The Lamp August 2014

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 71 No.7 AUGUST 2014

Nurses and midwives say hands off Medicare! +

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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.

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

VOLUME 71 No.7 AUGUST 2014

COVER STORY

12 | Bust the budget

Kerry Rodgers NUM PHOTOGRAPH: TIM DALBY

REGULARS

5 6 8 33 37 41 43 45 46 50

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

AGED CARE

22 | Nursing home changes on hold

Tony Abbott is no doubt hoping that community anger towards his first budget will subside with the passing of time. A turnout of 15,000 at the Bust the Budget rally in Sydney suggests otherwise.

COVER STORY

16 | Stand up and be counted

Take to social media and oppose the budget cuts.

COVER STORY

18 | Nobel prize winner says Medicare changes “absurd” Australian unions are the difference between an economy with decent wages and an American one where the low paid miss out, according to Nobel Prize winner Joseph Stiglitz.

COMPETITION

6 | Give away: Five pairs of MBT shoes

NORTHERN BEACHES

20 | A clash of visions

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

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

Subscriptions for 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.

There was an unexpected attendee at a recent meeting to discuss privatisation of the new Northern Beaches Hospital — NSW Premier Mike Baird.

THE LAMP AUGUST 2014 | 3

NURS SES AND MIDWIVES: W IT’S IMPORT TANT A TO N NOTE

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of th he NSW Nursses and Midwives’ Asssociation nsure your en ntitlement to: o to en » All Association services » Accident id t J Journ ney Insur I ance demnity » Prof o essional Ind Inssurance.

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EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

Baird to public sector nurses and midwives: take or leave your 2.27% New South Wales has a new Premier but the modus operandi remains the same. The state government has again unilaterally imposed its will on public sector pay and conditions.

“It is hard to see, within the pattern of public health policies emanating from state and federal Liberal governments, any empathy for nurses and midwives working in the public health system.”

When he was the Treasurer and Minister for Industrial Relations, new Premier, Mike Baird promised nurses and midwives a 2.5% pay increase. It was a sum members were prepared to accept, when improvements to nurse-to-patient ratios were on the table, in negotiations with the previous Labor administration.

Since then the Liberal government has pulled out all the stops to avoid paying even that modest increase in full, let alone acknowledging our claim for improved nurse-to-patient ratios.

First, it tried to reduce the 2.5% to 2.25% and get public sector workers to pay for the 0.25% increase in the superannuation guarantee legislated by federal government.

Following a union challenge, the NSW Industrial Relations Commission reinstated the full 2.5% pay increase to public sector workers, including nurses and midwives, in June last year.

Subsequently, the government has resorted to a succession of legal challenges, regulations and legislation to get its way. In the process it has treated with disdain the IR Commission, parliament and not least, the views of nurses and midwives.

Now, after a derisory process, which confirms that good faith bargaining is dead in NSW, the Ministry of Health has applied to vary the Public Health System Nurses’ and Midwives’ Award to increase wages and salary-related allowances by 2.27% from 1 July 2014.

In his public appearances Premier Baird is assiduous in displaying sincerity; at a recent meeting of the Northern Beaches Community Unions Alliance he claimed that he “believe[d] in looking after nurses” (see page 20).

One has to question this when you put the actions of the Premier and his government under the microscope.

On pay and conditions: if you want improvements beyond the 2.5% (minus super increases) you will have to trade off existing conditions. If you want to improve and extend ratios to improve patient safety then the

government expects nurses and midwives to pay for it through trade offs.

The Premier is undoubtedly sincere in his commitment to private sector involvement in running public hospitals. What does this mean for nurses and midwives working in public hospitals like Manly and Mona Vale that are about to be privatised? At the Dee Why meeting the Premier said “there are protections there, there are opportunities and no one will be forced to do anything”.

What he failed to mention was that the wages and conditions of nurses and midwives are only protected for the first two years of the new private operator’s 20-year contract. He also failed to mention what would be the fate of hardfought for ratios in those hospitals.

It is hard to see, within the pattern of public health policies emanating from state and federal Liberal governments, any empathy for nurses and midwives working in the public health system.

Privatising public hospitals, outsourcing palliative and mental health services, co-payments for GP visits, massive cuts to future state public health funding and cuts to preventative health programs are just some of the attacks that have rained down on the public health system, its nurses and midwives and Medicare, from Prime Minister Tony Abbott and Premier Mike Baird over the past few months.

The Abbott and Baird governments have been equally intransigent on these issues. They have not shown any willingness to listen to nurses and midwives, who live the experience of the public health system daily.

But in eight months we will have a state election and nurses and midwives will have a chance to have their say on how they judge the government’s approach to the public health system that we know the community cherishes.

Our job is to tell it how we see it, having listened to our members and with the benefit of the larger picture of the global forces that are driving conservative governments.

THE LAMP AUGUST 2014 | 5

COMPETITION

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I have many concerns about this budget.

I’m concerned about elderly people with chronic health issues whose only income is the pension, after being manual workers all their lives, who now are worried about choices they may need to make about which medications to buy and when they can afford to see their GP and specialists.

I’m concerned, as a nurse in a small country multi-purpose centre with emergency and outpatient departments, about collecting monies from patients out of hours – we don’t have security personnel or admin assistants out of normal office hours or on weekends.

I’m also concerned about having to inform a family after a presentation that they will be sent an account for services rendered by the health system.

My general concerns: the rich remain healthy while the poor live in financial worry about what they will do if they become unwell. It is not inconceivable that families may find themselves in a position where they have to choose which of their members is most unwell and the one to be treated.

It is very hard for me to get my head around the fact that in this day and age our elected leaders are actively choosing to disenfranchise those who are vulnerable in our society.

Bernadette Proctor RN, Ganmain

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.

Anonymous letters will not be published.

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

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YOUR LETTERS

Concerned by budget cuts These federal budget cuts are very concerning.

We are already told, find ways to cut in our department or else admin will do it. University fees are already expensive for nurses. Is Medicare really under threat? The health funds are very unsatisfactory and you pay enormously if you use your fund. What on earth are sick people who can’t work going to do? Doctors will stop doing expensive tests unless health funds can cover them.

Workloads! We only just got there. Now we will be forced to do more again, putting patient care at risk.

I am really worried for my patients and the resources I will not have to care for them.

Katy Hunt RN, Maroubra

Prison closures lead to job losses Re the push to re-open Kirkconnell Correctional Centre: I received a phone call from a prison officer who lost his job at Grafton due to the closure of the prison up in that area.

I lost my job as a nurse and received a redundancy when Kirkconnell Correctional Centre closed [in 2011]. It resulted in the loss of more than 50 local jobs and more than $5 million from the local economies of Lithgow and Bathurst.

At the time I presented a petition to the NSW Parliament with more than 1000 signatures, requesting that the decision be reversed and lobbied our local member Paul Toole to keep the prison open, which did not happen.

I did manage to save a few jobs by having officers relocated to positions at Bathurst and Lithgow.

I attended the Prison Closure Inquiry at Grafton and represented myself and other staff members affected by the Kirkconnell closure. The NSW Upper House inquiry, which I also lobbied hard for, found NSW Corrective Services failed in their duty of care towards rural and local small businesses by their failure to consider a rural and economic impact statement before making any decision to close prisons in country areas.

I wish to remind people that the Lithgow Prison was established by the then Greiner government in the 1990s, due to the oppressed Lithgow economy of the day.

I recently raised concerns on WIN News about an increasing prison population and possible overcrowding at Lithgow Correctional Centre, with the increase of bed numbers from 328 to well over 400 today. The prison population currently is close to 11,000 and if trends continue will reach 12,500 by March 2015, according to NSW Bureau of Crime Statistics.

The Kirkconnell centre has been mothballed since 2011 and is costing thousands of dollars a year in security.

Anthony Craig RN, Lithgow

Problem doesn’t lie with 457 visa holders I am working as a practice nurse in New South Wales. I received a copy of your magazine and had a glance through. Firstly, I appreciate your efforts to stand for the common people and nurses’ interests and welfare. But I read an article in The Lamp regarding the issue of 457 visa holder nurses vs. graduate nurses and I want to address the issue from the point of view of a (former) 457 visa-holder.

The article states that because of employers taking overseas nurses with 457 visas, graduates are not getting jobs.

I came to Australia after getting a 457 visa and had a lot of expenses to come here; courses to attain AHPRA registration, including the language requirements, as well as accommodation and travel.

When we were overseas, we were told it was favourable here for work and study and that is why we came. What I am trying to say is this: Australian registration is not free for us. We had to undergo a lot of stress and financial difficulties and at the end, not everyone gets a job here either. Employers usually sponsor 457 employees for permanent residency (PR) and in return they have to work for the employer for two more years.

Now let’s see the graduates’ problem. It is not pleasant to watch while they are not getting jobs and someone else gets it.

Why is no one trying to put an end to such courses and study requirements here so that no one can come from overseas to snatch their jobs? I think nothing will happen because the institutions don’t want to stop their source of money from overseas.

I reacted to this issue because I know many Association members have 457 visas.

Many times I’ve heard talk that we are here to snatch the jobs of poor graduates. Why is no one concerned about hiring overseas nurses from countries like Ireland and the UK? They have jobs, registration and experience there but the employers and institutions are hiring them directly too with PR status.

The Lamp author didn’t seem aware of such migration and job losses but only saw the problems with 457 visa holders.

Treesa Issac RN, Lake Heights NSWNMA responds The NSWNMA is sorry if you felt that 457 visa holders had been singled out for criticism in relation to the inability of graduate nurses to obtain positions.

We appreciate the difficulties that many current nurses on 457 visas have experienced, both in terms of cost and increased stress.

In 2012 Public Services International carried out an investigation, which the NSWNMA and the Queensland Nurses Union participated in, to gain an understanding of the issues facing nurses as 457 visa holders.The final report highlighted the concerns you raise, among others, and resulted in a number of recommendations.

As part of our response to a federal Department of Immigration and Border Protection consultation into the 457 visa program, we provided a copy of the PSI report and highlighted these concerns and recommendations.There needs to be increased regulation of the migration of nurses and midwives and the NSWNMA remains committed to that. Not only so that graduate nurses are able to obtain positions, but also so nurses and midwives employed on 457 visas receive equal and equitable access to work, education and social support.

Thank you for writing – it helps to have direct feedback.

THE LAMP AUGUST 2014 | 7

NEWS IN BRIEF

United Kingdom

British nurses consider strike over pay Hundreds of thousands of NHS workers, including nurses and midwives, are considering strike action in a dispute over pay.

The Guardian reports that health union Unison said it would ask 300,000 of its members to back walkouts following the government’s decision not to accept a recommended across-theboard 1 per cent wage rise for NHS staff.

If approved the industrial action will take place in early October, followed by further waves of strike action.

The strike would involve nurses, therapists, porters, paramedics, medical secretaries, cooks, cleaners and healthcare assistants.

Unison said the government’s decision not to implement the 1 per cent pay rise recommended by the NHS pay review body would deny 60% of NHS staff and 70% of nurses a pay rise for the next two years.

Christina McAnea, head of health at Unison, told The Guardian: “Balloting for strike action is not an easy decision – especially in the NHS. But this government is showing complete contempt for NHS workers.

“It has swept aside the pay review body’s recommendations and ignored the union’s call for a fair deal. Our members are angry at the way they are being treated and we are left with little choice but to ballot for action.

“We hope to work closely with the other health unions to plan and coordinate action. It is not too late however for [the health secretary] Jeremy Hunt to agree to further talks, without preconditions, to settle the dispute.”

The ballot will begin on 28 August and run until 18 September.

The Royal College of Midwives (RCM) said it would also ballot its members on whether or not to take industrial action.

“BALLOTING FOR STRIKE ACTION IS NOT AN EASY DECISION — ESPECIALLY IN THE NHS.”

Australia

Happy winner Sarah Talamayan RN was the happy winner of an iPad mini after completing Have Your Say, an important survey for the NSWNMA to find out exactly what’s on members’ minds about their future.

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8 | THE LAMP AUGUST 2014

NEWS IN BRIEF

United States

Health records hacked The hacking of people’s health records is escalating in the fragmented and privatised US health system according to security experts.

According to experts interviewed by the online news site POLITICO thieves see patient records in a vulnerable health care system as an attractive target.

On the black market a full identity profile contained in a single health record can fetch as much as $US500.

The Identify Theft Resource Center, which identified 353 breaches in 2014, said almost half of those occurred in the health sector. Criminal attacks on health data have doubled since 2000 according to the Ponemon Institute, an industry leader in data security.

1.84 million people have been victims of medical identity theft according to a Ponemon report released last year, including 313,000 victims in 2013, a 19 per cent jump on the previous year.

The out-of-pocket costs incurred by victims of medical identity theft averaged more than $18,000.

Since the US Department of Health and Human Services began tracking the numbers in 2009 more than 31.6 million individuals – roughly one in 10 people in the US – have had their medical records exposed through some sort of hack, theft or unauthorised disclosure.

Australia

Government criticised for treatment of detained children The federal government’s medical health provider – International Health and Medical Service (IHMS) – has been widely criticised for its treatment of children living in detention centres across Australia and in offshore processing centres in Nauru and Papua New Guinea.

According to the president of the Australian Human Rights Commission children with serious medical issues in detention camps are being given grossly inadequate treatment.

“The evidence we have suggests the delivery of medical services is poor and with all sorts of problems,” said Professor Gillian Triggs. “The mantra appears to be ‘take a Panadol and have a rest’.”

In May it was revealed there is no full-time IHMS psychiatrist on Manus Island, despite clinical assessments by IHMS that found about half the asylum seekers in detention on Manus Island and Nauru are suffering from significant depression, stress or anxiety.

Immigration Minister Scott Morrison had previously assured human rights groups that there was a psychiatrist on the island.

photo: chilout.org

“THE EVIDENCE THAT WE HAVE THAT SUGGESTS THE DELIVERY OF MEDICAL SERVICES IS POOR AND WITH ALL SORTS OF PROBLEMS.” THE LAMP AUGUST 2014 | 9

NEWS IN BRIEF

Australia

Richest 1% own same as poorest 60% The richest 1 per cent of Australians now owns the same amount of wealth as the bottom 60 per cent, according to a new report by Oxfam Australia.

