difference. erence.

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OVER 45 STORES ACROSS NSW 1800 677 621

SOCIAL MEDIA

WHAT

Keep me logged in

Forgot your Password?

NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Dual registration deadline dropped AHPRA has removed its deadline for ENs, who are also RNs, to give up one of their registrations.

RNs to perform medical procedures?

A Grattan Institute report has suggested that RNs perform medical procedures as a cost-cutting measure.

A force for change!

RN Michelle’s birthday is on International Nurses Day

Hands off Medicare The Commission of Audit spoke – and it was worse than we feared.

Your super from pay rise The Court of Appeal has decided the state government can take superannuation out of your 2013 pay rise.

Most disappointed, last year I dropped my EN registration!

You should be able to take it up again, it hasn’t been that long.

You worked hard enough to get that qualification. Never surrender it!

Can someone please tell me if you keep both registrations does that mean you have to get double the amount of CPD points, pay for two registrations and do you have to do a certain amount of hours as an EEN as a condition of keeping dual registrations? I’ve just, in the last two weeks, registered as an RN. The AHPRA policy is not out yet but I am certain you will have to do RN three months practice within five years and 20 CPD points per year and EN three months practice within five years and 20 (possibly overarching) CPD points per year.

Hell no! Bad enough they are thinking of protocols for RNs to give out antibiotics, etc, in ED. Lots of extra responsibility with no extra pay. No thanks.

Nurse Practitioners are fantastic; we need more of them.

AiNs have a role in the first level of care under the supervision of an RN only. The taking of and interpretation of obs/symptoms/assessments require extensive learning and experience.

The cost may go down but mortality will rise (with very nasty legal/settlements). Oscopies, while common, have risks for injury – I would not have anyone but an experienced medical surgeon do mine.

I share my birthday, today, with Florence Nightingale. She fought for change and look what she achieved. Together we can do anything!!

If anyone was nursing back in the 80s you will remember a cost in the OPD of $15! We were forever chasing money that never materialised. Surprise, surprise! It didn’t work then and it won’t work now.

Who voted for this?

I don’t understand how the government says we can’t afford Medicare – we already pay for Medicare.

Word’s can’t even ... thanks NSW for valuing me at less than 2.5%.

It’s ok; we have until we are 70 to make up the difference. Nothing like flogging a dead horse! // Thieves! // Where’s the dislike button!

Government doesn’t value caring – it can’t be measured, tick-boxed nor does it make money.

Sad state of society.

Enjoy the top position while you can Mr Baird. I don’t think you will be there for too long.

Gutted! Makes me feel really let down by my employer, NSW Dept of Health, who I’ve worked for faithfully and fully for about 42 years :(

PHOTO GALLERY

These nurses from Scone wrote messages for International Nurses Day.

Nurses at our aged care forum in May were a force for change!

Newcastle University nursing students joining the NSWNMA.

Mona Vale Hospital nurses don’t want the new Northern Beaches hospital to be privately run.

THE LAMP JUNE 2014 | 41

Enrolled Nurse State Conference 2014 The Enrolled Nurse Professional Association NSW are pleased to invite you to the 21st Enrolled Nurse state conference being held in Tweed Heads at the Tweed Ultima Conference Centre. The conference is organized by ENPA enabling delegates to discuss and disseminate information to other nurses, forge friendships and networking with colleagues.

Imagine having a long soak in spa bath then wrap yourself in a uffy gown and sit by an open ďŹ re in the privacy of your own suite Melba House Boutique B&B in Katoomba can offer you just that!

In this awarded AAA rated 4.5* B&B a sumptuous gourmet breakfast is served in your suite before you venture out for a walk or visit to local art galleries, antique shops or one of the fabulous cafes and restaurants. s Please visit our website for direct online booking at www.melbahouse.com.au Alternatively phone Sue on 02 47824141 with any enquiries.

HIGHLIGHTS s %.gS WORKING IN !GED #ARE s 0AEDIATRICS -EDICAL 3URGICAL .URSING s ,OOKING AFTER YOURSELF

WHEN & WHERE 18-19 September, 8-9am for registration Tweed Ultima Conference Centre, 20 Stuart Street Tweed Heads Members $320 for both days. Non-members $350.

