The Lamp September 2014

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 71 No.8 SEPTEMBER 2014

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CONTENTS

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

VOLUME 71 No.8 SEPTEMBER 2014

Hunter Office 8-14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258

COVER STORY

12 | War on health on two fronts Both the state and federal governments have aggressive, ideologically driven policy agendas that are not conducive to health.

Lyn Hopper RN and Britta Houser RN PHOTOGRAPH: SHARON HICKEY.

REGULARS

5 6 8 37 39 41 43 47 48 50

COVER STORY

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

COMPETITION

4 | Recruit a new member and go in the draw to visit Vanuatu.

18 | Horror stories from American health

US RN Britta Houser shares the horror stories of some of the patients she and her colleagues have cared for.

COVER STORY

22| Ratios now part of ALP health policy

The NSW Labor Party has made a giant step forward by making ratios a central part of its health policy.

COVER STORY

32 | Annual conference dinner

Kapow!

Delegates show heroic resolve for ratios!

COVER STORY

24| Australia’s health funding is sustainable

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.

Peter Martin, economics editor for the Age newspaper delivered a measured analysis of Australian health costs to annual conference.

THE LAMP SEPTEMBER 2014 | 3

RECRU CRUI UIT A NEW MEMBBER & GO IN TH E DRA D AW W TO VISITT

NSWNMA is pleased to anno ounce the NSWNMA A’s 2014 – 2015 Recrruitment Incentive Scheme T Travel ravel Prize Priz ze

THEE WINNER AND A FRIEND WILL BE FLLYI NG OFF TO B EAUTI FU L VVAN A UAATU! AN The prize consists of airfares forr two (ex-Sydney) to Vanuatu, Vanuatu, staying 5 days in a luxurious 4-star hotel with breakfast each day, a pampering package, champagne and choc package colates on arrival.

Every member m you sign up over the year gives you a tic cket in the draw!

form. Y Recruitment Incentive Scheme.

t make pplication w/s in the NSWNMA

P IZE DRAAWN PR WN

300 J U N E 2015

Photograph: Vanuatu

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

A clear choice The presentations of the NSW health minister and the shadow minister for health at our annual conference highlighted the clear differences between the two main parties when it comes to health and wages policy in NSW.

This aggressive and radical policy agenda at the federal and state levels poses an enormous threat to a health system that has stood Australia well for many decades now.

This year our annual conference grappled with the multitude of difficult issues that now confront us.

The Abbott government’s first budget has put us on notice that we cannot assume the continued existence of Medicare as a universal health care system.

The proposal for a co-payment for GP visits, radiology and pathology plus increases in pharmaceutical co-payments are a significant first step towards the end of bulk billing.

The savage cuts to health spending set the scene for the public health system to fail and for the private sector to take over all save a safety net for the poor.

The Abbott government is paying incentives to state governments to privatise infrastructure. This could have grave consequences for our public hospitals which are now open to be taken over by private capital.

At the state level the Baird government has already revealed its zeal for privatising public hospitals with a decision on the new private operator of the new Northern Beaches hospital imminent and the strong possibility of the new Maitland and Byron Bay hospitals to follow suit.

This aggressive and radical policy agenda at the federal and state levels poses an enormous threat to a health system that has stood Australia well for many decades now.

Numerous prominent economists and economic commentators have demolished the weak and unconvincing arguments that have been put forward to justify these attacks.

At annual conference the much respected economics editor for the Age, Peter Martin, outlined the sheer dishonesty of the hysterical scaremongering by treasurer Joe Hockey and federal health minister Peter Dutton about health spending (see pp 24).

Peter Dutton has been loudly claiming that in the 10 years between 2002 and 2012 the cost of Medicare benefits has increased by 124%, the cost of the Pharmaceutical Benefits Scheme has

increased by 90% and the cost of public hospitals by 83%. They are big numbers. They are numbers that are meant to scare. They are numbers that are being cynically used to proclaim the unsustainability of Medicare and to justify the vicious attacks on public health.

The number that Peter Dutton doesn’t dare whisper, as pointed out to us by Peter Martin, is that the economy has grown by 94% in that same timeframe. So the PBS and public hospitals are costing us LESS as a proportion of the economy while Medicare is costing us marginally more.

This dissembling about our health system is unconscionable.

Minister Skinner’s speech to conference was long on self congratulations but short on assurances for nurses and midwives. She seems to be averse to the very word ‘ratios’. There is a conspicuous silence about privatisation. She seemed to be outraged that delegates should dare to express their feelings about the government’s mean and authoritarian wages policy (see pp 20).

It is highly unlikely that the Baird government will move away from its position on any of these issues that are clearly not in the interests of nurses and midwives or the public health system that we all cherish.

In contrast, the ALP’s shadow health spokesperson Dr Andrew McDonald came to conference with concrete support for nurses and midwives and public health.

The NSW Labor party has made a giant leap forward by including ratios as a central feature of its health policy (see pp 22).

Ideally, we would like to see bipartisan support for improved and extended ratios. There is still time for the NSW Liberal Party to do so.

If not, the state election in March will be a timely opportunity for the NSW public to make the clear choice they now have about the future direction of our public health system.

We will be encouraging them to do so.

THE LAMP SEPTEMBER 2014 | 5

YOUR LETTERS

COMP PETITION

W TWO WIN AMAZING HOLID DA AYS YS AT AT

euroboda alla Less than 4 hours from Sydne ey and 2 hours from Canber ra, Eurobod dalla is home to award winning Montague Island, sland, 83 stunning beaches, amazing he eadlands and vast tracks of National Parks and forests brimming with wildlife.

The Lamp is of fering members s a chance to win not one but TWO HOLID DA AYS YS in Eurobodalla on the ‘unspoilt South Coast NSW’, thanks to Beachcomberr Holiday Park, Potato Point and Wilirr yunna – Radiant Sun Yoga Retreat at Broulee.

Radiant Sun Yoga Yoga Retreat is of o fering a weekend inclusive of all meals and accommodatio on for one lucky person to escape for a weekend to rechar ge, reconnect and reener gise. Beachcomber Holiday Park is provviding a family holiday for 2 adults and 3 children where you can immerse in wildlife, beach and fishing at the front door!

To enter the competition, simply write your name, address, membership number and the prize you want to win n on the back of an envelope and send to: Eurobodalla Competition 50 O’Dea A Avenue, venue, Wa aterloo, NSW W,, 2017

Competition entries from NSWNMA members only. Competition opens 1 September 2014 and closes 30 SSeptember 2014. Conditions apply: Beachcomber voucher is valid for 12 months from the date of the first draw, subject to availability, and is not available during peak season or long weekends Christmas school holidays and Easter school holidays. Radiant Sun Yooga vooucher is subject to advertised retreat dates and to be used by the end of July 2015. Must be booked direct with Beachcomber and Radiiant. They are non-transferable and not redeemable for cash for unspent portion. The prizes are drawn on 1st of the month following the competition. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW permit nno: LTTPM/14/00042.

More profit but less RNs I can sympathise with the difficulties those with 457 visas experience (Lamp Letters August 2014]. I encounter racism on a daily basis.

What about the registered nurse in Australia who seeks employment in a nursing home?

I recently enquired at two nursing homes to be told: “We aren’t recruiting for any nursing positions” or “the position has been filled”. Puzzled, I then saw in The Lamp July 2014 that the government was going to remove the need to have RNs 24/7 in nursing homes.

I would have emailed my local MP but he is inactive due to the Independent Commission Against Corruption (ICAC) inquiry.

So I have written a letter to my federal MP and asked why nursing home providers should be given another avenue to increase their profit margins?

Jenny Yee,Wyong First conference – and I’ll be back!

I was lucky enough to attend the recent annual conference for the first time, as a delegate for the Glen Innes branch. I had an excellent time and I’m hoping to attend next year.

Professional Day had a great line-up of speakers delivering interesting and entertaining topics. Jane Caro and Lisa Wilkinson were a hit. I loved the trade stands but wished there were more nurse-related product stands, for example scrubs, shoes, nurse bags or equipment.

The catering at the conference and at the Mercure Hotel was delish but the lines and organisation were a bit out of order.

The second day was a highlight for me as they presented the life membership awards. It was great to see nurses receive awards for their lifetime dedication to their union and profession.

Day two was on fire, bringing heated discussions and showing the passion delegates have for their profession and patients when Health Minister Jillian Skinner took the stage.