The report also revealed that the country’s nine richest individuals had a net worth of US$54.8 billion, more than the combined bottom 20 per cent of the population, or 4.54 million people.

“Income inequality in Australia has been on the rise since the mid-1990s, despite all sections of Australian society experiencing some increase in income during the same period,” the report said.

“In 1995, Australia had an average level of inequality compared to other wealthy OECD member countries. Today we are below average, having become less equal than our peers despite having a better-performing economy than most.”

A poll of 1016 people across Australia found that 79 per cent of people felt the gap between the rich and the poor had widened over the past decade “and the majority of those people said that’s made Australia a worse place to live”.

Oxfam Australia’s chief executive, Helen Szoke, told The Guardian that Australia should use its role as the host of November’s G20 meeting in Brisbane to put inequality on the agenda.

“It’s about what role Australia can play in ensuring that gap doesn’t grow so big that we have major problems globally in the future,” she said.

“IT’S ABOUT WHAT ROLE AUSTRALIA CAN PLAY IN ENSURING THAT GAP DOESN’T GROW SO BIG THAT WE HAVE MAJOR PROBLEMS GLOBALLY IN THE FUTURE.” — Helen Szoke, Oxfam Australia

10 | THE LAMP AUGUST 2014

Australia

Profiting from your health Screen jockeys in financial markets are licking their lips in anticipation of money to be made in Australia’s private hospital sector.

An initial public offering of shares in Healthscope Ltd, Australia’s second-largest private hospital operator, is expected to raise as much as $2.57 billion, making it the country’s third largest ever listing.

The planned listing underlines the growing appeal to investors of the healthcare sector in Australia, where governments at the state and federal level are looking to increase private participation in health.

The newly-listed company will have a market valuation of between $3.33 billion and $3.81 billion.

Managing director Robert Cooke told Reuters the company is planning to invest around $274 million in building new private hospitals between 2015 and 2017.

The number of Australians with private health insurance – the biggest driver of private hospital revenue – has risen from 9.8 million to 11 million since 2009, just under half the population. The Commonwealth pays an up to 30 per cent rebate on private health insurance premiums.

Australia

New laws threaten penalty rates Legislation before the federal parliament will strip current protections around individual flexibility agreements (IFAs) and make it much easier for employers to force workers to forgo penalty rates, says the ACTU. “Hundreds of thousands of workers could be moved off safety net conditions onto IFAs with less pay and less conditions under a scheme that will make it virtually impossible for workers to recoup their losses,” said ACTU secretary Dave Oliver.

He says the proposed new laws contradict Tony Abbott’s pre-election promise that workers would benefit or, at least not be worse off, under his government.

“That was an outright lie. Mr Abbott is attacking the workplace rights of hardworking Australians including penalty rates, the minimum wage and imposing unfair individual contracts.

“History tells us that, under WorkChoices individual contracts cut penalty rates for an estimated 65 per cent of signed up workers, nearly 70 per cent lost annual leave and shift loading, half lost overtime and allowances and a quarter lost out on state and territory public holidays.

“This new plan will see workers working longer for less pay and outrageously includes a provision that requires them to sign away their future right to claim that the IFA left them worse off.”

The ACTU believes the use of IFAs to remove award entitlements will be most prevalent in low-paid industries such as aged care, cleaning, retail, hospitality, and disability sectors, where workers are highly dependent on the award safety net.

NEWS IN BRIEF

United States

Right-wingers seeks to make union bargaining fees illegal An anti-union organisation financed by right wing billionaire businessmen, the Koch brothers, is attempting to outlaw the agency fees paid by non-union members to unions that bargain on their behalf.

Fruit, veg … and a health check Woolworths is trialling a scheme offering health checks to customers – and it has upset the Australian Medical Association and the Pharmacy Guild of Australia.

According to The Sydney Morning Herald nurses employed by the retailer have been checking blood pressure and cholesterol levels in customers across nine stores in New South Wales and Queensland since October. The trial will be reviewed before a decision on a full store rollout is made.

AMA president Brian Owler told the SMH the healthcare system was “built on general practice and highly qualified GPs leading primary care teams”.

He said that with health delivered in a retail environment “there would be no access to patient history and no privacy.”

Pharmacy Guild of Australia president George Tambassis told the ABC it was “hypocritical” for a supermarket that profits from selling tobacco and alcohol products to claim to be interested in healthcare.

The Grattan Institute’s Dr Stephen Duckett says he sees the plan as a commercial response to the Coalition’s proposed $7 co-payment for GP visits.

“People might be thinking of using Woolworths as an alternate source of advice to a GP,” he said.

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Australia

The case has been described as the most important labour law case the US Supreme court has had to consider in decades.

If the case is successful every state in the US will essentially turn into an anti-union “right to work” state, which would be a significant blow to the collective bargaining efforts of public sector unions and would complicate thousands of existing contracts between organised workers and municipalities, cities, counties, and states across the country.

According to the Centre for Media Democracy’s PR Watch, the National Right to Work Legal Defense Foundation, which has mounted the case, was founded 60 years ago and “has been a national leader in the effort to destroy public and private unions”.

The shadowy group, which along with two sister organisations has a combined revenue of $25 million a year, also recently filed a law suit to block workers in the Volkswagen Chattanooga plant from voting for union representation, and to prevent Volkswagen from voluntarily consenting to any future organising drives.

Our postgraduate courses equip you with the leadership, research and clinical expertise needed to advance your nursing career. Join us this August at our PG Expo or visit our website to explore your future.

To find out more, visit sydney.edu.au/nursing/next-level THE LAMP AUGUST 2014 | 11

COVER STORY

12 | THE LAMP AUGUST 2014

Bust the budget Tony Abbott is no doubt hoping that community anger towards his first budget will subside with the passing of time. A turnout of 15,000 at the Bust the Budget rally in Sydney suggests otherwise.

NURSES AND MIDWIVES JOINED WORKERS from other New South Wales unions and members of the public in a mass rally outside Sydney Town Hall on Sunday 6 July, before flooding the streets of the CBD in a march to show opposition to the Abbott government’s hostile attacks on Medicare, education and other social services.

Addressing the large crowd Mark Lennon, secretary of Unions NSW, described the latest federal budget as more than unfair.

“Not only is it unfair, it is deliberately unfair, because this is not just about the budget, this is about a change of the agenda for this nation.

“This is about a change in the philosophical direction of the country.”

He said that while the Abbott government was “for the few” everyone “has a right to a job, a right to decent services including health and education and to a decent retirement income.

“Our health system is one that the working people of this country paid for during the [1983 Prices and Income] Accord, when they gave up decent wage increases for a universal health system.”

Kerry Rodgers, a Nursing Unit Manager working in operating theatres spoke at the rally on behalf of the NSWNMA. She said changes to Medicare and cuts to health funding were “absolute madness”.

“There is no funding crisis facing Medicare. A crisis has been manufactured by the Abbott government and is driven

by Liberal ideology. Healthcare funding as a percentage of GDP is running at less than comparable OECD countries,” Kerry said.

“When spending is expressed as a cost per head of population our system is the second cheapest of comparable OECD countries. Our health system delivers world class outcomes for patients.”

ACTU secretary Dave Oliver said the budget was only the beginning of an attack by the Abbott government on the living standards of workers.

“Today we are not just coming out against Tony Abbott’s budget, we are coming out against the Americanisation of our society.Today we are defending the Australian way of life,” he said.

“They also want to cut penalty rates and reduce the minimum wage. There is legislation before parliament to bring back individual agreements.”

Dave Oliver says the Royal Commission into unions shows Tony Abbott doesn’t like unions because they have a proven track record in opposing attacks on working people.

“That’s why he has a $60 million witch hunt against unions yet won’t lift a finger against the Commonwealth Bank ripping off people. Tony Abbott wants to take out the union movement. I have news for you Tony. This movement is here to stay.”

“THERE IS NO FUNDING CRISIS FACING MEDICARE. — Kerry Rodgers, NUM

THE LAMP AUGUST 2014 | 13

COVER STORY

“NURSES AND MIDWIVES SAY HANDS OFF MEDICARE!” — Kerry Rodgers NUM Nepean Hospital

Not long ago Kerry Rodgers confronted the treasurer Joe Hockey on ABC’s Q&A program, about the assault on health in his budget. She addressed the Bust the Budget crowd on behalf of the NSWNMA. “I’m here to represent 60,000 New South Wales nurses and midwives, with their collective voice, to defend our universal health care system, which is one of the best in the world.

“Let’s be clear about two major issues: the Abbott government has no mandate for introducing GP co-payments or for slashing the health budget.

“In the lead-up to the federal election Tony Abbott repeatedly stated there was no threat to health, education or pensions. In doing so he unashamedly lied to the Australian public and has shown he is not worthy to lead this country.

“There is no funding crisis facing Medicare. A crisis has been manufactured by the Abbott government and is driven

by Liberal ideology. Healthcare funding as a percentage of GDP is running at less than comparable OECD countries.

14 | THE LAMP AUGUST 2014

“When spending is expressed as a cost per head of population our system is the second cheapest of comparable OECD countries. Our health system delivers world class outcomes for patients.

“What is wrong with that equation?

Nothing unless you are Tony Abbott, Joe Hockey or Peter Dutton. The Liberals believe we should have a user pays system with the privatisation of services and where profits are put before patients.

“It is disgraceful. Not one study has shown that the privatisation of services provides better outcomes. In fact it drives up prices and has been shown to deliver worse patient outcomes.

“Over the next four years New South Wales hospital funding will be cut by $1.2 billion. Australian dental health services will be cut by $390 million.

Preventative health programs will be slashed by more than $367 million. They will be dismantling Medicare Locals and privatising those services.

“At the same time that billions are being ripped out of healthcare, Abbott continues to support huge tax concessions for big business and major

banks, and continues measures such as the diesel fuel subsidy that means taxpayers directly contribute to the business costs of some of Australia’s richest people, such as Gina Rinehart.

“What does this mean for New South Wales? Co-payments combined with the slashing of primary healthcare funding are creating a perfect storm headed for our already overstretched, under resourced EDs, already facing a three per cent increase in presentations according to the New South Wales government.

“For our poorest and most vulnerable patients this means misery. There will be longer waits in ED and sicker patients as they have not been able to access timely care. If they need admission there may not be a bed available due to funding cuts.

“For staff there will be increased workloads and more frustration as they are unable to deliver the care they know they should be giving.

“This is absolute madness.

“The only crisis facing Australia is the moral, ethical, compassionate bankruptcy of the Abbott government.”

“STUDENTS GIVE THE BUDGET AN F FOR FAIL.” — Jade Tyrel, former president National Union of Students “This budget has breathed fire into the students of Australia. Their message for Tony Abbott is ‘keep your hands off our education’. Our education is not for profit and nor should it ever be. We want to put a big F for fail on Tony Abbott and Joe Hockey’s budget. The budget is a failure and a crime.

“If these changes get through, inequality will skyrocket. Education is a human right and not a privilege and should always be free.

“Students look at this budget and have one thing to say ‘It shall not pass!’”

“THEY ARE TRYING TO PIT US AGAINST EACH OTHER.” — Maree O’Halloran NSW Welfare Rights Centre “Our job is to help people who need to access the social security system – a system that has been built up so we don’t have the rich living in fortresses and the poor living in ghettos.

“What this nation needs is not cuts to welfare but a job plan. But what do we hear from the treasurer Joe Hockey? That people [on social security] are taking money from their neighbors. He is trying to break our solidarity and pit us against each other.

“This budget would rip our social protection asunder. If the budget is passed it will break the social security net for those who need it most.”

“I’M INCENSED

BY THE WAY OLDER AUSTRALIANS HAVE BEEN DEMONISED!” — Lyn McIver Fair Go For Pensioners “The changes in the budget have demonised those who can’t speak for themselves. I’m incensed by the way older Australians have been demonised.

Enough is enough Tony.

“We don’t have an economic crisis in this country. What we’ve been told in the media is lies and deception.

[Disability] can happen to anyone in life.

Everything can change immediately and it can change the lives of everyone in their circle.

“We can’t allow people to fall through the cracks and end up on the streets of this great city.”

THE LAMP AUGUST 2014 | 15

COVER STORY

Take to social media and oppose the budget cuts 16 | THE LAMP AUGUST 2014

THE AUSTRALIAN NURSING AND MIDWIFERY FEDERATION has developed a set of social media tools so nurses and midwives can have their say about the Abbott government’s budget changes, and lobby senators to stop them becoming law.

Federal Secretary Lee Thomas says the ANMF has developed the tools to engage members and supporters in online political activity.

“This is focused on the new senate. We want the senate to be under no illusion that the planned changes to Medicare and the introduction of the GP co-payment are bad for health and bad for the community.

We want the senate to vote against these changes and stop them becoming law,” she said.

Tell us what you think of the budget and health The 2014 federal budget has alarmed health workers across the country with its introduction of a GP co-payment that erodes the basis of Medicare, brings much higher fees for x-rays, scans and pathology tests, and makes major cuts to public hospital funding.

Visit www.nswnma.asn.au/our-budgetpoll/ and tell us what you think in our budget poll. Here’s what some people have already had to say:

“Hospitals will become overburdened with people who have not sought treatment for a minor problem which has then developed into a major problem.

People will die because they stopped their medications or missed vital pathology tests or did not get vaccinated.”

“I work with a very marginalised group of mental health clients – it’s hard enough to have them attend a GP and [get] blood tests etc. The GP copayment will make this exceedingly difficult and in the end these clients will suffer, as they will delay check ups etc.”

“As an aged pensioner on a very tight budget, I would have to limit my visits to the doctor and I would find the extra money for drugs also a burden. Sometimes my doctor refers me for scans, x-rays and ultrasounds and that would really be too much and would mean less money spent on food or letting some bills go unpaid. This budget is so unfair.