REGISTRATIONS CLOSE - Friday 6 September

ENQUIRIES & REGISTRATION Registration form is available from www.enpansw.org.au or contact the Enrolled Nurse Professional Association PO Box 775, Kingswood NSW 2747, Tel: 1300 554 249 Email: Rebecca – rjroseby@gmail.com Employers requiring an invoice please email rjroseby@gmail.com

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.

OfďŹ ces in Sydney and Newcastle with visiting ofďŹ ces in regional areas (by appointment).

Call the NSWNMA on 1300 367 962 and ďŹ nd out how you can access this great service.

42 | THE LAMP JUNE 2014

test your

knowledge 1

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Across 1. The administration of blood to replace red cells or blood products lost (5.11) 9. Wavelike, such as a vibration, fluctuation, or oscillation (8) 10. Dynamometer (9) 11. A single entity (3) 12. Nevertheless (3) 13. Experimental allergic neuritis (1.1.1) 14. Any weblike tissues (5) 15. Acceptable daily intake (1.1.1) 16. Constriction of the orifice of the prepuce so that it cannot be drawn back over the glans (8) 18. Tetanus antitoxin (1.1.1) 19. Hairs growing at the entrance to the external acoustic meatus (5)

20. Nanocurie (1.1) 21. Simultaneously (8) 24. Makes easier (5) 26. Growth hormone (1.1.1) 28. Dimply skin caused by uneven fat deposits beneath the surface (9) 29. Having two heads; pertaining to a biceps muscle (9) 33. A nursing classification (1.1.1) 34. The adult form of an insect (5) 35. Consumed; taken solid food (5) 36. Most important; principal (4) 37. The gravest form of pregnancy-induced hypertension (9) 38. Body or muscular tone; tonicity (5)

Down 1. Basal lamina (8.8) 2. Brings into being; creates (10) 3. Inflammation of the skin (10) 4. Any of the cold-blooded vertebrates constituting the class Reptilia (10) 5. An uncommon neoplasm of neuroepithelium in a sensory nerve (16) 6. Behaving nervously or restlessly (9) 7. Flatfoot (9) 8. An amino acid obtained from arginine by splitting of urea (9)

17. Preliminary tests or examinations (10) 22. Causing a straining or purifying process (8) 23. Intensify (8) 25. Echo planar imaging (1.1.1) 27. Tricyclic antidepressant (1.1.1) 30. A relatively narrow tubular passage or channel (5) 31. A solid with a triangular or polygonal cross section; used to correct deviations of the eyes (5) 32. Lacrimal fluid (5)

THE LAMP JUNE 2014 | 43

and go in the draw to

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

Get lost in Singapore

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

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

Remember ffor or every every new member you recruit/ha recruit/have ve recruited from 1 Jul Julyy 2013 to 30 June 2014 means you will ha have ve your name submitted to the dra draw. w.

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

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

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

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

NURSING RESEARCH ONLINE

The Australian Journal of Advanced Nursing is a vehicle for nurses to publish original research and scholarly papers about all areas of nursing. Papers aim to develop, enhance, or critique nursing knowledge and provide practitioners, scholars and administrators with well-tested debate.

The predictors and outcome of psychiatric disorders among survivors post-earthquake: survey from Sichuan China Dongling Liu, Xiaolian Jiang, Samantha Pang, Sijian Li Nearly 70,000 people lost their lives, 374,643 people were injured and 17,923 were recorded as missing. Experiencing a disaster can profoundly affect one’s psychological well being. The subject of the mental health of survivors of natural disasters has attracted attention from researchers and many studies have provided evidence of psychological effect post-earthquake. Little research has been done to examine the predictors of psychiatric disorders long term after a disaster. In recent years, an increasing number of studies have been published indicating several psychosocial consequences of disasters. But little research has been done to examine both the predictors and outcome of psychiatric disorders two years after the disaster. The present cross-sectional study was conducted to assess the psychiatric disorders of the survivors in 10 shelters in Sichuan province, south-west China. The aim of the study was to investigate levels of psychiatric disorders two years after the earthquake and identify risk factors and the outcome of psychiatric disorders among survivors. www.ajan.com.au/Vol31/Issue3/1Jiang.pdf