I wished there was more time for delegates to speak up and tell her where the nursing-hours-per-patient-day could go. I am a postgrad RN with seven years nursing experience as an AiN, EEN and now RN, who had 11 patients delegated to me on one shift. That’s not safe.

A one-to-four ratio needs to be introduced before patients suffer or nurses quit. Mrs Skinner was not happy to hear we were not happy. Let me say Twitter went wild when she walked out. Dr Andrew McDonald (shadow Health Minister) was well received by the room and gained a lot of support for his ideas.

The annual conference dinner was well worth attending, with the theme of Disney characters and superheroes. It was a great night with a huge turnout. I was one of the many Minnie Mouses. The photo booth was a hit as well as the great band.

Friday, the last day of conference, saw a lot of tired delegates wearing sunglasses, drinking loads of coffee and beroccas. I am looking forward to next year’s conference and would recommend it to any new delegate.

I would like to thank the NSWNMA for organising a wonderful event.

Crystal Liesegang,Tenterfield

YOUR LETTERS

LETTER OF THE MONTH

Local governments support Medicare As health workers you may be interested to learn that the 2014 National General Assembly of Local Government held its annual meeting in Canberra in June. It was attended by more than 500 local governments from all over Australia. About 1000 mayors and general managers met to discuss key issues and debated 200 motions from councils across Australia.

Community health is a concern of local government. My motion regarding Medicare was first submitted to and supported by Willoughby City Council in north Sydney (on which I am a councillor). It was then submitted to and overwhelmingly supported by the assembly.

“This National Assembly calls upon the Federal Government to commit to funding Medicare universal health for all Australians. Medicare provides equitable, accessible, advanced, high quality care to all Australians to ensure that all Australians have access to essential health care, which ensures a healthy population essential for its economic and social development.”

Every step can make a difference…

Kind regards Lynne Saville RN, OHN, M App Sc (Env Health), Chatswood

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.

letter of the

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

“Whatever your next purchase, remember Union Shopper.

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

unionshopper.com.au • 1300 368 117

NEWS IN BRIEF

Britain

Fist bump to reduce flu A new study published in the American Journal of Infection Control has found that “fist bumping” instead of shaking hands by way of greeting can reduce the transmission of bacteria by up to 90 per cent.

Even swapping a firm handshake for a gentler, briefer shake could have a significant impact on reducing the spread of infection.

The spread of infectious diseases is lower with a fist bump because it is faster than shaking hands and there is less surface area exposed, meaning there is less chance for bacteria to spread from person to person.

“WHEN THERE’S FLU GOING ROUND OR COUGHS AND COLDS, DEFINITELY IF YOU WANT TO TOUCH SOMEONE AS A GREETING A FIST BUMP IS MUCH BETTER THAN A HANDSHAKE. Scientists at Aberystwyth University in Wales tested different forms of greeting and how they affected the transmission of E.coli. They found that the most bacteria were passed during a handshake, around half as much in a high five and 90 per cent less when bumping fists. The most bacteria were passed from a strong handshake.

Dr Dave Whitworth senior lecturer at the university said: “People rarely think about the health implications of shaking hands. But if the general public could be encouraged to fist bump, there is a genuine potential to reduce the spread of infectious diseases.

“When there’s flu going round or coughs and colds, definitely if you want to touch someone as a greeting a fist bump is much better than a handshake.

“It potentially could have a significant impact on reducing flu when there is an epidemic.”

8 | THE LAMP SEPTEMBER 2014

Britain

Plan to cut obesity among nurses Overweight doctors and nurses will take part in weight loss competitions under an NHS plan to tackle obesity, reports the Sun newspaper.

About 700,000 of the 1.3 million people working for the NHS are overweight or obese, the paper reported.

To address this staff members will get access to healthier food, more gyms will be built and NHS sites will be made more cycle-friendly, while prizes will be offered to employees who lose weight.

Recent figures show that almost three-quarters of people aged 45 to 74 in England are overweight or obese.Young adults are the only age group with a normal average body mass index, according to the Health and Social Care Information Centre.

NHS England’s chief executive Simon Stevens said: “It’s hard for the NHS to talk about how important this is if we don’t get our own act together. I think the NHS has got to make an example in helping our own staff and hopefully other employers will follow suit.

“A lot of the food in hospital canteens, not just for patients but for staff, is chips and burgers.

The NHS, as an employer, for our own nurses and other staff, could we offer positive incentives? Yes I think we could. And some hospitals have begun doing that.”

NEWS IN BRIEF

United States

THERE WERE 658,000 ARRESTS FOR MARIJUANA POSSESSION IN 2012

Call to repeal marijuana prohibition The editorial board of the influential New York Times newspaper has called for the US government to repeal the ban on marijuana.

“There are no perfect answers to people’s legitimate concerns about marijuana use. But neither are there such answers about tobacco or alcohol, and we believe that on every level – health effects, the impact on society and law-and-order issues – the balance falls squarely on the side of national legalization,” it said.

“The social costs of the marijuana laws are vast. There were 658,000 arrests for marijuana possession in 2012, according to FBI figures, compared with 256,000 for cocaine, heroin and their derivatives. Even worse, the result is racist, falling disproportionately on young black men, ruining their lives and creating new generations of career criminals.

“There is honest debate among scientists about the health effects of marijuana, but we believe that the evidence is overwhelming that addiction and dependence are relatively minor problems, especially compared with alcohol and tobacco.

“Moderate use of marijuana does not appear to pose a risk for otherwise healthy adults. Claims that marijuana is a gateway to more dangerous drugs are as fanciful as the Reefer Madness images of murder, rape and suicide.”

Australia

Pregnancy and alcohol: women want to know A new project aims to encourage health professionals to talk to women who are pregnant, or planning pregnancy, about alcohol.

Research shows that 97 per cent of women want to receive information on pregnancy and alcohol from their health professional and that women look to their health professionals for correct advice, rather than relying on advice from family, friends or the internet.

The Women Want to Know project was developed by the Foundation for Alcohol Research and Education in collaboration with leading health professional organisations. The project consists of resources for health professionals and consumers, demonstration videos of health professionals talking to pregnant women about alcohol, and free online training, with CPD accreditation, from key health professional bodies.

Alcohol is linked to several adverse consequences in pregnancy including miscarriage, premature birth, low birth weight and Foetal Alcohol Spectrum Disorders (FASD). FASD has severe lifelong consequences for the child including physical and behavioural deficits. For these reasons the National Health and Medical Research Council recommends that abstaining from drinking alcohol is the safest option for women who are pregnant or planning pregnancy.

Information on the project is available at www.alcohol.gov.au

THE LAMP SEPTEMBER 2014 | 9

NEWS IN BRIEF

NSW Nurses and Midwives’ Association gratefully acknowledges the sponsorship provided by the following companies for our Annual Conference held at Rosehill Gardens 30 July, 31 July and 1 August 2014

“SINCE THE OUTBREAK BEGAN IN FEBRUARY THE EBOLA VIRUS HAS KILLED 660 PEOPLE ACROSS GUINEA, LIBERIA AND SIERRA LEONE...”

West Africa

Ebola “out of control” The aid organisation Médecins Sans Frontières (MSF) has described the Ebola outbreak in West Africa as “out of control”.

Since the outbreak began in February the virus has killed 660 people across Guinea, Liberia and Sierra Leone, according to the Independent. With a mortality rate as high as 90 per cent, it has put a strain on weak health systems.

A growing number of health workers have also caught the disease, despite stringent requirements regarding the use of protective clothing and visors.

The World Health Organisation says around 100 health workers have been infected by Ebola in the three countries, and 50 of those have died.

Local and international health workers must combat fear, suspicion and local traditions for burying the dead in their efforts to prevent the spread of Ebola.

10 | THE LAMP SEPTEMBER 2014

First State Super HESTA Super Fund ME Bank Mercure Hotel Sydney Angel Mah-Chut Architects Chifley Financial Services Commonwealth Bank Fuji Xerox Australia Pty Ltd Offset Alpine Printing Phil Gilbert Motor Group Scott and Broad/Clark Pacific

The Association also thanks the following companies for their contribution and assistance DB Health DU’IT Ferndale Mints Heritage Brand Hirudoid Cream Lindt Chocolates Lippincott Wilkins & Williams Nivea No Time to Lose Precision Printers

NEWS IN BRIEF

World

Return of the plague Bubonic plague, the bacterial infection that wiped out roughly half the population of Europe in the 14th century, and millions more during an outbreak in China in the 19th century, is again rearing its ugly head.