Please help us.”

“Health care is a basic right and no one should ever be afraid that they will be unable to afford treatment. I am more than happy to pay taxes so that those who need a little assistance can get it when they need it.”

“I am concerned that the environmental vandalism that forms part of this budget will impact on health for generations to come and be irreversible.”

“I am concerned that scrapping the CSIRO and creating a ‘medical research fund’ is a way of moving taxpayer dollars to private enterprise, and that private enterprise doesn’t research with ‘common good’ in mind; they research with the aim of profiting, therefore illnesses with less money-making potential will be ignored.”

“I work with very disenfranchised young people who will forgo their medication or visiting their doctor so that they can afford to eat or pay their rent. I see elderly people every day who need to see my colleagues and I hear their stories of working all their lives so that they can be healthy and independent when they get older. It rips my heart out that they also have to decide between affording to eat, pay their utility bills or to come and see their doctor and get their medication.”

For more online resources to save Medicare go to http://www.nswnma.asn.au/get-involved/defending-medicare-and-public-health/

WHAT YOU CAN DO ON THE ANMF’S NEW WEBSITE • Pledge against a budget lie, cut or broken promise.

• Promote your pledge to Facebook and Twitter using #healthcareemergency.

• Change your Facebook profile to fit the campaign.

• Share the campaign with friends and family.

• Donate money to a not-for-profit organisation that has lost funding due to the budget cuts.

Nurses, midwives and supporters will have a chance to nominate which budget lie, budget cut or broken promise they want to pledge against, such as cuts to the federal health budget, the introduction of GP co-payments, changes to family tax benefits, changes to pensioner payments or university charges.

Once you make your pledge against these lies, cuts and broken promises, the website will allow you to automatically promote your pledge to Facebook and Twitter using the hashtag, #healthcareemergency.

“We will make sure this is seen by decision makers, including key senators

and MPs,” Lee Thomas said. “We will be visiting senators in Canberra, while your branch will be taking action to show senators that these lies, cuts and broken promises are not okay, that we did not vote for these cuts, and Tony Abbott and his government have no mandate to introduce these broken promises.

“This campaign is not simply going to go away, we must hold the government to account for the healthcare emergency they are creating.

“Nurses and midwives must stand together against these terrible budget changes which are the beginning of the end for Medicare.”

THE LAMP AUGUST 2014 | 17

COVER STORY

Nobel prize winner says Medicare changes “absurd” Australian unions are the difference between an economy with decent wages and an American one where the low paid miss out, according to Nobel Prize winner Joseph Stiglitz.

ON A RECENT VISIT TO AUSTRALIA PROFESSOR Stiglitz, who is Nobel laureate for economic sciences, nominated Australian budgetary changes to university fees and Medicare as the two biggest mistakes the Australian government could make, that would take it down the American path of widening inequality and economic stagnation.

Professor Stiglitz was asked by Fairfax Media to nominate two mistakes he thought would make Australia more like the US. He described the Abbott government plan to deregulate universities as “a crime” and the move to a GP co-payment “absurd”.

“Countries that imitate the American model are kidding themselves,” he said. “It seems that some people here would like to emulate the American model. I don’t fully understand the logic.”

Professor Stiglitz says Australia has one of the best healthcare systems in the world.

“Your outcome per dollar is probably the best or one of the best.Your equality of access is one of the best,” he said. “Why would anybody … try to make your system like the American system? The US is at the bottom.

“As for talk about a price signal, people don’t make decisions about medical tests and procedures based on price. Maybe for cosmetic surgery they do, but for poor people, price signals price them out.”

“WHY WOULD ANYBODY … TRY TO MAKE YOUR SYSTEM LIKE THE AMERICAN SYSTEM? THE U.S. IS AT THE BOTTOM.” — Professor Stiglitz

18 | THE LAMP AUGUST 2014

UNIONS ARE DELIVERING Professor Stiglitz said that the American market model had failed American workers, with inflation-adjusted income of a US household lower than it was 25 years ago, and the typical inflation-adjusted income of a male full-time worker its lowest in 40 years.

When Fairfax asked what Australia had done right that the US had not, he replied: “unions”.

“You have been able to maintain stronger trade unions than the United States.The absence of any protection for workers, any bargaining power, has had adverse effects in the United States.

“You have a minimum wage of around $15 an hour.We have a minimum wage of $8 an hour.

That pulls down our entire wage structure.”

Pensioners hardest hit by co-payments A Sydney University study suggests the combined impact of higher co-payments will hit those 65 and over the hardest. A pensioner couple will face additional out-of-pocket costs of $200 a year.

It found one-in-four adult visits to a GP involved at least one additional pathology or imaging test, meaning the minimum out-of-pocket cost for the consultation would be $14.

About 3 per cent of visits involved both tests, or $21 in expenses.

The full impact of the GP copayment and changes to the Pharmaceutical Benefits Scheme (PBS) would mean a self-funded, retired couple could expect to pay, on average, an extra $244 a year in health costs, or $199 for a pensioner couple, according to the study.

Health cuts threaten AAA rating The influential ratings agency Standard and Poors says the state’s AAA credit rating is under threat because of Abbott government budget cuts, in particular to health.

“We expect that the cuts could create longer term pressure for the state, in the absence of commensurate policy measures to increase other funding sources or dampen growth in demand for services,” the ratings agency said.

According to the Australian Financial Review NSW budget papers say that cuts to federal grants programs, especially the National Hospitals Funding Agreement, would leave the state $16 billion worse off per year by 2050.

The average patient with type 2 diabetes would face additional bills of $120 a year regardless of age, while families would pay $38 extra per child under 16.

A co-author of the study Dr Clare Bayram told the Sydney Morning Herald she was surprised by the size of the financial impact on pensioners.

“It really emphasises that it’s not going to be evenly distributed,” she said. “These people need to use the services, they’re not making a choice.”

Australian Medical Association president Brian Owler said the study showed that GP co-payments had the greatest impact on the most vulnerable in our society.

“It’s the sort of modelling that really should have been done before the proposal came out.”

Budget measure will lead to destitute young The federal government has allocated $230 million over four years to provide emergency relief to those affected by a budget measure that will see jobseekers aged under 30 waiting six months before becoming eligible for unemployment benefits.

According to the Sydney Morning Herald the federal government expects 550,000 applications for assistance, which will be delivered by charities in the form of vouchers for food, transport or medications, parcels of food or household goods, clothing or by helping to pay rent or utility bills.

Department of Social Services deputy secretary Serena Wilson admitted in a senate hearing that there was a risk some of those affected by the budget change would become homeless.

Maree O’Halloran, president of the National Welfare Rights Network, says youth unemployment will not be addressed by forcing young people into destitution.

“The $230 million to be spent on emergency relief for those left with no safety net would be better spent providing 100,000 job seekers with wage subsidy programs for four years,” she said.

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PRIVATISATION

A clash of visions There was an unexpected attendee at a recent meeting to discuss privatisation of the new Northern Beaches Hospital — NSW Premier Mike Baird. He did not make himself available to answer questions but he did make clear his commitment to private involvement in the running of “public” hospitals. The well-attended meeting at Dee Why RSL was organised by the Northern Beaches Community Union Alliance. The NSWNMA welcomes the support of the Alliance in keeping Northern beaches hospitals public. Here’s what some of the participants had to say.

BRETT HOLMES GENERAL SECRETARY NSWNMA “PRIVATISATION ALLOWS COMPANIES TO MAKE A BUCK OUT OF PEOPLE’S MISERY.” “It is an honour to be able to tell the story that we would like you to hear Premier and hear it loud and clear.The government means to close Manly hospital and downgrade services at MonaVale to almost nothing and the bright new shining Frenchs Forest hospital will be a private entity. This move to private health is ultimately about dismantling our public health system which serves us well. It is about private providers salivating at the thought of getting their hands on public money to operate services and not have to put any of their money at risk.

Why would multi-billion dollar companies like Ramsay be interested in entering into the business of providing public health if there wasn’t a profit motive involved? Make no mistake, this is about dismantling our universal health care system and putting profits before patients.

Our world class universal health system is a major target for this government and we are currently on the front line of defending it. Co-pays, or any form of user pays, are the slippery slope to a for-profit US-style model and bait for profit driven companies like Ramsay and Healthscope to enter the market and make a buck out of people’s misery.

Private hospitals want to expand their

20 | THE LAMP AUGUST 2014

“NOBODY WANTS A US-STYLE HEALTH SYSTEM.”

market. By guaranteeing public beds in the new Northern Beaches hospital the government is bankrolling the private sector. This way the private provider can access patients with private insurance at minimal start up cost.

Nobody wants a US-style health system – it doesn’t matter who you ask – yet both our federal and state governments in their ideology, backed by the vicious federal budget, are heading in that direction.

The NSW Nurses and Midwives’ Association is committed to stopping the

privatisation of the new Northern Beaches Hospital and we’ve already been campaigning for months with our fellow unions in this room and concerned community groups. We must stop this while we still can. If Campbell Newman can see sense and reverse the decision then Mike Baird should be able to as well.

I don’t think any of us, including the premier, want a US-style health system.

Premier, I invite you to defend our public health system and not let it go down the path of a privatised system.”

LYN HOPPER RN “WHO IS MY EMPLOYER?” “If this hospital is so public who is my employer. Is my employer Ramsay, the biggest donor to the Liberal Party, or Healthscope? It is not going to be the public sector. It is not going to be the Ministry of Health. If that’s my employer it makes it a private hospital in my book.”

NSW PREMIER MIKE BAIRD “I BELIEVE IN THE PRIVATE SECTOR.” “I am not going to put forward any policy that I don’t strongly believe is in the longterm interests of the community.

I had many people come to me and say we need a quality hospital and quality facilities on the Northern Beaches, including Lyn Hopper and I pay tribute to her for standing alongside me to fight for this.

The question then comes down to the model. It does make sense for a private hospital to be here and we obviously need a new public hospital.

By sharing facilities in the middle – an emergency department, x-ray, operating theatres – there are great efficiencies that can go into better services and better facilities. By having a management team that manages the private hospital, giving them capacity to also manage the public hospital, we end up in a position where we’ve got a top level public hospital and, obviously, a private hospital next door.

Now, it is a public hospital. It’s exactly the same if you turn up at Mona Vale or if you turn up at Manly.There’s no difference.

The only difference is that it will be a world-class facility.

I will support partnering with the private sector if we can deliver better facilities, improved services and great outcomes for the community.That’s what I believe in.

I also believe in looking after our nurses, there are protections there, there

are opportunities, but no one will be forced to do anything.

I understand the concerns you raise and apologies if I haven’t got time to answer the questions today, but I can assure you that the model we are putting forward is in the community’s interest; it is partnering with the private sector. Apologies if not everyone here agrees.”

Take action at our pop up shop The NSWNMA has set up a pop-up shop at 335 Condamine Street in Manly Vale. We will be holding a series of activities to inform the community about the dangers of a privatised system.

To get involved email lridge@nswnma.asn.au

“I WILL SUPPORT PARTNERING WITH THE PRIVATE SECTOR … THAT’S WHAT I BELIEVE IN.”

THE LAMP AUGUST 2014 | 21

AGED CARE

Nursing home changes on hold A push to abolish the requirement to employ RNs around the clock in nursing homes has stalled.

REGISTERED NURSES WILL REMAIN ON duty around the clock in nursing homes throughout New South Wales – for now.

In June the Minister for Health Jillian Skinner promised that the status quo would remain for 18 months while a “joint consultation process”, involving the NSWNMA, takes place.

Mrs Skinner said NSW Health was committed to providing all aged care residents with “a high level of care that addresses their complex health needs”.

She said the consultation process aimed to reach “a consensus position for the way forward”.

“CHANGING THE LAW ‘IS NOT IN THE BEST INTERESTS OF RESIDENTS’.”

— Brett Holmes NSWNMA General Secretary

The NSWNMA raised the alarm over a proposed amendment to the NSW Public Health Act which aimed to remove the requirement for an RN to be employed around the clock in care settings classified as nursing homes. These make up almost half of aged care facilities in NSW. Employer organisations have called for “flexibility” in staffing and claim they are best placed to decide when to roster RNs. General Secretary of the NSWNMA Brett Holmes says he is pleased Mrs Skinner has acknowledged the NSWNMA’s concerns and ordered that the status quo remain – for the time being.

“Removal of the legislated requirement, to have registered nurses on duty 24 hours per day in aged care homes, is not in the best interests of residents,” Brett said.

22 | THE LAMP AUGUST 2014

“The Ministry of Health knows that unwell or injured aged care residents can often end up in public hospital emergency departments and hospital beds.

“Having RNs in nursing homes can make a significant difference as to whether a resident must be sent to hospital and when they can return.”

In NSW law the definition of a nursing home relies on wording from the federal Aged Care Act, which previously referred to “high care” and “low care”.

However the Act was recently changed to incorporate a new approach to bonds and payment systems and no longer distinguishes between high and low care.

According to NSWNMA Council member Debbie Lang RN, who has two parents in residential care: “This change effectively makes the definition of a nursing home in New South Wales redundant and undermines the staffing requirements associated with this.

“As well as this change affecting the state Public Health Act, it also affects the Poisons and Therapeutic Goods Act, which also refers to the federal definition for nursing homes in describing who can handle different schedules of medicines, particularly in aged care.”

Debbie says it is up to the NSW government to decide to amend state law to keep the current level of staffing

“WE MUST DO ALL WE CAN TO PROTECT THE CURRENT STANDARDS.” — Debbie Lang RN protection – and medication handling – or do nothing and let this go.

“If they walk away from the current state law they will be leaving it up to the providers to staff how they wish.

“We must do all we can to protect the current standards.”

Mandatory RNs “wasteful” say providers The Aged & Community Services Association of NSW & ACT has described the requirement to have an RN on duty at all times for high-care residents as “a waste of limited resources.”