The effects of mindfulness training on reducing stress and promoting well-being among nurses in critical care units Hee Kim Lan, Pathmawathi Subramanian, Norshiah Rahmat, Phang Cheng Kar Although the working environment of critical care nurses may appear to be more conducive and comfortable, as they have a limited number of patients, the expectations regarding patient care and patient outcome are much higher com-

pared to other general nurses. This is mainly due to their responsibilities in taking care of critically ill patients, the high demands from patients and family members and the complex use of sophisticated technology. The effect of prolonged, unmanaged stress can have a negative impact on nurses’ personal or professional lives, causing physical and psychological changes, such as job stress, anger, anxiety, insecurity, dissatisfaction and frustration; decreased productivity; physical ill health like depression; and back injuries. There is a need to develop a culturally acceptable mental health program to help nurses cope with excessive stress. The concept of mindfulness originates from ancient contemplative traditions, particularly Buddhism. However, since the 1970s, it has been integrated in a secular way for stress reduction, psychotherapy and healthcare. www.ajan.com.au/Vol31/Issue3/3Pathma.pdf

Overseas qualified nurses (OQN) in Australia: reflecting on the issue Grazyna Stankiewicz, Margaret O’Connor AM In recent years, the provision of healthcare in countries around the world has faced a range of pressures as it seeks to address new demands and expectations, often in the context of a constrained or shrinking resource base. Often these pressures have concentrated on the structure and nature of the nursing workforce; how might this workforce be efficiently and effectively developed, organised and managed, to meet upcoming challenges. A major driver for nursing mobility is the chronic and severe global shortage of registered nurses in many countries, not only Australia. The reasons for emigration of OQN are many and not necessarily related to the nursing profession. According to Bieski, (2007), in the United States of America … “foreign recruitment is not a permanent solution for the escalating international shortage of nurses”.

The migration of nurses in the United Kingdom was initially presented as “a quick fix” to solve the

acute nursing shortage, but over time has become an essential and periodic strategy in the overall nurse recruitment policy. Australia, like many other developed countries, is facing an ageing population. Ageing, together with increases in chronic diseases and longer life expectancy, is creating more consumer demand for health care and requires comprehensive involvement of different health professionals, especially nurses. www.ajan.com.au/Vol31/Issue3/4Stankiewicz.pdf

Health literacy, does it make a difference?

Anne Johnson Low levels of health literacy are a significant problem in Australia. Population measurements of functional health literacy levels (ABS 2008) indicate that 59% of the Australian population aged 15 to 74 years did not achieve an adequate health literacy skill level to meet the complex demands of everyday life and work in a knowledgebased economy. Although low levels of health literacy are disproportionate in certain demographic groups, such as the elderly, people from non-English speaking backgrounds, and people with low general literacy; low levels of health literacy affect all segments of the population.

Health literacy levels can be context specific and can change depending on the problem being addressed, when the interaction takes place, and clarity of communications. Unfamiliar words, concepts, instructions, being ill itself, as well as the stress, fatigue, and fear produced by illness can also be challenges, as physical and psychological stressors impact on a person’s ability to pay attention, comprehend, and remember information. This article will provide an introduction to health literacy by covering an overview of key literature about understanding health literacy as a concept, and the importance of health literacy to health care. www.ajan.com.au/Vol31/Issue3/5Johnson.pdf THE LAMP JUNE 2014 | 45

The Edith Cavell Trust

Scholarships for the academic year 2015 Applications for the Edith Cavell Trust Scholarships are now being accepted for 2015. Members or Associate Members of the NSW Nurses and Midwives’ Association or the Australian Nursing and Midwifery Federation (NSW Branch) are invited to apply.

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

2. Registered or enrolled nurses who wish to attend:

an accredited clinical nursing education course of six months or less, either full-time or part-time; an accredited nursing conference or seminar relevant to applicant’s clinical practice.

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

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

Applicants must be currently

registered with the Nurses and Midwives Board of Australia.

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

For further information or forms, contact: The Secretary – The Edith Cavell Trust 50 O’Dea Ave, Waterloo, NSW 2017 T Mrs Glen Ginty on 1300 367 962 E gginty@nswnma.asn.au W www.nswnma.asn.au – click on ‘Education’

Applications close 5pm on 31 July 2014

BOOKS

BOOK ME Harvard’s Nursing Guide to Drugs (9th ed.)