Recently,Yumen, a Chinese town with a population of 30,000, in the northwestern province of Gansu, was placed on lockdown after the death of a man who had handled a marmot – a small rodent – while farming.

In the past decade and a half there have been plague outbreaks all over the world, including in Peru, Madagascar, India, Algeria and the Democratic Republic of Congo.

After an outbreak occurred in Kyrgyzstan, the World Health Organisation’s (WHO) epidemic disease expert Eric Bertherat told the BBC: “Because bubonic plague is such a rare event, local medical staff are not prepared to diagnose the disease and treat it

appropriately, which means the first patient usually dies without even a diagnostic.”

WHO works with local medical authorities when plague outbreaks are identified.

If identified quickly bubonic plague from flea bites can be treated successfully with antibiotics.

But if it is allowed to spread to the lungs and become pneumonic plague – and passed on through saliva – patients can die within 24 hours of infection and the mortality rate is “always very high”.

Michael Keyte, representing First State Super and Brett Holmes from the NSWNMA presented certificates to the winners of the NSWNMA’s inaugural International Nurses’ Day and International Midwives’ Day Short Story and Poetry competition at annual conference: (from left) Ariane Blom for her entry Serendipity; Mary Perry for Those Were The Days and Kathleen Wurth for The Ambulance. Michael also announced First State Super would continue to sponsor the competition next year.

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COVER STORY

War on health on two fronts Both the state and federal governments have aggressive, ideologically driven policy agendas that are not conducive to health, NSWNMA General Secretary Brett Holmes told annual conference.

Nurses, midwives and like-minded members of our communities will have to become a significant force if state and federal government attempts to destroy Medicare and our public health system are to be halted.

In his report to the annual conference NSWNMA General Secretary Brett Holmes said the Association’s concerns, articulated over the past 12 months, had been substantiated with attacks on Medicare and the funding of the public health system. “[The public health system] is being set up to potentially fail and make way for the private sector to take over all but the safety net for the poor,” he said.

Brett said the Abbott federal government’s first budget, with its savage cuts to health and social welfare spending plus proposals for a $7 co-payment for GP visits, radiology, pathology and increases in pharmaceutical co-payments, undermined Medicare.

“They want the United States model of user pays and largely private health in12 | THE LAMP SEPTEMBER 2014

privatise infrastructure and leave the door open for big business to run the country via the blueprint set out in the National Commission of Audit report,” Brett said.

surance, which delivers worse outcomes at almost double the price,” he said.

The attacks on the public health system were part of a broader agenda to destroy “the social compact that Australians have come to treasure” he said.

“The Abbott federal government is also paying incentives to state governments to

MORE CUTS TO COME Current attacks on health are just the beginning, Brett says, with the forecast for future health funding from both the federal and state governments looking bleak.

“Around $220 million was removed from federal funding of New South Wales’ public hospitals in 2014-15 and the Commonwealth will spend almost $1.2 billion less on New South Wales public hospital services over the next four years,” Brett said.

“On 17 June, the Baird government handed down its last budget before the next state election. Despite claiming a record $19.9 billion health spend it also delivered a disappointing result to address growth funding within health”.

Brett says a statement from the Minister for Health Jillian Skinner that “NSW

“THEY DO NOT EVEN PAY YOU THE COURTESY OF PUTTING IN WRITING THE REJECTION OF THE CLAIM.” Health is working towards creating partnerships with the private sector, not-forprofit agencies and the Commonwealth” raises a serious concern.

“This means the rate of Public-Private Partnerships (PPP) involved in the delivery of health services will be on the rise in our state, despite previous failed attempts such as at Port Macquarie Base Hospital.”

“GREENFIELD” HOSPITALS LIKELY TO BE PRIVATISED Brett says it is “our belief that the current attacks on Medicare and our universal health by the Abbott federal government are part of an ideologically driven agenda”, to make the health sector ripe for the picking by private providers and move our health system towards a more US-style managed care model.

“The recent state budget indicates that all greenfield sites, like Byron Central Hospital, will be public-private partnership models and they have been privatising by stealth since they came into power.

“To date these include the new Level 5 Northern Beaches hospital, ADHC, mental health services, and community services like physical health, and drug and alcohol support.

“The NSWNMA continues to reject the private provision of public health services and the proposed loss of public sector conditions in the medium and long term for members at Manly and MonaVale Hospitals.

“The real details of the transfer provisions, including the need to maintain ratios

and quality patient care, remain hidden from public scrutiny.”

Brett says the NSWNMA is deeply concerned that the new Maitland Hospital at Metford will follow the same fate as the proposed new hospital for Sydney’s Northern Beaches at Frenchs Forest.

BAIRD GOVERNMENT IGNORES NURSES AND MIDWIVES Brett was scathing of the way the Baird government has treated nurses and midwives in their pay and conditions claim.

“They do not even pay you the courtesy of putting in writing the rejection of the claim,” he said.

“Our 2014 Public Health System wages and conditions claim for improved nurseto-patient ratios has been ignored by the Baird government and representatives at the Ministry of Health.

“We sat at the table and had useless discussions before eventually the Ministry of

Health was allowed to say they had “bargaining parameters” approved and that an offer could be made.

“We have made a pragmatic decision that we have little choice but to accept the money, get it into our members pockets and continue on with our campaigning to the next state election and beyond to achieve a fairer wages policy and safer patient care.

“It is unlikely we will see a change to the government-legislated pay outcomes under a Baird government, now or in the future.

“Only people power and pressure on politicians will change this. Our job, as a union, is to keep telling it how it is, facilitate our members articulating their own voices and use the collective voice to try and convince the voting public that they deserve a better health system and decent public services.”

“IT IS UNLIKELY WE WILL SEE A CHANGE TO THE GOVERNMENTLEGISLATED PAY OUTCOMES UNDER A BAIRD GOVERNMENT. ONLY PEOPLE POWER AND PRESSURE ON POLITICIANS WILL CHANGE THIS.” THE LAMP SEPTEMBER 2014 | 13

COVER STORY

Trade agreements a threat to our health There are not only domestic threats to our health system but also international ones Assistant General Secretary Judith Kiejda told annual conference.

In her role as health coordinator (Asia Pacific) for Public Services International, NSWNMA Assistant General Secretary Judith Kiejda says she is often shocked at “the general acceptance for the handing over of public health services to the private and non government sectors”.

“This international trend is evident everywhere and, as health professionals who know that patients fare better in universal healthcare systems, we must advocate for quality public health services at every opportunity,” she told conference.

Judith says there are a number of trade agreements in the pipeline, to which Australia could be party, which have the potential to impact on public services including health.These include the Trans Pacific Partnership (TPP) and the Trade in Services Agreement (TISA).

MORE POWER TO MULTINATIONALS The TPP is a trade agreement being pursued by 12 countries in the Pacific Basin including Australia.

The NSWNMA opposes the TPP, Judith says, as it does nothing to protect the rights of workers, poses threats to health care provision and would give foreign companies the right to sue Australian governments.

“The agreement has very little to do with actual traded goods, and is predominantly looking to make domestic legislation suitable to the interests of multinationals.

“The TPP is being negotiated in secret and Australians will not have the ability to have the agreement voted down in parliament.”

If the TPP is successful all Australians will be paying more for their medicines as it reduces the scope and function of the Pharmaceutical Benefits Scheme (PBS).

“Controversially, the TPP allows companies nominally based in any of the 12 TPP countries to sue Australian governments should we pass legislation that is deemed to affect their trade – even if it is clearly a health matter,” Judith said.

14 | THE LAMP SEPTEMBER 2014

the public. For example the New South Wales government was forced to buy back Port Macquarie Base Hospital due to systemic failures: TISA would see a failed privatised service continue in private hands, rather than it be reverted to public ownership,” she said.

Internationally, governments are already being sued for opposing mining that threatens the environment, drinking water and people’s health.

ACCELERATING PRIVATISATION The Trade In Services Agreement (TISA) threatens to accelerate the privatisation of all public services by forcing governments to open any new service to international tender.

Judith says that while the current NSW

ESTIMATES INDICATE THAT A ROBIN HOOD TAX IN AUSTRALIA WOULD GENERATE $12 BILLION OVER FOUR YEARS. government is already taking actions consistent with TISA, ratification of the agreement would also lock all future governments into the process.

“It will also prevent governments from reversing privatisation, even when it fails

ADVOCATING FOR THE “ROBIN HOOD” TAX Judith says the NSWNMA campaign for a financial transaction tax offers an alternative to the constant attacks on workers and their income that we are seeing in Australia and internationally.