The association represents not-for-profit providers operating 726 residential care facilities throughout NSW and the ACT. The association’s chief executive Illana Halliday told Australian Ageing Agenda recently that while skilled RNs were necessary in the provision of palliative care or short-term acute care in a facility, not all high care residents require an RN to meet their needs.

“It is probable that many residents with a high score in ACFI [Aged Care Funding Instrument] may still not need an RN, as the care they require is not acute or curative, it is about comfort and quality of life,” Ms Halliday said.

Removing RNs a backward step Skilled nursing care for the aged is essential, members say.

A REGISTERED NURSE WHO TEACHES aged care says the push to remove RNs from nursing homes runs counter to current trends in nurse education.

Janet Langridge RN, who has worked at a number of aged care facilities, says tertiary institutions now offer post-graduate degrees in aged care and dementia.

“This recognises that aged care is a specialty area that requires special skills,” she said. “On the other hand we have providers trying to have RNs removed from the floor.

“What should be occurring is the absolute reverse – lobbying for nurse practitioners in aged care.”

Janet teaches Certificate III in Aged Care at TAFE, which includes a medication component.

“The current curriculum is not aimed at training assistants in nursing to manage complex care needs. Nor are there any moves afoot to significantly alter the curriculum,” she said. “Certificate III courses provide basic information on medication administration. However to administer medication they need to be supervised on site by an experienced nurse and given competency by that organisation to administer medication.

“I am concerned that, with some providers becoming registered training organisations, there is a blurring of boundaries.

“There is real potential for policy errors to be perpetuated throughout organisations, and for expediency to override safe practice when deciding how to staff facilities.

“I would be very concerned if providers … became solely responsible for the in-house training of high-level administration of medications.”

Janet says the move to get rid of RNs is a humanitarian failing because “it suggests our elderly do not require trained professionals taking care of their complex needs”.

“It is not just the aged. Due to the lack of suitable beds for young disabled people we frequently have residents from the 18 to 35 demographic.”

Janet says AiNs lack sufficient knowledge and skills to adequately manage a range of tasks including tracheostomies, catheterisations, morphine infusions, gastrostomy feeds, peritoneal dialysis, complex wound care and lymphoedema bandaging.

“What would happen after hours if a catheter blocks or an infusion needs replacing? The resident would be sent to accident and emergency.

“This transfers the cost from the aged care provider to the public health system.”

In other reactions from NSWNMA members a student nurse who works as an assistant in nursing, said she could not imagine an aged care facility operating safely without RNs. MERRYN ANDERSON WORKS AS A CASUAL AiN at a southern Sydney nursing home while studying for her nursing degree.

“I was very upset to hear that the requirement to have RNs in nursing homes around the clock may be removed,” she said. “I understand it is about staffing flexibility in order to save money, because AiNs are cheaper. However I think the care provided would be unsafe for residents.”

Merryn said she had learned a lot about procedures such as changing dressings, mobility, feeding and infection control while being supervised by RNs at the nursing home.

“The AiNs I work with are very knowledgeable about aged care but they rely on the RNs to do stuff which we are just not qualified for.

“It would be a big worry for an AiN to have the responsibilities of an RN.”

“THERE IS REAL POTENTIAL FOR EXPEDIENCY …

TO OVERRIDE SAFE PRACTICE.” — Janet Langridge RN

“I THINK THE CARE PROVIDED WOULD BE UNSAFE FOR RESIDENTS.” — Merryn Anderson AiN

THE LAMP AUGUST 2014 | 23

AGED CARE

425 aged facilities at risk An advocacy group has called on the state government to keep the law that ensures a registered nurse is on duty at all times in a nursing home.

IN A LETTER TO MINISTER FOR HEALTH Jillian Skinner the Quality Aged Care Action Group (QACAG) said it was up to the state government to maintain the role of the RN as required by the NSW Public Health Act. “Without action some 425 nursing homes would be affected in New South Wales and we are convinced that quality of care would suffer,” said the president of QACAG Margaret Zanghi.

“We do not believe it is enough to fall back on the [federal] Aged Care Act nor the assumed goodwill of providers to ensure registered nurse cover in nursing homes.

“Many QACAG members have had experiences with care homes, and we have already faced the consequences of poor

24 | THE LAMP AUGUST 2014

“WE DO NOT BELIEVE IT IS ENOUGH TO FALL BACK ON THE GOODWILL OF PROVIDERS TO ENSURE REGISTERED NURSE COVER IN NURSING HOMES.”

staffing for the care of our loved ones.

“Many of us are shocked to find out that, despite over 75 per cent of people in residential aged care having high care needs – and therefore high level funding – if the facility is not a nursing home there is no requirement for a registered nurse on duty at all times.

“New South Wales has long protected the rights of frail older people to have a registered nurse on duty in a defined nursing home, as a minimum.

“To lose this would open the way for lower registered nurse cover and reliance on less qualified staff despite the high level needs [and subsequently higher funding] of the people receiving nursing home care.”

Nurses back new agreements Nurses at the Lady of Grace nursing home in the northern Sydney suburb of Dural have negotiated an improved agreement.

IN A BALLOT OF 50 NURSES AND OTHER employees working at the Lady of Grace nursing home all but one approved a new three-year agreement that includes annual pay increases of 3.25 per cent.

“Nurses are really pleased with the outcome and how smoothly the negotiations went,” Enrolled Nurse Pauline Edwards, delegate of the facility’s NSWNMA branch said.

“We started by collecting ideas from staff about the sorts of improvements they wanted,” she said. “It took three meetings with management to come to an agreement. Management initially wanted a four-year agreement with annual increases of 2.7 per cent.”

Pauline says the agreement now provides for full time employees who work Saturdays and Sundays to be paid full penalty rates for public holidays that fall on their days off.

The agreement provides for up to three days paid union leave per year to allow NSWNMA members to attend conferences, courses and other union activities.

It also says management cannot make changes to shifts without an employee’s agreement.

NSWNMA officials said negotiations only took three meetings – including a marathon final session – thanks to the commitment of delegates and members to reach agreement.

They said the employer’s agreement to paid leave for union business was a recognition of the “hard work and commitment” to the negotiation process and the importance of effective delegates.

In other aged care news, nurses overwhelmingly approved a new three-year enterprise agreement for the six highcare facilities operated by Scalabrini Village Ltd. The agreement includes a 3 per cent annual wage increase and improvements to the classification structure to recognise diversity of nursing roles.

Improvements to classifications, training and the career path include: • Introduction of AiN Grade 2 for all nurses with a Certificate IV in aged care including a medication module

“NURSES ARE REALLY PLEASED WITH THE OUTCOME AND HOW SMOOTHLY THE NEGOTIATIONS WENT.”— Pauline Edwards EN, delegate for the Lady of Grace nursing home NSWNMA branch

Front row left to right Mary Johns and Pauline Edwards.

Back Row: Jessica Hearn and John Holmes

and second year undergraduate nurses.

• Creation of AiN/EN Transition Nurse Grade 3 to provide one-onone care for new residents and families with an emphasis on residents with dementia.

• Team Leader Grade 4 to be open to Grade 2 AiNs and ENs and replace the existing AiN Team Leader allowance.

• Introduction of Nurse Educator – an EN responsible for some clinical

education of AiNs and ENs and more general education.

• Quality Coordinator position to be open to ENs as well as RNs. • Certificate IV course costs to be paid by Scalabrini.

• Minimum two hours pay when called in for mandatory training.

Other features of the agreement include an increase in the casual loading to 25 per cent. Casuals have a right to overtime after 38 hours in a week or 76 hours in a fortnight.

THE LAMP AUGUST 2014 | 25

AGED CARE

“I WANT TO TEACH PEOPLE THAT PALLIATIVE CARE IS ABOUT DOING EVERYTHING FOR THAT PERSON THAT IS FOCUSED ON COMFORT AND QUALITY.” — Jane Mahoney, CNC

26 | THE LAMP AUGUST 2014

Alert to the red flags of dying Residents in aged care deserve fairer access to palliative care says clinical nurse consultant Jane Mahoney.

MORE AND MORE PEOPLE REQUIRING palliative care are arriving in residential aged care facilities.Yet according to the National Aged Care Alliance, its availability is the exception rather than the norm.

“Ten to 15 years ago patients would have remained in hospital until the end of their life,” palliative care CNC Jane Mahoney told a recent NSWNMA forum for aged care nurses.

“Now residential aged care staff are being pulled and pushed in every direction because people are being trolleyed in, they are much sicker and with higher needs. Our skills are being tested all the time.”

Jane worked as a CNC for palliative care in the South Western Sydney Local Health District for 15 years.

“I looked after people in the community who were palliative in the acute care hospitals, in private and public hospitals and in residential aged care facilities.

“I think there was always a feeling deep down in my soul that we really weren’t giving the residents in aged care facilities a fair share of our palliative care nurse consultancy. They came in right down the list, I’m ashamed to say.”

Since establishing her own business in 2010, Palliative Aged Care Consultative Service, which provides clinical consultancy and education to aged care facilities across New South Wales, her feelings have been confirmed.

“Residents in aged care weren’t getting fair access to palliative care.”

Jane and a small team of specialist nurse consultants provide consults and assessments, symptom management, palliative care planning, facilitation of case conferencing, GP liaison, accreditation support, Aged Care Funding Instrument (ACFI) maximisation and education.

“We look at the quality of care we

give to people with a life threatening or life-ending illness. We encompass everyone who is looking after that person or is a part of his or her life. We look at all their symptoms, be they physical, psychological, emotional or spiritual.”

The World Health Organisation defines palliative care as improving the quality of life of patients and their families facing the problems associated with a life threatening illness.

“Until you start working within that area you really don’t know how that translates,” Jane said. “Pain is a very obvious symptom we look for but I think other symptoms are equally important, if not more so.Yet within that ACFI tool they only see pain as having validity, which annoys me.

“You often have someone who has no pain, but may have intractable, dreadful nausea and that is a palliative care emergency because having nausea 24/7 is absolutely dreadful.

“We would look at and address pain, nausea, vomiting, loss of function, loss of movement, body imaging issues.”

Jane recommends assessment and re-assessment of residents and their level of dependence and says often they cannot come to terms with their changing health status.

“Sometimes denial is a very adequate coping mechanism for many people. So it’s not about slapping them out of denial it’s about working with them and walking the journey with them.”

Often facilities have a culture of sending people to hospital come the end of their lives.This might be because of lack of GP support, lack of staff, or lack of education.

“You can change that culture, knowing you have wonderful skills you can apply, with the right support and the right education and a bit of teaching to GPs,” she told the forum.

“It’s our role to be alert to what I call the red flags of dying. Often the resident is showing signs of deterioration and that is often a sign of them moving toward the end of their life.

“We need to be aware and awake to these and things like recurrent infections, recurrent UTIs, recurrent respiratory tract infections, multiple courses of antibiotics. Any change in swallowing should be a big red flag, as should revolving hospital visits.

“If you send a resident to hospital for their breathing, they’ll be seen in ED and ED will say ‘what the hell has the nursing home sent them here for?’

They’ll say to the family ‘what do you expect us to do, they’re dying don’t you know?’ and they’ll send them back.

“If you have someone uncomfortable and not getting quality treatment with their symptoms, you may have no alternative but to send them to hospital.

But ask to speak to the senior nursing or med staff on that shift in ED, tell them if they’re going to send them back they require terminal medications to be sent back with them.

“There’s a lot of talk about advanced care directives and advanced care planning and that definitely has a place. But sometimes we’re in a situation where we can’t get an advanced care directive because the person is not in a position to do that.

“So we’re talking with families and residents about what the focus of care should be, what is meaningful for you as a resident. That’s what palliative care is about and it’s a team approach.”

Too often, Jane says, the term palliative care is used in the sense of “there is nothing more we can do.”

“I want to teach people that palliative care is about doing everything for that person that is focused on comfort and quality. It’s just part of the fabric of what we do in an aged care facility.”

THE LAMP AUGUST 2014 | 27

AGED CARE

Keep calm and stop bullying Members working in aged care have heard how new national laws can help

NSWNMA OFFICIALS HAVE HELD SEMINARS at eight locations across the state to explain new anti-bullying laws to members.

The national laws, introduced by the previous Labor government, took effect on January 1 this year and empower the Fair Work Commission (FWC) to deal with bullying in some workplaces. The laws apply to most aged care providers but not state government organisations such as NSW Health.

They are designed to allow workers affected by bullying to apply directly to the FWC for a fast hearing of their complaint.

The commission can order that bullying must stop and that an employer must develop policy and provide training to combat bullying, for example. However the commission cannot impose financial penalties or order compensation.

NSWNMA Industrial Officer Katherine Rynne said bullying was defined 28 | THE LAMP AUGUST 2014

“THESE LAWS ARE AIMED AT STOPPING FUTURE BULLYING. THEY ARE NOT AIMED AT PUNISHMENT OR COMPENSATION FOR PAST BULLYING.” as unreasonable behaviour that creates a risk to health and safety, by causing anxiety, depression and stress, for example.

“Bullying covers a range of behaviour including – but not limited to – victimising, humiliating, intimidating and threatening behaviour,” she told members at the Parramatta seminar.

“It is not necessary to prove that harm

to health and safety has actually occurred.

“Bullying has to have happened more than once. It cannot be a one-off incident.

“There must be a risk that the bullying will continue because these laws are aimed at stopping future bullying. They are not aimed at punishment or compensation for past bullying.”

Katherine said the laws apply to all

Are you being bullied?

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

• You must give your employer a chance to put a stop to the bullying before the Fair Work Commission will accept your complaint. Follow your employer’s policy and procedures on bullying to lodge a complaint.

• If your employer does not have specific bullying policies and no clear protocols on how to respond, call the NSWNMA for advice.

• If management fails to act on your complaint, or is unable to stop the bullying, you can complain directly to the commission. The NSWNMA can help you lodge a complaint.

• The commission must start to deal with your application within 14 days.

• It can arrange a mediation session involving an external mediator. If bullying continues the case can go to a hearing where you may be required to give evidence.