SPECIAL INTEREST

Adriana Tiziani Mosby (through Elsevier Australia) www.elsevierhealth.com.au RRP $68.14 ISBN 9780729541411 (paperback)

This ninth edition of Havard’s Nursing Guide to Drugs continues to provide reliable, drug information for nursing and midwifery students and practitioners.

User-friendly and fully up-to-date, the textbook delivers safe drug administration information regarding form, action, use, dose, adverse effects and interactions in compliance with current pharmaceutical guidelines from the Therapeutic Goods Association (TGA). This edition also features icons that indicate drug cautions during pregnancy and breastfeeding, and another that indicates drug-specific restrictions in sport.

What Makes a Good Nurse? Why the Virtues are Important for Nurses (1st ed.)

Derek Sellman, foreword by Alan Cribb Jessica Kingsley Publishers www.jkp.com RRP $34.95 ISBN 9781843109327

This book is offered as a contribution to the philosophical basis of nursing practice and nursing education. It argues that nursing is an inherently moral practice and that this places moral obligations on individual nurses to cultivate the sort of disposition necessary to ensure their actions enable, rather than diminish, human flourishing. Sellman provides those in the caring professions with a rationale and a practical understanding of the importance that particular values – including justice, courage, honesty, trustworthiness and open-mindedness – play in the practice of nursing.

He explains why and how nurses should strive to cultivate these virtues, as well as the implications of this for practice.

Psychological Treatment of Older Adults: A Holistic Model Lee Hyer Springer Publishing Company www.springerpub.com RRP $70.00 ISBN 9780826195913

This book focuses on relationship building, prevention, education, and multi-pronged interventions for common co-morbid problems and communication.

It does so in the context of a team made up of professionals from different disciplines, patients and their families. Hyer advocates for a good dose of relationship building and psycho education before proceeding to treatment. When treatment is necessary, he advocates for psychological treatment as the best first-line treatment, because medications do not produce better results than psychological treatment, and can and often do, produce harmful side effects in older adults.

So I Hit Him: Surviving Life as an Institutionalised Alien Mark Whatham Big Sky Publishing www.bigskypublishing.com.au RRP $29.99 ISBN 9781922132284

This is the compelling story of a man who, despite all odds against him, considers himself to have had a lucky life. Born in a former workhouse hospital in Manchester, England with multiple disabilities and not expected to survive, Michael was placed in care almost from birth. By the time he was 17 he had been placed in more than 30 institutions and suffered every manner of physical, emotional and sexual abuse and neglect.

His Asperger’s became the key to his survival in a hostile world, enabling him to endure punishment, deprivation and emotional conflict. His rage and frustration created a man who used violence to deal with most situations in life. Be prepared to suspend judgment as you read his inspirational story.

Promoting Health: The Primary Health Care Approach (5th ed.)

Lyn Talbot and Glenda Verrinder Churchill Livingstone/Elsevier www.elsevierhealth.com.au RRP $99.95 ISBN 9780729541572

The key principles of primary health care – equity, social justice and community empowerment – underpin each section of this book. Current policy and practice initiatives have been updated and at the conclusion of each chapter there is a series of critical thinking questions that may be used to prompt personal reflection and broader reading about the issues raised. They could also be used to guide group exploration in a teaching setting.

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 JUNE 2014 | 47

MOVIES

movie of the month Set in a modern Ireland wracked with the damages of generations of child abuse, Calvary is a must see film, writes Stephanie Gray.

Father James Lavelle (Brendan Gleeson) is a good priest who is faced with sinister and troubling circumstances brought about by a mysterious member of his parish.

The film opens with a parishioner threatening Father James’ life during confession, announcing he will kill him the next Sunday.

The priest has a week to put his own house in order.

The unseen voice of the confessing parishioner tells him about the horrific child abuse he has suffered by a “bad priest”. He doesn’t ask for absolution saying he will do his own absolving.

The unseen voice of the confessor says “There’s no point in killing a bad priest. I’m going to kill you instead because you’re innocent”.

As the week progresses the forces of darkness begin to close in around Father James.

He is not a stereotypical priest who entered the seminary at 18.

He found his vocation in middle age, having been married with a now grown up daughter. He is a widower and a recovering alcoholic.