“It is a great alternative,” she said. “A Robin Hood tax is not a tax on the financial transactions that we make in our everyday lives; it will not affect how you access your pay, pay your bills or transfer money when paying loans. It is a modest tax on trading of financial instruments such as stocks, bonds, derivatives, futures and credit default swaps; trades that occur at a rate of thousands per second. Dealers and financial institutions make profits on each transaction.

“A Robin Hood tax does two things; it raises much needed revenue for things like public health and aged care services, and it helps to stabilise the world economy by decreasing the volume of risky trading behaviour.”

Judith says the NSWNMA will raise awareness of the Robin Hood tax with a two-week roadshow leading to the G20 summit in Brisbane in November this year.

The roadshow will visit key rural and regional locations on the way to Brisbane.

Estimates indicate that a Robin Hood tax in Australia would generate $12 billion over four years.Across Europe the estimates are $240 billion annually.

According to Oxfam, that is enough to wipe out extreme poverty around the world four times over.

To find out more visit our Tax Justice and Fair Trade Facebook page at https://www.facebook.com/groups /1462305950654708/

Governance a high priority wives to embark on undergraduate or postgraduate studies. As the Trust scholarships are only available to members and associate members, it is a great reason to encourage non-members and students to join the Association,” she said.

The NSWNMA Council has placed focus on ensuring the best possible governance structures are in place in this time of extraordinary union scrutiny by the Abbott Coalition government, Association President Coral Levett said in her conference report.

“All councillors, and appropriate NSWNMA staff members have now received the mandatory governance training as required by the Fair Work Commission.

“This training further consolidated prior training and placed it in a clear union-focused perspective. As you can appreciate, this subject matter is somewhat removed from the daily clinical and management roles of the nurses and midwives on our Council.”

Coral congratulated the 37 members who won Edith Cavell Trust scholarships

for the 2014 academic year.

“These scholarships are awarded to enable current and future nurses and mid-

NSWNMA grows in strength and numbers

The NSWNMA recorded an increase of 1904 financial members in the 12 months to 30 June 2014. This brought the NSWNMA to a financial membership of 59,869 at 30 June 2014. This was a 3.28% increase over 12 months. There was:

• • •

ANNIE BUTLER ANMF ASSISTANT FEDERAL SECRETARY Coral told conference the Australian Nursing and Midwifery Federation (ANMF) has had a change in the leadership team with former NSWNMA Organiser Annie Butler recently appointed to the Assistant Federal Secretary role.

“With Federal Secretary Lee Thomas and Annie Butler at the helm, we will continue to be at the forefront of the professional and industrial arenas at the federal level,” she said.

An increase in the public health system of 1214 members (3.15%).

An increase in residential aged care of 422 members (4.39%).

An increase in private hospitals of 151 members (3.21%).

THE LAMP SEPTEMBER 2014 | 15

COVER STORY

ADHC nurses win support in fight for conditions Ageing, Disability and Home Care RN Vicki Yep says annual conference was an opportunity for ADHC nurses facing privatisation to brief delegates and gain support from the rest of the Association.

ADHC branches were given conference support for resolutions in support of nurses who may have to choose between forced transfer to non-government providers, or leaving the disability sector altogether.

“I also had an opportunity to speak to nurses from other sectors who had no idea ADHC was being privatised, and what it will mean to lose a service of last resort,” Vicki, secretary of the Association’s Norton Road Specialist Supported Living ADHC branch said.

“Annual conference also gave ADHC nurses a chance to become more aware of issues in other fields of nursing. That’s what I really like about conference; the opportunities for networking and learning from others.”

The Liberal state government says that by 2018 it will no longer provide direct disability services. There is no certainty of continuing employment for staff that may be transferred against their wishes.

“We hope there is still a chance for ADHC to remain as a service of last resort, for people with complex medical and behavioural issues. Realistically we know ADHC will not remain a large service provider,” Vicki said.

“The challenge now is to make sure ADHC nurses maintain their rights and conditions in the transfer to the non-government sector.

“The private sector acknowledges it needs our nurses’ experience and expertise for the transition to succeed. However, we know they most likely won’t [want to] pay us the same wages or maintain current award conditions.

Delegates urge anti-violence campaign Nurses and midwives are to be surveyed on their experience of workplace violence and risk management procedures available to deal with it.

“Anecdotally everyone will tell you the level of violence has increased.”

– Glenn Hayes RN CNS 16 | THE LAMP SEPTEMBER 2014

“ADHC has always been the fallback for really difficult and expensive clients the NGOs are unable to support. We are concerned that this option will no longer be available when the NDIS [National Disability Insurance Scheme] is fully implemented.

“My fear is that some of these clients will end up with nowhere to go and at significant risk to themselves and others. Or be forced to live in inappropriate placements, such as in aged care, the prison system or hospitals. ”

“We hope there is still a chance for ADHC to remain as a service of last resort.”

– Vicki Yep RN

Annual conference carried a resolution from the Royal Prince Alfred Hospital branch calling on the Association to run the survey as part of a campaign to counter violence in the public health system. The resolution called for the campaign to begin once current award negotiations have finished.

A delegate of the Association’s Illawarra Mental Health Branch, Glenn Hayes, who attended the conference, said a survey of the extent and degree of violence was needed in order to implement risk management plans.

“The union should take it on as a major issue,” he said.

Glenn is a trainer in aggression management, teaching staff evasive techniques based on defensive martial arts principles. Courses are compulsory for all entrants to the mental health service and refresher courses are held annually.

“Staff are exposed to so much aggression that they are desensitised to it a lot of the time,” he said. “There is a good deal of aggression going on around us that we don’t even report. In particular verbal abuse, which is often quite threatening and personal.

“A lot of it is not reported or officially taken further due to the prevalence of other levels of aggression that we document intensely.

“Anecdotally everyone will tell you the level of violence has increased. It is a huge concern for our staff and I get the same message from other parts of the mental health service.”

However Glenn says it’s not just a problem for mental health nurses.

“Accident and emergency staff face really high levels of aggression as do staff on medical wards who deal with dementia patients, for example.”

We can win ratios for all “It will be a long, hard battle but it can be done. If they can do it in California we can do it over here,” said Maitland Hospital theatre nurse Kim Plaizier.

“Maitland is our only local hospital and we will fight for it to stay in public ownership.”

Kim, a first-time delegate to the NSWNMA’s annual conference, was referring to the successful campaign by Californian nurses to establish nurse-to-patient ratios, and the lessons for nurses and midwives in New South Wales.

American nurse Malinda Markowitz, vice president of National Nurses United, addressed the annual conference on the Californian victory and their current campaign to extend ratios to the rest of the United States.

“Malinda Markowitz was inspiring; I got a lot out of her talk,” Kim said.

“She explained that it was a long fight but they got there through persistence. We can do the same if enough of us are prepared to get active and stick together.

“Malinda stressed the need to form alliances with patients and the community to successfully take on the government and health system.”

Kim said it was interesting to hear the problems and experiences of nurses from other health facilities around NSW on issues such as ratios, staffing and privatisation.

“When Health Minister Jillian Skinner addressed conference she said if nurses were not happy with conditions at the new Northern Beaches privatised hospital, they could always get a job in the public sector.

“But for us, Maitland is our only local hospital and we will fight for it to stay in public ownership.”

– Kim Plaizier RN

Boost to campaign to keep Maitland public Maitland Hospital nurses have welcomed annual conference’s support for a campaign against possible privatisation of a new local hospital.

Conference endorsed a Maitland Hospital branch motion committing the Association to a campaign in the state electorate of Maitland “to celebrate the contribution of public hospitals in the Hunter Valley and against the possible privatisation of any new hospital.”

Branch president Christine Hele said Minister for Health Jillian Skinner refused to rule out giving the new hospital at Metford to a private operator.

“Our members at Maitland wanted some formal recognition that the union would be upping the campaign. It was good to get that reassurance at annual conference – it came as a great relief to a lot of people,” she said.

“We are glad to see the union is passionate about our health system remaining public.”

Branch members have letter-boxed residents and organised a stall at a shopping centre to “inform the community and get them involved.”

Christine said the branch also set up a stall to collect signatures on a petition at Steamfest, a Hunter Valley festival of steam trains, but was asked to leave after local Liberal MP Robyn Parker complained it was “too political”.