• The commission can issue orders against the employer as well as your co-workers and even visitors to the workplace.

• It can order the employer to put a stop to the bullying, monitor the employer’s conduct and direct the employer to provide information and support to staff.

What is bullying?

Bullying at work is repeated unreasonable behaviour directed towards a worker or group of workers that creates a risk to health and safety. Examples include:

at work them deal with bullying.

• Verbal abuse.

• Putting someone down.

• Spreading rumours or innuendo about someone.

• Interfering with someone’s personal property or work equipment.

• Deliberately excluding someone from workplace activities.

• Deliberately denying access to information or other resources.

• Withholding information that is vital for effective work performance.

• Deliberately changing work arrangements, such as rosters and leave, to inconvenience a particular worker or workers.

employees, including management, as well as volunteers.

“Bullying does not include reasonable management action carried out in a reasonable manner.

“For example, it is reasonable for an employer to allocate work but probably not reasonable to allocate one worker a whole lot more work than another worker.

“It is reasonable for managers to give fair and constructive feedback on a worker’s performance.

“It is not reasonable, for example, to give someone a dressing down in the corridor in front of residents and other workers.

“If you work with someone with a personal hygiene problem it is reasonable to take that person aside and have a conversation about it. It is not reasonable to hold your nose every time you walk past them.”

NSWNMA organiser Lynette Flanagan presented a case study of a recent bullying complaint to the FWC.The case involved an Association member who was being bullied by another worker.

“Our member worked in a dementia unit. Her co-worker would come into the unit when residents were settled and calm and deliberately disturb them to the point of agitation. Then she would leave, while our member struggled to resettle the residents,” Lynette said.

The member complained to management but management took no effective action.

“The bully had a close relationship with management,” Lynette said.

“Our member developed extreme anxiety and depression. She felt that no one was listening to her or believed her and that contributed to the breakdown of her health.”

The member called the Association, which helped her complain to the FWC. “FWC ordered mediation and things improved for a while. But bullying started again so we went back to the commission.

“They called the employer in to explain their failure to address bullying. The employer was very clearly told they had to take action and the bullying stopped.”

Lynette, who previously worked as an aged care Assistant in Nursing, said it is never too early to call the NSWNMA for advice on bullying.

“It is wise to get us to help because there are a lot of forms to fill out,” she said.

“The complaint must come from one or more individuals being bullied. We cannot make the complaint on your behalf but we can advise you on how to deal with the problem and help you lodge a complaint.”

THE LAMP AUGUST 2014 | 29

HISTORY

Will our first women’s health centre survive?

Parramatta Female Factory Entrance. photograph courtesy of ralph hawkins

The Parramatta Female Factory is a little known and fascinating part of Sydney’s colonial history — and the NSWNMA is supporting its nomination for World Heritage listing.

For more information visit www.parramattafemalefactoryfriends.com.au or www.parragirls.org.au 30 | THE LAMP AUGUST 2014

NURSES AT AUSTRALIA’S FIRST DEDICATED women’s health centre were “incompetents” and “for the most part drunken men and in some cases drunken women” according to official documents.

They were employed to care for free women and convict residents at the Parramatta Female Factory, itself a “source of moral corruption, insubordination and disease” according to Samuel Marsden, the Flogging Parson.

But while you might argue about the morals of its inmates and the quality of its nursing care, there’s no doubt that today the factory is a big ticket historical item.

Which is why NSWNMA Assistant General Secretary Judith Kiejda has urged the state government to support its nomination for World Heritage listing.

“It is quite incredible that such an historic site could be at risk of private development,” Judith said. “The site is an integral part of the early history of the Australian settlement and particularly critical to the story of convict women’s history in Australia.”

An estimated one in seven Australians is said to be descended from 9000 female factory convicts, with more than 5000 of them coming from Parramatta.

“It’s a huge women’s story and it’s a

huge Australian story and that’s why we want World Heritage,” historian and curator Gay Hendriksen, president of Parramatta Female Factory Friends, said.

“The facts present quite a different picture to the descriptions of degenerate women with little chance of reform.”

Literacy levels were close to that of immigrants at 75 per cent for the English women and 46 per cent for the Irish. The women also brought more than 180 trades with them.

“That suggests laziness was not an inherent trait,” Gay said. Sixty five per cent had no prior convictions before transportation. “This suggests the majority were not of the crime class.”

FIRST OF 12 FACTORIES The foundation stone for the Parramatta Female Factory was laid in 1818 by Governor Lachlan Macquarie, who commissioned convict architect Francis Greenway to design a factory to accommodate 250 to 300 female convicts. It operated from 1821 to 1847 and replaced an earlier factory above the jail, where 200 women worked but only 30 could be accommodated at night. By 1842, 1200 women and 200 children were crammed into the second factory.

Augustus Earle (1793-1838). Female Penitentiary or Factory, Parramatta [circa 1826?]. rex nan kivell collection nk12/47. national library of australia.

Parramatta was the first of 12 more female factories and followed the establishment of Hyde Park Barracks, also designed by Greenway, which opened in 1819 to accommodate 600 male convicts.

Yet despite their common history only Hyde Park Barracks has UNESCO World Heritage listing under the title of Australian Convict Sites, representing the best surviving examples of large-scale convict transportation.These include The Cascades Female Factory in Hobart built in 1828.

“In the Tasmanian female factory there’s only a wall and a small cottage still standing,” Gay said. “We have the original Greenway buildings and a whole lot more and we predate all but three of the 11 world-listed heritage convict sites.”

Parramatta was rejected from the initial 2010 World Heritage listing because of custodianship concerns.

“The NSW government is the custodian and they would have had to provide the right level of custodianship for acceptance,” Gay said. “At the moment there’s a big question mark over that because they’re looking at developing the whole of the heritage precinct of North Parramatta. Our concern is what are they planning to do? Will the female factory survive?”

WOMEN OVERLOOKED At present the Greenway building on the Cumberland Hospital site is being used for training, storage, offices, client consultation and a credit union.

Gay believes with listing it can be a money-making educational and historical tourist attraction like Port Arthur. “Think what a bonus it would be to have this in Sydney.”

The 1837 Molesworth Inquiry into conditions in female factories found that “society fixed the standard of the average moral excellence required of women much higher than that which it had erected for men … a higher degree of reformation is required in the case of a female, before society will concede to her that she has reformed at all.”

To which some might mutter “Plus ça change.”

Gay thinks the female factor might originally have been a reason for ignoring the heritage value of the Parramatta factory while other convict sites were more publicly acknowledged. “But now I think it’s really that it has been part of a government institution and in government hands for 190 years and not had a public profile.”

She has been able to locate only four images of convict factory women from

1804 to 1856 when Parramatta was operating as a factory, and no cloth from the thousands of yards convict women would have produced there.

“You’ll see images of convict men and we have images of women when they’ve left the factories and are in a family situation. But for nearly half a century there was nothing, they were not considered important enough.”

WORLD HERITAGE 2015 The Parramatta Female Factory Friends are hoping the factory will be reconsidered for World Heritage listing in 2015.Another organisation made up of former residents of the Parramatta Girls Home is seeking to have the entire Parramatta Factory Precinct, including the factory, an orphanage, a mental asylum and a girls’ home, declared Australia’s first international Site of Conscience.

“We want to keep it simple so we’re looking at listing for the original footprint of the female factory hospital site only,” Gay said. “ We d o n ’t k n ow w h a t t h e government’s plans are. And we’re trying to be positive and to advocate peacefully.

But we will do what is necessary if there is risk.”

THE LAMP AUGUST 2014 | 31

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ER WE A R A C ANC THIS N I P L I C N U O C Y A D L I OD F DA F

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32 | THE LAMP AUGUST 2014

ASK JUDITH Am I being punished?

Service. It should be made available to all eligible employees within the Health I am an RN working in the public system.

Service to promote the development of a Recently there have been complaints that I made highly trained, skilled and versatile medication errors and I have been advised I will workforce, which is responsive to the be performance managed by the NUM and the requirements of government and health CNE. I feel like I am being punished. Can my service delivery. employer do this? (b) Permanent staff who are full-time or part-time, and full-time temporary Yes, the employer is obligated to investigate employees are eligible to apply for leave. and respond to clinical performance concerns Part-time temporary employees and under the provisions of Policy Directive permanent part-time employees are PD2005-180 which states in part: granted leave on a pro rata basis. Casual “… Approaches to performance feedback: staff are not eligible for this form of leave.”

The focus of ‘managing for performance’ When your manager refuses to grant the should be on providing on-going and tworequested study leave they are required under way feedback. the Ministry of Health policy directive PD For staff to learn and improve, feedback 2006_066, part 7 “Eligibility”, to provide the should be: objective; specific; constructive; following advice: focused on behaviours; free from the use of “Where learning and development leave is not negative language and behaviours; and approved, employers should ensure: occur as soon as possible after an event or • Advice is timely to allow the staff key milestone.” member to consider alternative The policy also states that performance arrangements; management “ … is most effective when • the reason for non-approval of leave is provided in a supporting environment which clear and stated in writing to the staff is based on learning and development.” member; • the staff member is advised of the How much study leave? availability of a review process.”

I am an RN working in the public sector and would like to know how much study leave I am Long service blocked entitled to in a calendar year, as I would like to I am an EN who has worked at the same public attend a conference interstate. My manager has hospital for 18 years. I know that I am entitled to denied my request and some of my colleagues Long Service Leave (LSL) but every time I have advised me that I am entitled to five days. request it I am told that I cannot go because the Is this correct? department is too busy. Can my manager refuse The amount of study leave per year is at the to grant me LSL? discretion of the employer as per Clause 55, LSL is arranged by mutual agreement between sub clause (iii), (a) and (b), of the Public Health you and your employer.Your employer’s System Nurses’ and Midwives’ (State) Award obligations are to make sure that when you (2011) . have accrued the appropriate entitlement for “(iii) ELIGIBILITY LSL they don’t place any unnecessary (a)Access to learning and development constraints to prevent you taking it. If your manager cannot give you the leave at the time leave is at the discretion of the Health

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

you request, they should negotiate a time frame with you that allows you to take the requested leave when it is suitable to both parties. I refer you to the Ministry of Health policy document, PD2006_092, section 12.

Single RDO not on I am employed in the public sector and rostered to work 12-hour shifts. On the past five rosters I have been rostered off on single days. Are management allowed to roster this way?

No, the award does not provide for single rostered days off when a 12-hour roster program is in place. Clause 5, sub clause (v), (g) of the Public Health System Nurses’ and Midwives’ (State) Award (2011) states: “Employees shall not be rostered on single days off unless it is at the request of the employee.”

Time off to care for parents I am an RN working in the public system. Both of my parents need to go into a hostel and I need some time off to assist them with this transition.

What type of leave should I ask for?

In this circumstance you are entitled to request Personal/Carer’s Leave, which is provided under Clause 32, sub clause (xi) (b) of Part B Personal/Carer’s Leave of the Public Health System Nurses’ and Midwives’ (State) Award (2011). Personal/carer’s leave comes out of your sick leave and you can provide your manager with evidence for this leave such as a doctor’s certificate or a statutory declaration.

The evidence supplied should include the name of the person requiring your care, what relationship they have to you and that they have a condition which requires your care or support. If you run out of sick leave you can elect to use any untaken annual leave or long service leave as part of your personal/carer’s leave request.

THE VOICE OF LEADERSHIP — GET ALONG TO ETTALONG Nursing & Midwifery Unit Managers Society of NSW Inc. Annual Conference “The Voice of Leadership – Get Along to Ettalong” Friday 17 October 2014 Ettalong Diggers, Ettalong Beach To book please visit www.numsociety.org.au Phone: 02 8970 0128 Email: numsexecadmin@optusnet.com.au Web: www.numsociety.org.au THE LAMP AUGUST 2014 | 33

SHORT STORY AND POETRY COMPETITION

TH O S E WE R E T HE DAY S B Y M A RY P E R RY

I t’s interesting how a bit of historical reflection – that’s new-speak for reminiscing – can make you realise that life isn’t so bad after all.

Quite often one hears how “this wouldn’t have happened years ago…” or “things were better back when I was a student nurse…” or “PACE (MET) criteria charts take away a nurse’s need to think…… …………….…”

Anecdotes of drama, gore, and disasters were flying thick and fast at the reunion of my mum and her nursing colleagues. I called them “the old reunionites”– I went along for the ride (and the free feed) just to see if any of those tall tales I had heard over the years actually had a milligramme of truth in them and could be verified. Especially the one about the politician – let’s call him the honourable Mr Etho. The patient my mum said she will NEVER forget.

Scenario: The honourable Mr Etho was admitted to the surgical ward for a routine procedure – cholecystectomy.

He was given the only private room attached to the surgical pavilion ward. This was the room always allocated to the wealthy or the dying – preference being in that order! It was situated at the farthest end of the ward so that noise emanating from the main area would not disturb the patient and privacy was optimal – just perfect for a famous politician wanting anonymity and probably post-operative medicinal assistance provided by his associates.

The honourable Mr Etho was described by the “reunionites” as a charming, portly gentleman who admitted to “a bit too much of the good life” when he tipped the scales at 110 kg; his ruddy complexion and facial spider naevi supporting his comment.

Alarm bells should have started ringing right then – “Mum, grab the AWS chart stat!”

“But darling, he was so polite, and he was a famous politician, and when I admitted him I was an innocent 1st year nurse, and AWS charts hadn’t been invented.”

Anyway, pre-op assessment was within acceptable limits so he was shaved, starved, wrapped up and packed off to theatre.

It was two days later that my mum was re-assigned to care for the honourable Mr Etho. In his secluded, private room, the honourable Mr Etho was resting quietly – obs stable (although slight tachycardia present), tick; abdominal suture line intact, tick; T-tube drain (they were quite large back in those days) secured, patent and draining, tick; nasogastric tube secure and patent, tick; IV therapy running to time, (no pumps back then), tick; mental status – mmmmm, a little bit agitated – probably just everything catching up with him……………..