Although he continues to comfort his own fragile daughter, Fiona (Kelly Reilly) and reach out to help members of his parish with their various scurrilous moral – often comic – problems, he feels sinister and troubling forces closing in, and begins to wonder if he will have the courage to face his own personal Calvary. Calvary is the site where, according to the Christian gospels, Jesus was crucified.

Set and filmed in a coastal town in County Sligo, the scenery is rich, wild and bleak. This film is also a capitulation of the setting.

Patrick Cassidy’s melancholy score is summoned at just the right moments.

Calvary presents us with a satirical image of a country that is cracked and fractured into pieces, with utter conviction that the incalculable abuses have exacted, and will continue to exact, a terrible human price.

Stephanie Gray is an RN with the Australian Red Cross Blood Services IN CINEMAS JULY 3

METROMEMBERGIVEAWAY Email The Lamp by the 12th of the month to be in the draw to win a double pass to Calvary thanks to Transmission Films. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

48 | THE LAMP JUNE 2014

EDUCATION@NSWNMA

DVD SPECIAL OFFER

WHAT’S ON JUNE 2014 ——— • ———

Appropriate Workplace Behaviour – 1 day 11 June Newcastle • 9 July Albury 13 August Port Macquarie Topics include why bullying occurs; antidiscrimination law and NSW Health policies; appropriate behaviour in the workplace; identifying unlawful harassment and bullying; what to do if subjected to unlawful harassment and bullying.

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

Are you meeting your CPD requirements? ½ day 12 June Newcastle • 10 July Albury 14 August Port Macquarie Suitable for all nurses and midwives to learn about CPD requirements.

Members $40 Non-members $85 ——— • ———

Based on the memoirs of British midwife Jennifer Worth, this much-loved series follows nurse Jenny Lee and her fellow midwives from Nonnatus House convent as they care for the expectant mothers of 1950s Poplar, in London’s East End. Poplar was heavily bombed in both world wars, and many of its residents were forced to live in condemned buildings in substandard conditions for years after. In these difficult conditions the midwives of Nonnatus house work to bring the highest standards of modern midwifery to their patients.

In series three Chummy (Miranda Hart) and PC Noakes (Ben Caplan) return to the area with baby Freddie, while former Sister Bernadette, now Shelagh (Laura Main), leaves behind her habit and prepares for her wedding to Dr Turner (Stephen McGann). As the times change so do the women’s hairdos and the challenges they face to bring modern medicine to the vocational work they do.

As a bonus this three disc DVD set features cast interviews with stars including Jessica Raine (Jenny), Miranda Hart (Chummy) and Jenny Agutter (Sister Julienne).

Legal and Professional Issues for Nurses and Midwives – ½ day 13 June Newcastle • 23 June Parramatta 11 July Albury • 15 August Port Macquarie Topics include Health Practitioner Regulation National Law, potential liability, the importance of documentation, the role of disciplinary tribunals and writing statements.

Members $40 Non-members $85 ——— • ———

Computer Essentials for Nurses and Midwives – 1 day 18 June Prince of Wales Hospital, Randwick 6 August Prince of Wales Hospital, Randwick

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

Aged Care Seminar Series – 1 day 20 June Parramatta Suitable for all RNs, ENs and AiNs.

Members $75 Non-members $170 ——— • ———

Policy and Guideline Writing 26 June Gymea

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

Mental Health and Drug and Alcohol Nurses Forum – 1 day

RURAL MEMBER GIVEAWAY

18 July NSWNMA, Waterloo

Members $30 Non-members $50 ——— • ———

Stress and Burnout – 1 day 30 July Gymea

Members $85 Non-members $170 Email The Lamp by the 15th of this month to be in the draw to win a dvd set of Call The Midwives Series 3 thanks to Roadshow Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

——— • ——— To register or for more information go to

www.nswnma.asn.au/education or phone Matt West on 1300 367 962

THE LAMP JUNE 2014 | 49

DIARY DATES

conferences, seminars, meetings diary dates is a free service for members. Please send event details in the format used here: Event name, Date and location, Contact details; by the 5th of each month.

Send event details to: Email: lamp@nswnma.asn.au Fax: 02 9662 1414 Post: 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space.