“No one I speak to wants a private hospital, but most of them don’t know what a public private partnership (PPP) means and

therefore don’t see it as a danger,” Christine said. “We explain that if we set a precedent with a PPP our health system will gradually end up like the American system – unaffordable for a lot of people.

“People are becoming more aware about the push for privatisation that’s happening everywhere, not just in health.”

“We are glad to see the union is passionate about our health system remaining public.”

– Christine Hele RN THE LAMP SEPTEMBER 2014 | 17

COVER STORY

Horror stories from American health Britta Houser is an American RN who features in the NSWNMA’s television ad about privatisation.

At our annual conference Britta spoke about what it is like to be a nurse in the privatised U.S. health system.

Here she shares the stories of some of the patients she and her colleagues have cared for.

“IN ORDER TO HEAR WHAT IS WRONG WITH our system, all you need to do is ask nurses and patients,” Britta says. “I take care of patients every day who have delayed seeking care because of cost. This leads to diagnosis of disease at more advanced stages, and sometimes means that we can only provide symptom management for a disease that could have been treated if it were diagnosed earlier.”

“Every day, nurses see the adverse affects of privatised healthcare on patients and their families.At the end of the day, I know that I could be the aunt grieving the death of a child; it could be my father dying in the waiting room. I realise that if I didn’t have insurance and catastrophe struck, it could be my family facing bankruptcy.

“It is clear to nurses in the United States that despite healthcare costing the nation a great deal, patients are suffering from lack of care. It is now clear that we have a duty to protect our patients from unethical healthcare policy and the damaging effects of private hospitals making money off the suffering of our patients.

18 | THE LAMP SEPTEMBER 2014

“The nurse’s duty to patient advocacy does not end with an individual patient interaction, but rather extends to challenging a system if it is operating in a way that harms patients.”

SARAH’S STORY “Several months ago I was working at Kaiser (a large not-for-profit hospital system that is also an insurance company). I met a 25year-old woman who I will call Sarah. She had been experiencing diffuse abdominal pain for three months. Sarah did not have health insurance coverage and delayed seeing a doctor. She finally obtained an appointment at one of the publicly funded community clinics and was diagnosed with likely gastritis and prescribed an acid reducing medication. After several weeks, Sarah still felt like something was wrong and sought care at Kaiser’s Emergency Department. Because the initial conservative treatment had failed, her ER workup was more robust and revealed Stage III ovarian cancer.

What was certainly one of the worst days of this young woman’s life became

more tragic when the ER providers tried to admit her to the hospital. The ER providers were told that Sarah would not be admitted to the Kaiser hospital because she did not carry Kaiser’s private insurance.

The providers were instructed to transfer her to Highland, the overburdened local public hospital.

Sarah is luckier than some, because our community has a public hospital for those without insurance. In many communities, she would have had to delay treatment while she navigated a lengthy and confusing insurance process, only to apply for insurance she couldn’t afford.”

WILLIAM’S STORY “We often do not have enough nurses to watch the central heart monitors for telemetry patients. Last year, William was as at the Kaiser ER awaiting admission to the ICU for sepsis.

A new patient came in to the critical room next door and William’s nurse went to assist with the new patient’s workup.

Because of the decreased staffing, no one

was available to watch the telemetry monitors when the charge nurse also stepped away to help with this new patient.

William’s condition worsened, he went into a lethal heart rhythm, but it was several minutes before anyone noticed the alarm.

When William’s nurse was finished helping the patient next door and returned to William’s room, his heart was no longer beating and CPR was started. Despite thorough resuscitative efforts,William died that night.

As you all know, it is standard practice in the emergency department to prioritise treatment for the sickest patients.We often leave a room or two open in case someone with a gunshot wound, stroke, or heart attack comes in. Kaiser has made a decision to focus on customer satisfaction scores and we are being told to room every patient immediately. Whereas best practice would guide an ER to leave a patient with minor illness in the waiting room, at Kaiser that patient may be given the last open bed in the department. This directly impacts patient outcomes when there is no room available for a critical patient.”

EVELYN’S STORY “One evening last winter, a patient I will call Evelyn came in to Kaiser’s ER complaining of chest pain. The triage nurse alerted the charge nurse and requested an EKG. Because all the rooms except the code room were full, Evelyn returned to the waiting room. While waiting Evelyn became unresponsive and was rushed back to a code room.

Despite resuscitation Evelyn died in our ER that night, likely from a massive heart attack.We don’t know if the outcome would have been different for Evelyn if there had been a room available for her immediately.The nurse who triaged Evelyn that night left work with a heavy heart.

He told me he wondered if we could have changed the outcome for Evelyn with an open room, and I am certain he thought about her for many months after.

This illustrates the dangerous cultural shift that is taking place in hospitals across the United States. We are seeing the focus moving away from providing excellent patient care and moving towards providing customer service.”

GENEVIEVE’S STORY “Genevieve was six months old when her parents took her to their local ER at Kaiser Hayward for a fever. She was seen and discharged home. When Genevieve was not getting better the next day, her grandmother insisted that she needed to be seen again. Genevieve’s parents returned with her to the local ER where she was seen and diagnosed with meningitis.

Kaiser Hayward used to have a paediatrics floor, but it was recently closed to consolidate services and save money.

Genevieve had to be transferred 22 miles away to Kaiser Oakland. She was admitted to the paediatrics floor there.

Genevieve died after arriving at Kaiser Oakland. As you know, meningitis has a high mortality rate. It’s unclear if a timelier admission to a local pediatrics floor would have changed the outcome for Genevieve.

We do know that any delay in treatment of infection and sepsis results in increased mortality.”

To watch a frank discussion between Lyn and Britta about US and Australian healthcare go to Support Nurses on Youtube.

Campaign builds as election approaches “Most people are shocked and horrified to hear they will lose two acute public hospitals and get a private hospital in their place.” — Lyn Hopper RN

With a state election due next March the NSWNMA is stepping up its campaign against privatisation of hospital services on Sydney’s Northern Beaches district.

The state government will close Manly and Mona Vale hospitals and wants the new replacement hospital it is building at Frenchs Forest to be privately owned and run, with nurses and midwives employed by the private operator.

The Association’s annual

conference unanimously supported resolutions from branches at Manly and Mona Vale hospitals in favour of a public hospital.

“We cannot allow our government to gift public hospitals to private companies because our patients suffer, our conditions suffer and our public health system is dismantled,” the Mona Vale branch resolution said.

NSWNMA Councillor and Manly Hospital branch president and delegate Lyn Hopper says the union needs to step up the campaign over the next eight months leading to the state election.

She says the campaign should combine on-the-ground activities with the Association’s statewide TV and radio advertising.

Northern Beaches nurses have been letter-boxing homes and leafleting people at bus stops, markets and the Manly Wharf.

“We need to educate the public about privatisation of their health care system in every way possible,” Lyn said.

“Most people we speak to are shocked and horrified to hear they will lose two acute public hospitals and get a private hospital in their place.

“They say they were under the impression they were going to get a new public hospital.

“Some form of health facility will remain on the Mona Vale hospital site, basically as a GP service, but it won’t take acute admissions.

“The new Frenchs Forest hospital will be owned and operated by a private

operator, probably Healthscope or Ramsay, with nurses employed by that company.

“It will be run for private profit and the government will use taxpayer funds to pay for public beds in the facility.”

Both Ramsay and Healthscope are major donors to the Liberal Party.

“Until we know who the owner will be we won’t know what conditions nurses will be employed under,” Lyn says.

“Manly and Mona Vale are both ratio hospitals so protecting our nurse-topatient ratios will be a vital issue. There are no ratios in private hospitals so there is a strong possibility that a private owner will not want to maintain them.”

THE LAMP SEPTEMBER 2014 | 19

COVER STORY

Our message to the minister: we’ll keep fighting!

Minister Jillian Skinner announced some small enhancements to the health system at our annual conference but delegates were resolute in keeping the big-ticket items of improved and extended nurse-to-patient ratios and a fairer wages policy, on centre stage.

THE NEW SOUTH WALES MINISTER FOR health Jillian Skinner came to our annual conference armed with improvements to the health system that amounted to fairy dust.

Elected delegates representing 179 public health system branches came armed with resolutions to continue the fight for patient safety, fair industrial laws and a vibrant and equitable public health system in NSW. In her speech to the conference Ms Skinner spent some time restating what her government has done in health since attaining office. But going forward there were only a handful of small initiatives.

She promised 30 new clinical support officers for smaller acute hospitals and mental health units and 30 new facility nurses for smaller acute inpatient facilities.