Mum then carried on with the usual busy morning activities out in the main ward and left the honourable Mr Etho to recuperate.

“But mum, the ruddy complexion, the spider naevi and the ‘too much of the good life’”…………… …

The honourable Mr Etho was next checked about an hour later during which time he had managed to work himself up into a frenzied state of mania. And like a true politician he had the tenacity of a Bull Mastiff protecting a 3 week old “maturing” chicken carcass – the growling jowls, gnashing teeth, and squinty eyes – definitely ’Mastifflike’.

The nurse call bell was way over the other side of the bed, and calling out was of no use owing to the geographical setting of the room – just perfect for a famous politician wanting anonymity and probably post-operative medicinal assistance provided by his associates.

What to do? Mum said it was the scariest moment of her career. Confronted by the honourable (now “Mastifflike”) Mr Etho with one fat leg stuck through the bedrails as he tried to escape, T-tube drain (they were quite large back in those days) being wrenched from its securing sutures, and IV line which had once been in his arm now being ripped out by his teeth. He hadn’t yet started on the nasogastric tube………

Mum couldn’t quite tell where most of the blood was coming from arm? abdominal region? or the enormous skin tear now developing on his leg as it sawed away on the bedrail.

The only way to get to the nurse call bell was to crawl under the bed while trying to avoid the pools of blood – Mum said she felt like a soldier on bivouac training crawling through the mud; and at the

34 | THE LAMP AUGUST 2014

same time was wondering how long it would take for the cavalry to arrive. As she had indicated to her other colleagues on the shift that the honourable (now “Mastifflike”) Mr Etho was stable, albeit a little bit cranky, her colleagues would not be on the alert for a pending disastrous situation.

Mum’s thoughts: stay calm…….., someone please, please, please answer the call bell; the honourable (now “Mastifflike”) Mr Etho please don’t fall on me, and please don’t bleed to death; should I start screaming or will that make the honourable (now “Mastifflike” Mr Etho even more agitated??

Next thing mum knew, the honourable (now “Mastifflike”) Mr Etho had managed to pull the IV pole over landing on top of her legs as she crawled out from under the bed. Someone please, please, please answer the call bell now!!!

There was no stopping the honourable (now “Mastifflike”) Mr Etho. The growling had now crescendoed into roars, and the honourable (now “Mastifflike”) Mr Etho decided that the nasogastric tube was next to go. No, not the nasogastric! Abdominal contents spilling into his lungs on the way up??????

Mum’s thoughts: stay calm…….., someone please, please, please answer the call bell; should I stay or should I go and get help???

Decision was made to stick her head out the door and yell – the honourable (now “Mastifflike”) Mr Etho couldn’t possibly get any worse………..

Mum’s thoughts: stay calm…….., someone please, please, please hear me! The situation is totally out of control, I think this is all my fault, I hope he doesn’t die.

As the honourable (now “Mastifflike”) Mr Etho was stuck with his blood soaked leg protruding through the bed rails, – at least he couldn’t fall over the top, one small mercy.

Help finally arrived in the form of the wardsman sauntering past after his tea break. The sauntering rapidly turned into a run when he heard the roaring and screaming and crashing of a falling IV pole.

The wardsman was so stunned by what he saw that all he could do was gawk! Several times mum had to yell at him to go and get reinforcements – as many as possible! Meanwhile mum was left trying to hold down his arms, ducking to avoid punches, trying not to trip on the fallen IV pole and blood soaked floor, and trying to keep that NG tube in-situ. Mum said she learnt that rubber soled shoes become extremely slippery when they come into contact with a floor being rapidly covered in copious fresh blood, and “if it wasn’t for the adrenaline coursing through my veins I would have been a blubbering mess huddled in the corner” – that came later…….

Real help quickly arrived – two RNs, the RMO, and following on, the resusc team. But even trying to hold the honourable (now “Mastifflike”) Mr Etho down required four staff members with very big muscles – his level of anxiety, aggression, and probably fear, escalating the more we tried to restrain him. It is amazing just how much strength a person can acquire during a state of such mania!

Even with successful restraint, the resusc team had to try and find venous access to administer sedating medication. Long gone was his IV cannula, and with thrashing arms and legs and gnashing jowls, the team had to settle for intra muscular administration, and then wait until it took effect.

Twenty minutes passed and still the honourable (now “Mastifflike”) Mr Etho maintained his level of anxiety, aggression, and probably fear, thrashing and roaring. More IM medication administered – more waiting and restraining. Was the honourable (now “Mastifflike”) Mr Etho hypotensive? hypovolaemic? hypoxic? tachycardic? about to die? – No way of knowing as it was impossible to check his vitals and with no IV access, impossible to administer any fluids.

Mum’s thoughts: stay calm…….., the situation is totally still out of control, I think this is all my fault, I hope he doesn’t die, I hope my other patients don’t need anything because it’s just too bad if they do!

An hour after the arrival of the cavalry, the honourable (now not quite so “Mastifflike”) Mr Etho began to calm down and 15 minutes later the resusc team had achieved a level of sedation adequate to transfer the honourable Mr Etho to high dependency for assessment, monitoring, and patching up.

Mum was left with clearing the devastation, and catching up on her other patients. She described the room as looking like one from a murder scene. The soiled blood-soaked bed linen strewn across the floor mixed with blood covered IV pole, discarded IV infusion bag, mattress and bed rails covered in blood, discarded wound dressings where the team had attempted to stem the flow of the honourable Mr Etho’s haemorrhaging from arm, abdominal drain site (they were quite large back in those days), and leg.

Mum didn’t even attempt to clean her shoes; she threw them out as soon as she could get them off her feet and the long shower she took couldn’t wash away her feelings of distress for the honourable Mr Etho, and her feelings of failure and guilt.

So the next time you have to make a PACE (MET) call for a slightly abnormal parameter, and perhaps thinking what a waste of time it is, remember Mr Etho being “a little bit agitated” with a “slight tachycardia”, and remember my mum.

Find more stories at www.nswnma.asn.au/nswnmamembers/short-stories-and-poems-2014/

THE LAMP AUGUST 2014 | 35

SHORT STORY AND POETRY COMPETITION

T H E AMB UL ANC E B Y K AT H E R I N E W U R T H

I

park my work car at the end of a country lane, the jacarandas are gently framing the edges of historic streets, the old cottages are nestled in old gardens. I can hear birds deep in the trees and it is like time has stood still. It is a sleepy village.

I take a big breath of winter air. I have not met this palliative care patient before. I have to force the wrought iron gate open and the latch is stiff with rust, I make a mental note to go around the back at my next visit. I am surprised when someone answers the front door, it is so still and quiet. The door struggles to scrape across the carpet and it is a slow greeting to the patient’s carer. She looks hostile towards me even after I have introduced myself. “I can’t do this any more, I have a bad back and I just cannot do this any more!” She is his resentful ex-wife. I can see that she is exhausted and has reached her limit. Her deep wrinkles speak to working hard and playing hard. Now she just looks hard. She is greyhound thin and twitchy for more than her next cigarette. Her tight hipster jeans swing ajangle of chains and keys.

Her mobile phone hangs from her grooved neck in a pink shoe sock. She looks older than she is and her agitation punches her chewing gum and forces her pacing.

Then I see him. I have never seen anyone so close to death sitting upright. He looks frightened and I shake his frail hand putting all my kindness into my smile. He is jaundiced, his leaving eyes fluoro yellow, his jaw slack and skin swollen with malignancy. We talk for a while, I am gentle and quiet and it seems to be what he needs. I take on his energy and vocabulary – we talk about being “buggered”, “pulling up stumps”, “hitting the wall”, about being “stuffed”. I talk with tenderness and it is like we have known each other a long time. I gain his trust as I hold his cold purple hands. I try my pulse oximeter but cannot get a reading. I cannot find a manual pulse. I keep talking quietly and knowingly and he points me to his feet. He allows me to unwrap his velcro joggers and soaked socks – his freezing feet have pitting marbled oedema, his skin is an inkpad taking my fingerprints. I hold his feet like a prayer and take the moment with him. It gives me pause and I feel the humility and complete privilege of this time. I check his mouth but I didn’t need to, he is frothing thrush and unable to swallow. He shifts uncomfortably and I ask his ex-wife for any analgesia. He has none. We find expired Nurofen in the back of the kitchen draw. He cannot swallow the second tablet.

I change chairs so I can face him directly. It is just him and I. He looks at me with questions in his eyes and enormous sadness. I know he wants to die at home. I know his carer cannot look after him any more. She has hurt her back and there is no one else to help. A son. But he works. A son? I am hopeful. Maybe he can help? No. He is busy, he is the chancellor at a city university. I have many thoughts at once – I think family, money, time, rescue, wild card. I choose to say, you must be very proud of him. It turns out to be the right thing to say … he nods and there is a rare smile. I meet his tired, accepting eyes. Is there any unfinished business? I ask. Is there anyone that you want to see or anything that you need to do? It seems too difficult to stay at home. You are losing ground. I think that your time is very short, I don’t think that you have very long to live now. His eyes meet mine. His voice is suddenly strong. How long? We maintain eye contact. Anytime from here on, a day or two, not much more than that. His shoulders come down, he relaxes and there is another smile. I am glad he says, that is such a relief. Thank you. He squeezes my hand and I win a wink.

I spend the rest of my time talking to doctors, bed managers and the ED. I speak to his chancellor son who insists dad goes to a private hospital. I encourage him to come see his dad. I tell him he is dying and if he wants to see his dad he cannot wait for end of term. He will check his schedule.

I come in to say goodbye to him after my calls and he is laying down on the lounge now, nursing a hot water bottle on his lap. I tell him the ambulance is coming soon. Never been in an ambulance before. His face is lighting up. Will it have sirens? I tell him he can ask them to have the sirens on. He beams. You are easy to please, I tell him, grinning. He tells me he feels so much better now. He looks different and there is a peace about him. We shake hands by way of farewell. Go easy I tell him. You too he says. We share the look that says we will not see each again and that is enough.

Find more stories at www.nswnma.asn.au/nswnmamembers/short-stories-and-poems-2014/

36 | THE LAMP AUGUST 2014

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

Never too late to go back to study www.nurseuncut.com.au/never-too-late-to-go-back-to-study

Twenty-five years after training as a nurse/midwife, Kate Dove went back to university to get her Masters in Midwifery – and loved it.

The path to a private health system – do we want to take it? www.nurseuncut.com.au/the-path-to-a-private-health-system-do-we-want-to-take-it

Coral Levett examines the two competing views of how health services should be provided. Are we at a crossroads?

Nursing on St Helena – an island in the Atlantic www.nurseuncut.com.au/nursing-on-st-helena-an-island-in-the-atlantic-ocean

Australian mental health nurse Ian Rummery writes about life and work on the tiny British island of St Helena.

My budget concerns www.nurseuncut.com.au/my-budget-concerns

Emergency nurse Angie Gittus lists the many things about the federal budget that have her worried.

A mini crisis for GP nurses www.nurseuncut.com.au/gp-nursing-crisis-after-devastating-medicare-announcement

Primary care nurses were shocked to discover their assessments were no longer claimable on Medicare – but the government backed away after pressure from nurses and GPs.

An injured nurse speaks www.nurseuncut.com.au/an-injured-nurse-speaks Karen was seriously injured in a violent attack at work but cuts to workers’ compensation led to her losing out.

New on SupportNurses YouTube channel Unhappy anniversary: WorkCover Emily Orchard RN on the second anniversary of cuts to WorkCover. > youtu.be/VqNuKT4AeG0 Disgraceful attack on Medicare Kerry Rodgers RN speaks at a rally in Sydney’s east. > youtu.be/9dwA9uMzDVA

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 Look for your local Ratios put patient safety first >> www.facebook.com/safepatientcare Branch page on Aged Care Nurses >> www.facebook.com/agedcarenurses our website.

THE LAMP AUGUST 2014 | 37

It’s t ttiime

to scrub b up ffor 2014!

To orderr, faxx the order form to Glen Gintyy, (02) 9662 1414, post to o: NSWNMA, 50 O’Dea Avvenu ue, Waterloo NSW 2017 or email gense ec@nswnma.asn.au

Order your NSWNMA campaig gn scrub uniforms for d make an impression! conference and rally times, and

Merchand dise order forms also available a on

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54

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SOCIAL MEDIA

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NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Dementia blowout

The federal government axed the dementia and difficult behaviours supplement saying there’d been a cost blowout. Isn’t there a dementia blowout due to the growing number of older people?

Security concerns

After several nurses were assaulted by a patient at John Hunter Hospital the NSWNMA voiced concerns about security and emergency protocols.

Sad death Understaffing and lack of ratios in aged care were cited as factors in the sad case of a death in a New South Wales nursing home.

This is an absolute disgrace. Dementia is on the increase as well as severe behaviours. Aged care staff, we really need to get loud!

The government has totally lost the plot.

This is going to put more pressure on state hospitals; finding beds for [moderate] to severe dementia patients is not easy ... And now facilities are not even remunerated? What incentive does a facility have for taking on these patients? They have really underestimated the skill and expertise required!

Giving more support to carers keeps people at home longer and is a lot more cost-effective than having people in residential care.

The people who have worked hard all their lives to build this country are apparently worth nothing.

Please support our colleagues, keep each other safe. Report every act of violence, not only via your workplace incident report but also notify the police. I was assaulted at work and the offender was jailed.

If the patient was cooperative during transport with the ambos then the risk of a sudden outburst was probably assessed as low. You can’t sedate a guy solely on his history.

Given the planned closure of Hunter Residences there definitely will be an increased risk for ED staff and patients when clients are transitioned within the community. It is a foreseeable risk so more needs to be done.

All inspections should be unannounced with less emphasis on paperwork.

Accreditation in its early years did have a lot of impact on the care given but now it is a waste of money, which is paid for by the providers, who in turn cut corners e.g. staff.

Most places have a really good idea of when unannounced visits are due. The problem lies with staffing levels, RNs being replaced by endorsed cert IVs who will never have the level of expertise of an RN, and profit being the main objective even in the so-called not-forprofit companies. The state government should be held accountable if the accreditation process is falling short.