NSW Turning the Tide on Continence – education day 14 June Port Macquarie $50 morning tea/lunch provided Keynote speaker: local pharmacist Pauline Chiarelli jca43356@bigpond.net.au Ann 0413 992 468 International Dementia Conference 2014 26-27 June Sydney www.dementiaconference.com/ ANCAN & CFA NSW Continence Education Day 27 June Burwood Marilyn Woodcock cfansw@optusnet.com.au Neurosurgical Nursing Professional Development Scholarship Committee 11th Annual Conference 27 June Milsons Point diane.lear@health.nsw.gov.au www.aci.health.nsw.gov.au/networks/neurosur gery NSW Urological Nurses Society seminar 18 July Charlestown urological_nurses@hotmail.com www.anzuns.org/nsw Through These Lines – a play about Australian nurses in WW1 24 July-5 August Newcastle www.civictheatrenewcastle.com.au/index.php Vascular Focus: Management of Peripheral Arterial Disease 8 August Liverpool $165. SVNSW member: $120 Tanghua Chen tanghua.chen@sswahs.nsw.gov.au www.sswahs.nsw.gov.au/Liverpool/events.html 25th Annual Susan Ryan Neonatal Seminar 1-2 August Parramatta www.susanryanseminar.gofundraise.com.au

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 EN Professional Association PO Box 775 Kingswood 2747 1300 554 249 Spiritual Care in Contemporary Nursing Practice 20 September Nurses Christian Fellowship NSW www.ncfansw.org 3rd Asia-Pacific International Conference on Qualitative Research in Nursing, Midwifery and Health 1-3 October Newcastle www.icqrnmh.info PANDDA 2014 Conference – Professional Association of Nurses in Developmental Disability Areas 15-16 October Parramatta www.pandda.net Nursing & Midwifery Unit Managers Society of NSW Annual Conference 17 October Ettalong www.numsociety.org.au

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Bones on the Beach – Orthopaedic Conference 25 October Wollongong karin.tarne@sesiahs.health.nsw.gov.au 6th Australian Rural & Remote Mental Health Symposium 12-14 November Albury www.anzmh.asn.au/rrmh/

ACT 3rd Biennial Australian Capital Region Nursing and Midwifery Research Centre Conference 16-17 October Canberra www.rcnmp.com.au Australia and New Zealand Society for Vascular Surgery Annual Scientific Conference 11-13 October Canberra www.vascularconference.com/2014/

INTERSTATE MHS Conference 2014 26-29 August Perth www.themhs.org 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/ conference-2014 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 @HISA_HIC 15th International Mental Health Conference 25-26 August Surfers Paradise www.anzmh.asn.au/conference conference@anzmh.asn.au Mental Health Service (MHS) Conference 26-29 August Perth www.themhs.org Australian Disease Management Association 10th Annual National Conference 11-12 September Melbourne www.adma.org.au/images/ConferenceFlyer2 014.pdf Paramedics Australasia International Conference 18-20 September Gold Coast www.paic.com.au Congress of Aboriginal and Torres Strait Islander Nurses and Midwives 16th National Conference 23-25 September Perth www.catsin.org.au ACMHN 40th International Mental Health Nursing Conference 7-9 October Melbourne 02 6285 1078 www.acmhn2014.com events@acmhn.org

Australasian College for Infection Prevention and Control Conference 23-26 November Adelaide www.acipcconference.com.au

INTERNATIONAL 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/ index.html International Conference on Infectious and Tropical Diseases 16 -18 January 2015 Cambodia www.ictid.webs.com

REUNIONS Royal Newcastle Hospital ‘Class of 74’ (40-year reunion) 6 June Newcastle Glenda Hughes 0408 411 516 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 Royal Newcastle Hospital April/May 1974 RN graduates 40-year reunion 30 August Newcastle Wendy Lewis 0407 861 722 wlew12@bigpond.com Sue Carroll (nee Hetherington) 0404 083 429 susancarroll1953@gmail.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 Qctober Helen Millan (nee Flanagan) helenmillan@bigpond.com NEC Prince Henry/POW Hospitals Oct 1972-75 group 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 Waikato Polytechnic Nursing Graduates 87-89 1-2 November New Zealand Molly Forbes 0403 904 650 mollywoppie@gmail.com

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