There was also an announcement of further unspecified enhancements to the role and number of nurse practitioners, 20 | THE LAMP SEPTEMBER 2014

and 1000 tablet devices for community nurses.

Ms Skinner said the tablet devices were an important step towards better integrating hospital and community services.

“I want to ensure our nurses have the most up-to-date and easy to use technological support,” she said.

NSWNMA General Secretary Brett Holmes said that while any improvements were welcome, the minister failed to address the real issues that impact on patient safety in those areas yet to get ratios.

“We welcome any commitment to additional funding and resources but we are skeptical of their impact on safe patient care unless they are legally guaranteed in the award,” he said. “The minister’s announcement only delivers the equivalent of 3.75 positions per Local Health District across rural New South Wales.”

Brett vowed that nurses and midwives

would continue the fight to improve the public health system.

“The fight for extended ratios is ongoing,” he said.“Our resolve is to continue fighting for expanded nurse-to-patient ratios into all public health facilities and specialty units, including emergency departments, neonatal intensive care units, critical care, children’s wards, community health and more country hospitals, to ensure patients are receiving the best possible care.”

Edward Makepeace, an RN from Royal North Shore Hospital, presented Jillian Skinner with a petition of more than 10,000 signatures from residents across the state that support improved nurse-to-patient ratios.

Delegates also made clear to the minister the anger felt by nurses and midwives towards the state government, for using its unjust industrial relations laws to block bargaining for wages and conditions. A

resolution passed by 179 NSWNMA branches the week before conference said: “We further note they have forced upon us an inadequate 2.27% increase.

We condemn the actions of the government, its outlawing of genuine Award negotiations and the removal of the independent umpire’s powers.”

Ms Skinner thanked the state’s nurses and midwives for the commitment and skill they bring to their work each day.

“On my regular visits to hospitals and health facilities across the state, I see the compassionate care that nurses and midwives provide to patients, their families and care givers. It is a large part of what makes me so proud to be New South Wales’ Minister for Health,” she said.“On behalf of the government, I thank our nurses and midwives for putting their patients first and for helping to make the New South Wales health system one of the best in the world.”

What Minister Skinner promised 30 new clinical support officers for smaller acute hospitals and mental health units.

30 new facility nurses for smaller acute inpatient facilities.

Further unspecified enhancements to the role and number of nurse practitioners.

1000 tablet devices for community nurses, giving them access to patient clinical information.

What Minister Skinner didn’t promise Improvement and extension of nurse-to-patient ratios.

Changes to the government’s unfair wages policy.

THE LAMP SEPTEMBER 2014 | 21

COVER STORY

Ratios now part of ALP health policy The NSW Labor Party has made a giant leap forward by making ratios a central feature of its health policy — meanwhile the government of the day won’t even mention ratios by name.

YEARS OF CAMPAIGNING BY NURSES AND midwives have produced another victory, with confirmation by the Shadow Minister for Health, Dr Andrew McDonald, that the New South Wales Labor Party has included the extension of nurse-to-patient ratios to all areas not previously covered, in its health policy.

“When it comes to nurse-to-patient ratios the nurses are right. I know just how right. Any discussion about ratios should only be about how to fund them rather than whether they should be introduced,” Dr McDonald told the NSWNMA Annual Conference.

“New South Wales ALP policy supports the widening of the ratios that were introduced when it was in government. It is there in black and white.”

Dr McDonald told the conference his party’s policies for the next election were simple and committed to paper.

“The first is more nurses doing more, the second is just telling the truth and the third is an opposition to the Americanisation and privatisation of the New South Wales health system,” he said.

TIME FOR THE TRUTH Dr McDonald said that after the introduction of ratios the second part of Labor’s health policy would be, “quite simply, just to tell the truth”.

“There is an enormous amount of vital health information that has been deliberately buried by this government. It is not the bureaucrats who want to hide this information, it is the politicians.

“For example, how long it takes to get an outpatient appointment, how many nursing vacancies there are in each hospital, 22 | THE LAMP SEPTEMBER 2014

which hospitals are being cut back to make the so-called ‘efficiency savings’.

“How different would the story be of Paula and Scott Bailey, the couple who had the baby in the car park at Nepean Hospital, if the public had been informed that there were 21 midwife vacancies in that unit at that time,” he said.

Dr McDonald said the third pillar of Labor’s health policy was opposition to the privatisation of the state’s public health system, starting with the state government’s plan for a private company to build and operate the new Northern Beaches Hospital at Frenchs Forest.

OPPOSING THE AMERICANISATION OF HOSPITALS DR MCDONALD SAYS THOUGH THERE is always a need to change and improve the NSW health system, “there is no system that provides better health care at less cost anywhere in the world”.

“The New South Wales and Australian health systems are sustainable.We currently spend 9.1 per cent of the Australian gross domestic product on health, about average for a country in the OECD, and in New South Wales we have the world’s fourth longest life expectancy.”

He says the current federal and state Liberal Party-run governments are combining to attack and undermine our public health system.

“At the federal level, the proposed $20 billion drop in New South Wales health funding by the Abbott government is a dereliction of duty.

“The proposed $7 Medicare co-payment for general practice and diagnostic tests will save barely $1 in every $1000 of

current healthcare expenditure. This is all about political ideology and an attack on universal health care rather than true health policy.

“At the state level this attack is in the form of privatisation of public hospitals.

The private health system is one of the great strengths of healthcare in New South Wales, however the private and public systems are best used in a complementary way, both doing what they do best, rather than have all of one or all of the other.

“The decision by this government to replace two public hospitals with one private hospital is an experiment that has never worked in the history of New South Wales.

“Labor opposes the Americanisation of New South Wales’ public hospitals. Labor opposes the forced relocation of staff from the public health system to a private provider. We oppose a private company making profit from the New South Wales taxpayer.”

NSWNMA General Secretary Brett Holmes welcomed the commitment given

by Labor and Dr McDonald.

“It’s a positive step forward in our fight for expanded nurse-to-patient ratios into all public health facilities and specialty units such as emergency departments, intensive care units, critical care, children’s wards, community health and more country hospitals,” he said. “We need the government to take our claim seriously and ensure that our nurses and midwives are able to deliver the best possible patient care.

“Our resolve is to continue campaigning for this important claim, putting patient safety first.”

“labor opposes the americanisation of new south wales public hospitals. labor opposes the forced relocation of staff from the public health system to a private provider. we oppose a private company making profit from the new south wales taxpayer.”

- Dr Andrew McDonald.

ALP Shadow Minister for Health

The three pillars of NSW Labor’s health policy • Extension of nurse-topatient ratios to all areas not previously covered.

• Opposition to the privatisation of NSW’s public health system.

• Telling the truth about vital health information.

COVER STORY

Australia’s health funding is sustainable Federal Treasurer Joe Hockey and Minister for Health Peter Dutton have been shrill and alarmist in their cost assessments of our health system.

Peter Martin, economics editor for The Age newspaper gave a more measured analysis to the NSWNMA Annual Conference.

ECONOMICS EDITOR FOR THE AGE, PETER Martin, says the May budget was preceded by a chorus of doom about the sustainability of federal health care spending, led

by Treasurer Joe Hockey and health minister Peter Dutton.

“It reached its peak in February. It seemed to come out of nowhere. Minister Dutton said in a speech to CEDA (Committee for the Economic Development of Australia):‘The system’s costs are spiralling, they were staggering, on an unsustainable path’. It was quite a speech. He also got an ‘unmanageable’ in there. That was somewhat alarming.”

24 | THE LAMP SEPTEMBER 2014

“AUSTRALIA’S GDP HAS JUMPED 94% IN THOSE 10 YEARS. JOE HOCKEY DIDN’T MENTION THAT, HE LEFT IT OUT.” Joe Hockey was equally strident: “If our health and education systems stay exactly the same Australia is going to run out of money to pay for them.”

“The minister said in his speech that

in the past 10 years – from 2002 to 2012 – the cost of Medicare benefits had increased by 124 per cent. And that’s big.The cost of the PBS (Pharmaceutical Benefits Scheme) had increased by 90 per cent and the cost of public hospitals by 83 per cent. Those are big numbers,” Peter Martin told the NSWNMA Conference.

What he didn’t say, Peter pointed out, is compared to what?

“GDP (gross domestic product) – the amount of money earned in Australia – has jumped 94 per cent in those 10 years.

He didn’t mention that, he left it out.

Maybe he didn’t have room for it.