The main problem I feel as an AiN is understaffing and that goes back to management. I know of a place that has 33 dementia residents … they have ONE night nurse on! As a nurse it sickens me. It’s unfair on residents and nurses!

I love my job and my oldies but some days I am so stuffed I cry. When will they see we need more staff, more funding and less bloody paperwork to be able to give these people the care and comfort they deserve?

From my experience in aged care the expected standards are high, but staff numbers are not near enough to ensure these standards can be properly maintained. There also needs to be a mandated ratio of RNs per resident.

Staff [members] are the scapegoats of a money hungry industry.

It is way past time for a Royal Commission into the aged care industry.

PHOTO GALLERY

Kempsey nurses wore red on June 30 to show they intend to keep on fighting for ratios.

Bankstown Hospital branch is standing up for Medicare – #copaynoway

Canterbury Hospital branch members don’t want a US-style health system in Australia.

Central Coast nurses hit Tuggerah station on a cold dark morning to talk to commuters about ratios.

THE LAMP AUGUST 2014 | 39

NURSING & MIDWIFERY SCHOLARSHIPS Open 21 July 2014 â&#x20AC;&#x201C; Close 15 September 2014 Scholarships are available for nurses & midwives in the following areas: > undergraduate

> midwifery prescribing

> postgraduate

> nurse practitioner

> continuing professional development

> emergency department clinical and non-clinical continuing professional development.

> nurse re-entry

Apply online www.acn.edu.au | scholarships@acn.edu.au | 1800 117 262 An Australian Government Department of Health initiative supporting nurses and midwives.

Australian College of Nursing is proud to be the fund administrator for this program.

6

th Austra alian

Rural & Remote Mentall Health Symposium 12thh - 14th november 2014 commercial club albury www w.anzmh.asn.au/rrmh

Keynote Speakers Include: Mr David Butt, CEO, National Mental Health Commission Dr Joseph Dunn, Psychs on Bikes Ms Rebecca Graham, Executive Director, Mental Health, Country Health South Australia Local Health Network Mr Douglas Holmes, Consumer Participation Coordinator, St Vincent's Hospital, Sydney Senator Fiona Nash, Assistant Minister for Health

Prof David Perkins, Professor of Rural Health Research, Centre for Rural and Remote Mental Health, The University of Newcastle A/Prof Russell Roberts, National Chair, Alliance for Rural and Remote Mental Health Senator Penny Wright, The Greens

Visit the Symposium website for more information. Early bird re egistration ends Friday 3rd October 2014.

40 | THE LAMP AUGUST 2014

he number of Australians experiencing mental health Th pro oblems in rural and remote areas is estimated to be co omparable to major urban centres. However, the rural and remote community faces a greater challenge with lim mited access to mental health services and support.

Th he Symposium theme, The Practitionerâ&#x20AC;&#x2122;s Voice, seeks to give voice to those practitioners who are faced with the ese challenges on a regular basis.

Th he symposium will include keynote speakers, co oncurrent sessions and workshops that develop skills

and remote communities.

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Across 1. A herniation of the diaphragm (16) 9. Occurring every eight years (9) 10. An organism requiring oxygen to live (6) 11. Laryngeal intraepithelial neoplasia (1.1.1) 12. To dry up (9) 13. Lacking brightness or color; dull (6) 14. Virus responsible for a severe and often fatal hemorrhagic fever in primates (5) 15. The friction of a surface to facilitate absorption of an ointment (10) 16. Trypanosomiasis (8.8) 24. Red blood cell (1.1.1)

25. Lawful (5) 26. A temporary state of mental confusion (8) 27. An officer appointed to inspect (9) 28. The substance composing the inner layer of the periosteum, from which bone is formed (8) 32. Extradural hemorrhage (8.8) Down 1. Gross self-neglect, usually in the elderly (8.8) 2. Periscope (9) 3. The act of clasping the hand of another (9)

4. Excessive, purposeless cognitive and motor activity or restlessness (9) 5. A rounded bony process, such as the protuberance on each side of the ankle (9) 6. In ultrasound, the complete transmission of sound so the image appears black (9) 7. The material within a cell nucleus from which the chromosomes are formed (9) 8. Involving great exertion or long effort (9) 17. To remove by cutting (6) 18. Being inactive (6)

19. Having the nature of a germ cell (8) 20. A notch (8) 21. The presence of potassium in the blood (8) 22. A fungus, used in herbal medicine for strengthening uterine contractions during childbirth (5) 23. A hardened patch or induration of skin or mucous membrane (8) 29. Transient Cognitive Impairment (1.1.1) 30. Observation care unit (1.1.1) 31. The main magnetic field measured in teslas (2)

THE LAMP AUGUST 2014 | 41

EDUCATION@NSWNMA

WHAT’S ON AUGUST 2014 ——— • ———

Computer Essentials for Nurses and Midwives – 1 day

: S H T T U EAL H

6 August Prince of Wales Hospital, Randwick

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

Appropriate Workplace Behaviour – 1 day 13 August Port Macquarie Includes understanding why bullying occurs; anti-discrimination law; how to behave appropriately in the workplace; what to do if subjected to unlawful harassment and bullying.

Customise your Master of Nursing

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

Are you meeting your CPD requirements? – ½ day 14 August Port Macquarie 10 September Batemans Bay 25 September Dubbo Suitable for all nurses and midwives to learn about CPD requirements.

Members $40 Non-members $85 ——— • ———

Legal and Professional Issues for Nurses and Midwives – ½ day

The UTS experience is person centred learning.

15 August Port Macquarie 11 September Batemans Bay 26 September Dubbo 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 ——— • ———

Basic Foot Care for Nurses – 2 days

4

majors

9 50+

clinical sub-majors

20 – 21 August Newcastle

Members $203 Non-members $350 ——— • ———

Enrolled Nurses Forum – 1 day

elective subjects

22 August NSWNMA, Waterloo

Members $30 Non-members $50 ——— • ———

Aged Care Seminar Series – 1 day 28 August Batemans Bay

Flexible entry and exit points including credit for Graduate Certificates from other universities and College of Nursing courses.

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

Tools in Managing Conflict and Disagreement – 1 day 3 September Parramatta

Members $85 Non-members $170 ——— • ——— To register or for more information go to

www.nswnma.asn.au/education

UTS CRICOS PROVIDER CODE 00099F

18467

health.uts.edu.au/pginfo

or phone Matt West on 1300 367 962

NURSING RESEARCH ONLINE

Abbott government attacks on bulk billing and public hospitals are unmistakably a strategy to undermine the very fabric of Medicare. The coalition doesn’t believe in the value of publicly-funded, universal access to health and never has. If you are in any doubt about how realistic the warnings about the destruction of Medicare are, look at what the David Cameron led coalition government is doing to the NHS in the UK. Can we afford the NHS? John Appleby British Medical Journal 2011;343:d4321 In an article for the Daily Telegraph in June, Andrew Lansley, England’s Health Secretary, made an interesting prediction. By 2030, he said (referring to England), “If things carry on unchanged, this would mean real terms health spending more than doubling to £230 billion.” He also stated that, “This is something we simply cannot afford.”

It is of course then a short step to an argument that the NHS must change (because unchanged equals unaffordable) and that the change it needs are the Secretary of State’s reforms. This is a version of the “politician’s syllogism”: 1. The NHS must change (otherwise it is unaffordable).

2. This (the reform) is change.

3. Therefore we must do this (the reform).

As subsequent changes to the NHS reforms have shown, such logic is debatable. But perhaps the premise is also questionable. £230bn is certainly a lot of money – as Mr Lansley points out, that’s equivalent to spending at a rate of over £7000 a second. But in what sense is it actually unaffordable? If the NHS in England were currently consuming £230bn, then as a proportion of GDP this would amount to 18% of GDP devoted to health. That compares with the actual figure of 8.5% of GDP. But the £230bn is not spending now, but what spending might be in 20 years’ time. It is equivalent to average real increases in spending of just over 4% a year – a bit more than the long run average for the NHS since 1948.

Crucially, however, the country’s capacity to afford higher spending will change over time. Over the next 20 years it is likely that the economy will grow in value.

The real question to ask about health spending is what we think we might get in return as a result of forgoing the benefits of spending increasing amounts of our wealth on other things.

For example, is the two year increase in life expectancy at birth we might possibly enjoy as a result of higher health spending, worth the benefits we will not get to enjoy from spending more on education, food, or housing?

38 Degrees 38 Degrees members donated to fund independent legal advice on the implications of the British government’s proposals to change the NHS in England. Solicitors were engaged to give their opinions on two aspects of the Health and Social Care Bill.

The Bill will remove the duty of the Secretary of State to provide or secure the provision of health services, which has been a common and critical feature of all previous NHS legislation since 1946. This is the means by which Parliament ensures the NHS delivers what the public wants and expects. Furthermore, a “hands-off clause” will severely curtail the Secretary of State’s ability to influence the delivery of NHS care to ensure everyone receives the best healthcare possible.

The Bill also contains a number of measures that will increase competition within the NHS at the expense of collaboration and integration and/or make it almost inevitable that UK and EU competition law will apply as if it were a utility, like gas or telecoms. What this could all mean: • No longer a National Health Service The NHS will be little more than a series of quasi-independent commissioning entities and providers, basically free to get on with the job.

• Loss of Accountability – the government washes its hands of the NHS Removing the Secretary of State’s legal duty to provide or secure provision of health services, and introducing a “hands-off clause” significantly reduces democratic accountability for the NHS. • Postcode lottery Because of changes in the bill there is a real risk of an increase in the “postcode lottery” nature of the delivery of some NHS services. Patients can no longer expect the government to ensure a consistent level of healthcare regardless of where they live.

• Exposing the NHS to competition law Taken together, these changes increase the likelihood of NHS services being found by the courts to fall within the scope of UK and EU competition law.

• Costly and complex procurement procedures The new commissioning groups will be subject to EU procurement rules when they commission local health services. This could mean that the NHS ends up spending a lot of time and money fighting legal action instead of investing in patient care. Or worse, it could mean they are reluctant to commission any services for fear of being sued.

• Fertile ground for private health companies (and their lawyers) Companies that bid unsuccessfully for NHS contracts will be able to challenge commissioning decisions in the courts. Private health providers have far more expertise and legal capacity than either public bodies or charities, and so are likely to be best placed to exploit these laws.

• Opening our NHS to private companies – privatisation by stealth These plans will lead to a system geared heavily in favour of private companies.

www.bmj.com/content/343/bmj.d4321.full.pdf+html

www.38degrees.org.uk/page/content/NHS-legal-advice/

NHS Expert Legal Advice

THE LAMP AUGUST 2014 | 43

LIONS NURSES’ SCHOLARSHIP Looking for funding to further yoour studies in 2015?

The trustees of thee Lions Nurses’ Schoolarship Foundation invite applicationss for scholarships forr 2015.

Nurses eligible for these scholarsships must be resident and employed within the State of NSW or ACT..

You must currently be registered w with the Nursing and Midwifery Board of Australia and working within the nursing profession in NSW or the ACT,, and must have a minimum of three years’ experieence in the nursing profession in NSW or the ACTT. Applicants must also be able to pproduce evidence that your employer will grant leave forr the required period of the scholarship.

D t il off eligibility Details li ibilit andd the th scho h larships l hi available il bl (which include study projects eithher within Australia or overseas), and appliccation forms are available from: www.nswnmaa.asn.au The Secretary Lions Nurses’ Scholarship Founddation 50 O’Dea Avenue, Waterloo NSW W 2017 or contact Matt West on 1300 3667 962 or mawest@nswnma.asn.au

Completed appllications must be in the hands of the secretary no later than 31 October 2014.

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

Compensation and negligence claims Employment and Industrial Law Workplace Health and Safety Anti-Discrimination Criminal Law Free standard Wills for members Probate / Estates Public Notary Discounted rates for members including First Free Consultations for members on all matters.

Offices in Sydney and Newcastle with visiting offices in regional areas (by appointment).

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

44 | THE LAMP AUGUST 2014

BOOKS

BOOK ME An Introduction to Community and Primary Health Care Edited by Diana Guzys and Eileen Petrie Cambridge University Press www.cambridge.org RRP $POA ISBN 9781107633094 Community nursing is the fastest growing area of nursing practice in Australia. This book offers an introduction to the theory, skills and application of community and primary health care. Based on the “Social Model of Health”, An Introduction to Community and Primary Health Care explores how social and environmental factors impact upon healthcare in Australian communities. It discusses the principles of health and mental health promotion, the importance of cultural competence and the practice of community needs assessment. The book is divided into three parts: theory, skills and health professionals in practice. This latter section encourages students to consider how various nursing roles address the issues of social justice, equality and access.

Clinical Cases: Medical-Surgical Nursing Case Studies Janine Bothe Mosby Australia (available through Elsevier Australia) www.elsevierhealth.com.au RRP $36.32 ISBN 9780729542074 Based on real life scenarios this series presents case studies complete with solutions, giving nursing students an opportunity to explore the scenarios they are likely to encounter in a variety of practice settings.

This text would be useful during exam preparation or as a study tool, providing an engaging approach to learning and revision.

Fast Facts for the ER Nurse: Emergency Room Orientation in a Nutshell (2nd ed.)

Jennifer R. Buettner Springer Publishing (available through Footprint Books) www.footprint.com.au RRP $34.95 ISBN 9780826199461 Chapters in this textbook provide a brief overview of the equipment, treatments and drugs used to manage common disorders and conditions frequently seen in the ER. The book includes disorder definitions, signs and symptoms, interventions, drugs, and critical thinking questions. Using a bullet-point format each chapter is organised alphabetically by disease and disorder within each body system. The book offers a structured approach to orientation.