CREATING A PHONY CRISIS “If our health, welfare and education systems stay exactly the same, Australia is going to run out of money to pay for them.” — Treasurer Joe Hockey, Sydney G20 Finance Ministers’ Meeting, February 2014.

“In the past 10 years we have seen: the cost of the MBS increase by 124 per cent; the cost of the PBS increase 90 per cent; the cost of public hospitals increase 83 per cent.”

— Minister for Health Peter Dutton, speech to CEDA, February 2014.

THE COMPARISON THEY CHOSE TO OMIT?

GDP GROWTH Australia’s Gross Domestic Product has grown 94 per cent. In fact, spending on the Pharmaceutical Benefits Scheme and public hospitals has been a smaller percentage of our GDP compared to 10 years ago, and the increase in Medicare spending has been reasonable.

“Now Medicare growth starts to look a lot less large. I pay more for my coffee than what my grandfather did but so what?

“The Pharmaceutical Benefits Scheme has grown by 90 per cent – so it’s taking up a smaller proportion of the economy than it was 10 years ago. He didn’t mention that.

“Public hospitals … have grown by 83 per cent – a much smaller proportion of the economy.”

SPENDING SLICE IS BIGGER BUT CAKE IS TOO In Peter Dutton’s CEDA speech he claimed that health expenditure was on

track to grow from 4 per cent to 7 per cent of GDP by 2050.

“By 2050 GDP will be 45 per cent bigger than it is at the moment. That’s a very conservative calculation.Treasury has done a calculation – they come up with 80 per cent bigger. I think the growth rates they have adopted are too high,” said Peter Martin. “However we are going to have a bigger cake. We are going to have money left over because food as a proportion of our income is not going to increase.

“Will we run out of money to pay for health? We may have to pay more for health. We may have to pay more of that

larger cake in tax. It doesn’t mean there will be less for other things.”

Peter pointed out that, not only have the costs been misrepresented, purely looking at the costs of the system only gives you half of the equation.

“Mobile phones cost an enormous amount more than they did but they provide us with a lot more. Benefits are half of the story as well as costs,” he said. “A 65-year-old woman in 1960 could expect to live to 81 years. Now she could live to 87.That is an extra six years of life that we have gained. Benefits are part of the story as well as costs.”

THE LAMP SEPTEMBER 2014 | 25

COVER STORY

People prepared to pay more tax for health A survey conducted by the Australian National University at each federal election suggests there have been significant changes in the priority for voters between the importance of tax and the importance of health and Medicare.

“LET’S GO BACK TO THE END OF the last century [the 1998 federal election],” said Peter Martin.

“Tax mattered, people wanted less tax. Only 10 per cent thought health or Medicare would swing their vote.”

“At the beginning of the next century there was a big decline in tax as an issue of concern, which is what you would expect as a society becomes wealthier and knows that the things it needs, such as health, can only be guaranteed through tax.

“Then something remarkable happened. At the start of the century the two lines crossed over. Our concerns about tax were diminishing to 16 per cent.

Our concerns about health were increasing.

“In 2007 – the election won

by Kevin Rudd – tax [as a priority issue] continued to decline.

Health and Medicare doubled [in importance]. It had become a real concern for voters.

“In the most recent election – the concern about tax? – little had changed, at about 10 per cent. Concern about health and Medicare? Up to 19 per cent.

“It makes sense that as a society becomes richer and has more free income – and it can’t spend much more on food – it decides to spend it on health and realises it can be best provided by government and becomes less resistant to it being funded by taxes. It makes sense and it is also what the surveys show.”

26 | THE LAMP SEPTEMBER 2014

ANU election survey Since 1987 the Australian National University has carried out the Australian Election Study survey, timed to coincide with federal elections, which asks the question: “Which has been the issue for you during the election campaign which will swing your vote?”

1998

Tax 23%

Health and Medicare 10%

2001

Tax 16.3%

Health and Medicare 16.1%

2007

Tax 11%

Health and Medicare 20.4%

2013

Tax 10.6%

Health and Medicare 19%

Alternative ways to balance the budget Peter Martin says it is true that our budget is not in balance and in time it will have to be.

“Joe Hockey is right when he says there is a problem,” he said. “But the government itself recognises there is no emergency to fix it. After all there are a lot of things it could have done which it hasn’t done.”

Peter says other measures that could have been adopted to balance the budget include: Taxing “bads” instead of “goods” e.g. carbon emissions. “If you were going to tax something, which would you rather tax? Something that was harming the planet or income? Not very difficult.”

Tax the high-speed financial transactions that “sowed the seeds of the financial crisis”.

(See Robin Hood Tax Page 14) Repeal super tax concessions, saving $30 billion. “We give concessions to invest in super which is compulsory. The concessions are skewed to those in the top 20 per cent of earners.”

Charge more GST — “Currently health and education are exempt.”

Charge more income tax — “In the ANU election survey people said they would accept that.”

• • • • •

Even the rich benefit from Medicare Peter Martin says health occupies a special place in our “hierarchy of needs” and differs from another cherished societal good, education.

“As we become wealthier these kinds of things, looking after our children’s education and looking after our longevity – our health – really matter,” he said.

“But health is different to education. They can both be privately provided to some extent and they are both what you want the wealthier you get, and they are what society wants, the wealthier society [becomes]. For health, though, taxes are the only way of being sure of getting it.”

Peter says the experience of Kerry Packer, media mogul and once Australia’s richest man, whose life was saved by care delivered through the public health system, illustrates this well.

“He was playing polo in Liverpool. He had a heart attack.

He died for a little while. He was taken to Liverpool Hospital in a public ambulance.There was no way that he could privately insure that he stayed alive. The only way of doing that in remote areas is having it provided by

taxpayers, having it provided by the government.”

Peter cited another example of a wealthy, prominent person, Joe Hockey, who reaped enormous benefit from a Medicare procedure.

“Joe Hockey had a gastric sleeve put on his stomach – 80 per cent of the content was removed. He has my enormous admiration. I think it took a lot of courage to do what he did.

He said something to me before he went away [for the operation].We were talking about diet and weight and he said ‘I’m going to do something’. And he did.

“The operation is new and costs Medicare millions. It has extended his life. It’s made him a different person and that is worth remembering when we talk about what is sustainable in terms of costs.”

THE LAMP SEPTEMBER 2014 | 27

COVER STORY

“If the legislation to introduce a $7 GP co-payment passes it would be the end of bulk billing in Australia.”

28 | THE LAMP SEPTEMBER 2014

We must maintain Medicare’s vitals Author and founding director of the Deeble Institute for Health Policy Research, Dr Anne-marie Boxall, says duplication between private insurance and Medicare is a longstanding policy problem that is eroding the basic principles of universal health care.

“MEDICARE IS NOT THE ENTIRETY of the health system,” Dr Boxall told the 2014 NSWNMA Annual Conference.

“But we should be fighting very hard for the principles Medicare is based on – universality, equity, efficiency and simplicity.”

The Whitlam government introduced Medibank, later to become Medicare, in 1975, on top of an existing voluntary, private insurance scheme.

“Medibank was so controversial that the Whitlam government had to pretty much leave the private system untouched.

“It wasn’t perfect public policy design but it was feasible and it did mean we got a universal healthcare system,” Dr Boxall said. “But we’ve had two systems running alongside each other ever since and successive governments have tried to tackle that in various ways, but none have done a very good job of it.

“This duplication is problematic because it does privilege those with private health insurance over people who aren’t insured.

“Because all Australians are entitled to use public hospitals, because they’re enrolled in Medicare by default, they’re paying for a product they don’t necessarily use.They [private and public health] cover the same thing and that’s fundamentally the problem.

“The way the system is set up, subsidies are needed to keep private health insurance viable.”

Dr Boxall, whose book Making Medicare: the politics of universal health care was published last year, says that while Medicare covers medical and hospital services, and a small range of allied health services, there are many other health programs and initiatives in Australia funded through a range of different means.

“There’s some research being done to

identify what those services are and the federal government has a program looking into this in detail and looking at some items on the medical benefits schedule which really are a waste of money – Vitamin D tests and a number of other things.

“That work is progressing slowly and I think if enormous effort was made on that we would pretty much be able to address this issue of the sustainability of the health system.”

Different countries have tackled mixed systems in different ways. In Canada private health insurance is not allowed to cover the same things as its public health service.

“The Netherlands, where they have competing insurance schemes which provide universal health care, works really well [because], in a country the size of a postage stamp, you can have a competing market for health insurance.