SPECIAL INTEREST Handbook of Evidence-Based Practices for Emotional and Behavioural Disorders: Applications in Schools Edited by Hill M. Walker and Frank M. Gresham Guildford Press (available through Footprint Books) www.footprint.com.au RRP $115.00 ISBN 9781462512164 (hardback) This authoritative volume provides state-of-the-art practices for supporting the approximately 20% of today’s K-12 students who have emotional and behavioural disorders (EBD) that hinder school success. Experts present evidencebased approaches to screening, progress monitoring, intervention, and instruction within a multi-tiered framework. Coverage encompasses everything from early intervention and prevention to applications for highrisk adolescents. Exemplary programs are described for broad populations of EBD students as well as those with particular disorders, including autism spectrum disorders and externalising behaviour problems. The book combines theory and research with practical information on how to select interventions and implement them with integrity.

NEW! The NSWNMA Library Catalogue is now online!

Visit www.nswnma.asn.au/library-services-online-library-catalogue/ for the link to open the catalogue, plus instructions on how to use it. Once you have searched by keyword or browsed the subject areas available you can send loan requests directly to the Library via a quick online form.

Many online resources can be accessed directly through web links included in the catalogue listing.

Humanizing Healthcare Reforms Gerald A. Arbuckle with foreword by Dr Maria Theresa Ho Jessica Kingsley Publishers www.jkp.com RRP $34.95 ISBN 9781849053181 This book examines the ever-increasing organisational and cultural turmoil in healthcare institutions and suggests how reforms, based on foundational values, can be achieved and maintained. Looking at the turmoil facing contemporary healthcare systems worldwide, resulting from the imposition of financial performance indicators, the author argues that a return to a values-based approach to healthcare will create positive transformation. Writing from the fresh perspective of social anthropology he takes a highly pragmatic approach to practice, emphasising the importance of values such as compassion, solidarity and social justice. This book will be useful for anyone interested in a better approach to healthcare reform, from clinicians and nurses, to managers and policy makers, as well as the interested reader.

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 AUGUST 2014 | 45

MOVIES

movies of the month

MAGIC IN THE MOONLIGHT This film written and directed by Woody Allen and set in the 1920s is romantic and old-fashioned, writes Stephanie Gray.

The film stars Colin Firth as British magician and master illusionist Stanley Crawford, who performs under the alias Wei Ling Soo. His best friend Howard sends him to the French Riviera to debunk the practices of spiritualist Sophie (Emma Stone).

Sophie and her pushy stage mother have taken up residence in a chateau in the south of France, owned by the naïve and sweet-natured Grace (Jackie Weaver). Grace, an extremely simplistic, but likeable, person, is desperate to make contact with her departed husband. Her son Brice is madly in love with Sophie.

The accuracy of Sophie’s sooth saying and her impressive trickery challenges Stanley’s cynicism and he too finds himself falling for her charms.

What follows is a series of events that are magical in every sense of the word and that send the characters — and the audience — reeling.

The romantic setting of the Roaring 20s and the fantastic location lend the film a natural enchantment.

In the end, the biggest trick Magic in the Moonlight plays is the one that fools us all, love.

Stephanie Gray is an RN with the Australian Red Cross Blood Services IN CINEMAS AUGUST 28 46 | THE LAMP AUGUST 2014

METROMEMBER GIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to Magic in the Moonlight thanks to eOne Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

DVD SPECIAL OFFER

20,000 DAYS ON EARTH Confessed Nick Cave fan Sue Miles defies anyone not to like him after watching this film.

20,000 Days on Earth, a drama-documentary, portrays a fictionalised 24 hours in the life of Australian musician and writer, Nick Cave.

Directed by Iain Forsyth and Jane Pollard the film was inspired by a calculation Cave had made in his songwriting notebook, working out his time on earth.

20,000 Days on Earth certainly takes an unconventional approach.

“The thing that seems so kind of prevalent in contemporary music docs is that they’re all about getting behind something, revealing something, taking away the mask, taking away the myth,” Forsyth has said.

“The important thing for us was not breaking the mythology.”

This fits with the duo’s work as visual artists: they have in the past restaged David Bowie’s final performance as Ziggy Stardust and the Cramps’ 1978 gig at Napa Mental Institute, and made two films about the emotional potency of mix tapes.

The film takes you almost literally, with Nick Cave at the wheel, on a journey through layers of fiction within layers of the performer’s past: the Birthday Party, Berlin, the Bad Seeds, a fabulous story about Nina Simone and so much more.

One key sequence takes place in the Nick Cave Archive, fictitiously transposed to Brighton from its home in Melbourne.

Photographs of a 1981 show by Cave’s influential post-punk band the Birthday Party are projected on to a concrete wall, each sequentially detailing the trajectory of a fan’s urine spilling onto the stage.

Cave speaks to the advancement of images as each frame from this fleeting moment of chaos presents a new avenue of introspection, historical reminiscence and personal history.

Deconstruction of such moments – moments whose incorporation into popular mythology illustrates the mutual exchange between anarchic spontaneity and the oft-rehearsed structures of rock and roll – is Forsyth and Pollard’s work.

Intimate family time, watching a movie with his 10-year-old twin boys in Brighton, eating pizza, moments of Nick being just a dad, except they can all recite the script of the film they are watching, which happens to be Scarface!

I defy you to not like this guy after seeing this film. Documentary or fiction it’s brilliant.

Live music is transformational, being part of the audience often a privilege, especially when you witness magic. This film captures this in abundance and delivers on many levels.

Sue Miles works in perinatal mental health at the Royal Hospital for Women, Randwick IN CINEMAS AUGUST 21

METRO MEMBER GIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to 20,000 Days on Earth thanks to Madman Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

David Attenborough takes you on an amazing journey into the hidden world of bugs using pioneering macroscopic camera techniques. Micro Monsters gets closer than ever to the fascinating, beautiful, scary and downright alien world of arthropods: spiders, scorpions and insects. Attenborough reveals how and why bugs became the most successful group of animals on the planet, outnumbering humans billions to one and able to survive environments deadly to us.

Ranging from the earliest simple organisms millennia before the dinosaurs, through their evolution into a bewilderingly diverse number of types and species, Micro Monsters shows the tactics these creatures use to survive and thrive. Armies of killer ants, spiders weaving silken trap doors, beetles shooting boiling chemicals at their enemies, bees communicating, deadly scorpions with a beautiful mating dance, termites that build air conditioned skyscrapers and the incredible double life of butterflies – all these and more presented by the world’s favourite naturalist.

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

THE LAMP AUGUST 2014 | 47

FIT FOR O

LIFE AND A

DEAT TH

DA ASH HES Claire Wilki kinson EMERGENCCY NURSE

I’ve always enjoyed running. I idolised Cathy Freeman n as a kid and dreamt of winning gold. But now running is about more than fun and fitness. In one shift I can cover more than 6.8km - and that’s on a quiet night. Which is why Th he Athlete’s Foot Fit Technicians fittted me with a pair of shoes that are comfortable and durable. Sometimes, a second nce between can mean the differen ecisions we life and death. The de with which we make and the speed w carry them makes all th he difference.

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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 your event details to: 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 Vascular Focus: Management of Peripheral Arterial Disease 8 August Liverpool tanghua.chen@sswahs.nsw.gov.au www.sswahs.nsw.gov.au/Liverpool/events.html We Work With Wounds: Preventing, Assessing and Intervening AWMA (NSW) 22 August Westmead Hospital info.nsw@awma.com.au 03 9696 1210 14th Rural Critical Care Conference 22-23 August Tweed Heads Jayne@eastcoastconferences.com.au www.ruralcritalcare.asn.au Better Practice Conference: Aged Care 28-29 August Sydney www.accreditation.org.au/education/betterpractice-2013/ Smart Strokes 2014 28-29 August Sydney www.smartstrokes.com.au smartstrokes@theassociationspecialists.com.au NSW Drug and Alcohol Nurses Forum 5 September Sydney www.danaonline.org darren.smyth@justicehealth.nsw.gov.au Neuro Bugs Seminar 5 September Westmead katherine.schaffarczyk@health.nsw.gov.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 Pain Management Seminar 12 September Wollongong Sonia.Markocic@sesiahs.health.nsw.gov.au (02) 4253 4426 Day Surgery Nurses NSW 2014 Conference – 13 September Darling Harbour conferencensw@adsna.info (02) 9799 1632 Children’s Hospital at Westmead Paediatric Perioperative Seminar 13 September claudia.watson@health.nsw.gov.au georgina.whitney@health.nsw.gov.au

Enrolled Nurse Conference 18-19 September Tweed Heads 1300 554 249 Spiritual Care in Contemporary Nursing Practice – Nurses Christian Fellowship NSW 20 September • www.ncfansw.org 3rd Asia-Pacific International Conference on Qualitative Research in Nursing, Midwifery and Health 1-3 October Newcastle www.icqrnmh.info Pain Interest Group Nursing Issues Professional development day 17 October Sydney www.dcconferences.com.au/pigni2014 Professional Association of Nurses in Developmental Disability Areas Conference 15-16 October Parramatta www.pandda.net Nursing and Midwifery Unit Managers Society of NSW Annual Conference 17 October Ettalong Beach www.numsociety.org.au Blacktown and Mount Druitt Hospital Nursing and Midwifery Research and Innovation Symposium 23 October: abstracts 8 August Abstracts: Michelle.Nehmer@health.nsw.gov.au

0439 266 642 Symposium: Caroline O’Donnell 0422 006 786 APNA Continuing Education for Nurses in General Practice 24-25 October Sydney www.apna.asn.au/nigp Bones on the Beach 25 October Wollongong karin.tarne@sesiahs.health.nsw.gov.au RPA Midwifery Conference 2014 1 November Sydney www.slhd.nsw.gov.au/rpa/cmnr rpawb.research@email.cs.nsw.gov.au Australasian Society of Anaesthesia Paramedical Officers National Conference 1-2 November Albury www.asapo.org.au High Dependency Nursing Conference 7 November Westmead Ryan.Thomas@health.nsw.gov.au

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6th Australian Rural and Remote Mental Health Symposium 12-14 November Albury www.anzmh.asn.au/rrmh/ Spotlight on Liverpool Lives A talk by Liverpool-born Dr Jennifer Harrison 13 November Liverpool City Library 10.30am-12pm

ACMHN 40th International Mental Health Nursing Conference 7-9 October Melbourne (02) 6285 1078 www.acmhn2014.com or events@acmhn.org PHAA 2nd National Sexual and Reproductive Health Conference 18-19 November Melbourne

ACT

http://phaa.net.au/NSRH2014Conference.php

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 Conference 11-13 October Canberra www.vascularconference.com/2014/

Australasian College for Infection Prevention and Control Conference 23-26 November Adelaide www.acipcconference.com.au Australian and New Zealand Addiction Conference 4-6 March 2015 Surfers Paradise www.addictionaustralia.org.au

INTERSTATE

10th Asian and Oceanian Epilepsy Congress

Nursing Informatics Australia 2014 11 August Melbourne www.hisa.org.au/page/hic2014nia Health Informatics Conference 2014 11-14 August Melbourne www.hisa.org.au/page/hic2014/ Aged Care Informatics Conference 13 August Melbourne www.hisa.org.au/page/hic2014aci Dementia and Recreation National Conference 20-21 August Melbourne www.totalagedservices.com.au/index.php?q= dr-conference.html 15th International Mental Health Conference 2014 25-26 August Surfers Paradise www.anzmh.asn.au/conference conference@anzmh.asn.au Mental Health Service Conference 26-29 August Perth www.themhs.org 6th Annual Correctional Services Healthcare Summit 28-29 August Melbourne www.informa.com.au/conferences/healthcare-conference/correctional-services-health care-summit Aged Care Nurse Managers Conference 30-31 October Melbourne www.totalagedservices.com.au/index.php?q= acnm-conference.html Dementia + Community Care Conference 30-31 October Melbourne www.totalagedservices.com.au/index.php?q= dcc-conference.html Third National Elder Abuse Conference 3-4 September Perth www.elderabuse2014.com/index.html ACSA National Conference 7-10 September Adelaide www.acsaconference.org.au Australian Disease Management Association Conference 11-12 September Melbourne www.adma.org.au/images/ConferenceFlyer2 014.pdf PHAA 43rd Annual Conference 15-17 September Perth

7-10 August Singapore www.epilepsysingapore2014.org/ 7th World Congress for Psychotherapy 25-29 August South Africa wcp2014.com; secretariat@wcp2014.com 3rd World Congress of Clinical Safety 10-12 September Spain www.iarmm.org/3WCCS Nurses Christian Fellowship International PACEA Conference 10-14 October Fiji pacea-region@gmail.com 4th International Conference on Violence in the Health Sector 22-24 October USA

www.phaa.net.au/43rd_Annual_Conference.php

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

INTERNATIONAL

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 40-year reunion RN graduates April/May 1974 30 August Newcastle Wendy Lewis wlew12@bigpond.com 0407 861 722 Sue Carroll (nee Hetherington) susancarroll1953@gmail.com 0404 083 429 SVH Lismore Past Nurses Group 60th reunion 30-31 August Marg McGrath 0439 092 333 Sue Felsch 0427 834 336 suefelsch@hotmail.com Mater Graduate Nurses’ Association reunion 19 October North Sydney Joan Taniane 0401 344 363 joans2458@yahoo.com Prince Henry Hospital PTS Jan 1964 Meet-up at annual PHH reunion 25 October Helen Millan (nee Flanagan) helenmillan@bigpond.com Prince Henry Hospital April 1964 class reunion 25 October Little Bay Margaret Vincent (nee Dewick) margie.v@optusnet.com.au 0413 293 812 NEC Prince Henry/PoW Hospitals October 1972-75 group 25-26 October Margret Brignall (nee Samuel) 0418 646 959; Sonia Keeling (nee Graf) 0407 221 407 Marcia Jarvis (nee Fitch) 0438 415 647 Dianne Walkden (nee Edwards) 0400 621 470 Gill Gillon (nee Horton) 0401 048 205 Waikato Polytechnic Nursing Graduates 1987-1989 reunion 1-2 November New Zealand Molly Forbes 0403 904 650 mollywoppie@gmail.com

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