“But can you actually have a genuine competing market in a country as large as Australia, where there are places no one wants to run a health fund because it’s basically unprofitable?”

Dr Boxall says Medibank was introduced to facilitate access to general practitioners, medical specialists and public hospitals at a time when medical bills were a leading cause of bankruptcy.

“Most people had acute illnesses or injuries, they saw a doctor, they went to a hospital, they were cured or they were not. It was much simpler in those days.”

But, she says, there are different health problems to address today.

“The chronic disease burden has grown enormously and we need treatment from a whole range of different health professionals. The issue for us now is not so much simple access to care; it’s about accessing quality care that is well coordinated among a whole range of dif-

ferent health professionals – and that’s difficult to do when we have so many different funding pools.

“Medicare is only one funding source for healthcare providers where a patient is receiving care from the public sector, the private sector, the public hospital, the private hospital, the medical specialist, the chiropractor down the road, a whole range of things: it’s challenging to do that.”

Dr Boxall told annual conference that almost two thirds of elective surgery in Australia is being performed in private hospitals.

“If you look at some specialist areas that’s about 75 per cent and that is a real challenge in terms of universality.”

There are also questions around private contracting: “It becomes very reliant on the nature of the contract that is negotiated and what quality measures you put in there and then what you do when things go wrong.”

CO-PAYMENT AN END TO BULK BILLING Dr Boxall told the conference that if the legislation to introduce a $7 GP co-payment passes it would be the end of bulk billing in Australia. As The Lamp went to print the proposed co-payment was still before the Senate.

While about 83 per cent of GP services are bulk billed, the rates between electorates range from 80 to 40 per cent. Only about 28 per cent of medical specialists bulk bill meaning that a significant number of Australians already pay a portion of their GP bills.

“The contribution from individuals toward their healthcare in Australia is very large, it’s been growing where in most other countries it has been shrinking,” Dr Boxall said.

THE LAMP SEPTEMBER 2014 | 29

COVER STORY

Winning hearts, minds, and ratios Postcards, rallies, letters, billboards and persistence, persistence, persistence.

Nurse campaigner Malinda Markowitz tells the epic story of winning ratios in California and how it led to an international movement for ratios.

“IT WAS A LONG LONG FIGHT, JUST LIKE I know you guys have been undertaking,” American nurse Malinda Markowitz told the NSWNMA 2014 annual conference.

“You’re going to fight your government and you’re going to fight the hospitals. You’re going to do education, you’re going to do lobbying, you’re going to be persistent and you’re going to form an alliance with your patients and the community because it’s an important fight for the patients and for their safe care.”

Between 1992 and 2012 the US health system underwent major upheaval following massive privatisation. In California alone, the number of community, government and not-for-profit hospitals decreased by 709 while for-profits increased by 349.

“In 1995 I worked in a community hospital bought and run by the largest forprofit healthcare corporation in the US, Healthcare Corporation of America [HCA],” Malinda said. “If they ever come into your country you need to fight like hell to keep them out.

“When they came in [to California] they had 165 hospitals, 115 freestanding surgery centres in 20 states and in England.

One year after they purchased two sister hospitals they closed one of them that was there to serve the poor and the elderly.

Then they had 274 layoffs of employees, 61 of them RNs.They even let go a chaplain we had for years for the patients.That’s what privatisation does to your hospitals.”

At the same time hospitals were doing clinical restructuring, which they labelled “patient focused care.”

“It had nothing to do with patients. It was about de-skilling and replacing RNs,” Malinda said. Proposals included training housekeepers to do blood draws.

30 | THE LAMP SEPTEMBER 2014

The union sued, the hospital involved rescinded its “workplace redesign” and the lawsuit was withdrawn. But at the same time patient assignments rose from eight to 10 in every hospital in the state.

“At my hospital they wanted unlicensed assistant personnel to do blood glucose testing and we were expected to do insulin based on that. They wanted them to do NG tube feeding and they wanted them to remove faulty catheters. We told them in no uncertain terms that was not going to happen. Not under our watch,” Malinda said.

“The California Nurses Association (CNA) realised that to stop this runaway train, or derail it, we had to increase our numbers because there’s power in numbers and when you have the power no one can ignore your union.”

In 1992 CNA had only 18,000 members, mostly in San Francisco. By 2008 the figure was 82,000 statewide. In 1996 it campaigned to have ratios legislated but was outspent 10-to-1 by the hospital industry, and its proposition was defeated.

But it raised community awareness of the campaign by nurses not only for staffing ratios but also for whistleblower protection and a ban on health management organisation (HMO) gag clauses.

HMOs arrange self-funded health care insurance for individuals and other entities and act as a liaison with health providers on a prepaid basis.

“We continued our fight in all arenas.

It was an epic fight with the nurses on safe staffing at Kaiser Community Hospital.

More than 7000 RNs called six short strikes in 15 months in 47 hopsitals and clinics,” Malinda said.

“We took to the streets to advocate for

the patients. We call this ‘street heat.’ We asked the public to give us their stories about things that happened to them because of cuts at Kaiser and we received hundreds of letters. We carried this on for six weeks and that made a huge difference in the community and we got national attention because we had formed a coalition with patients.

“It won approval from the legislature after we got hundreds of letters, calls and postcards but unfortunately the governor at that time decided he didn’t want to do that. He got a lot of hospital industry support to not sign the bill and he didn’t.

“At that point we knew we had to get much more political.We started interviewing, endorsing and working on candidates’ campaigns, only if they had the same values as we did and they signed on to some of the things that were important to us at the time.

“Our political clout grew and we made it really clear to these elected officials, and we do even more so now, that we’d get you elected but we can take you out in a moment if you start deviating from what you need to do.”

In 1999 the nurses had their bill introduced for the third time, backing the move with 14,000 letters of support and commissioning a poll that showed 80 per cent of Californian citizens supported staffing ratios.

“We had 1500 nurses at the state capital that day of the vote in the Senate and it was an amazing day. Our nurses took what they were doing very seriously, but they also had to be fun because we did these things over and over. That day you could feel the connectedness of all the actions we had done.”

In October 1999 the governor signed

the ratios into law, despite pressure from the hospital industry.

“We found out that right before he signed it one of his aides had a family member in a hospital and they had a very bad experience.”

In January 2004, California’s historic first-in-the-nation safe staffing ratios finally came into effect, after a 13-year battle and despite the continuing efforts of the hospital industry to overturn the law.

“In 2004 we knew we couldn’t keep ratios in California if we didn’t go across the country and make sure every nurse had the same,” Malinda said. “So we developed a national nurses organising committee and we went to other states to help nurses who had reached out to us for help.”

In 2008 National Nurses United (NNU) was established and Global Nurses United (GNU) followed that, with founding members from 12 countries including Australia.

“Through GNU we’re going to raise our collective voices and demand that world leaders take the necessary action to restore some kind of equality in our economies. With nurses from around the world anything is possible.”

“YOU DESERVE RATIOS BECAUSE YOU DESERVE TO BE ABLE TO GIVE THE CARE YOU WERE TRAINED TO GIVE.” — Malinda Markowitz, nurse and ratios campaigner

Safe ratio bills, based on the Californian legislation, are currently before the US House and Senate.

Malinda says HMOs and their managed care were at the core of patient care crises that nurses dealt with in California during the 1990s and early 2000s.

“Profits before safe patient care is their driving force. Bureaucrat gatekeepers decide what treatment you might have, what procedure and even if you get into the hospital. Not the doctors, not the nurses.

Managed care also encourages hospitals to control costs by limiting services. Usually, when it’s reducing costs, the nurses and the support system get cut.

“Your country is facing a similar scenario as your conservative government pushes your health care system toward American privatisation,” Malinda said.

“Thank goodness for you and your union for fighting to keep that out.

“You deserve ratios because you deserve to be able to give the care you were trained to give.We know there is power in the numbers and it’s about nurses helping nurses. We can help you. All you have to do is ask.”

THE LAMP SEPTEMBER 2014 | 31

COVER STORY

KAPOW! Members show heroic resolve for ratios!

32 | THE LAMP SEPTEMBER 2014

THE LAMP SEPTEMBER 2014 | 33

COVER STORY

There were plenty of princes and princesses at our annual conference dinner — which had the theme of Disney characters and superheros — but there was nothing Mickey Mouse about the resolve of delegate nurses and midwives to keep up the fight to spread ratios to all corners of the New South Wales public health system!

34 | THE LAMP SEPTEMBER 2014

THE LAMP SEPTEMBER 2014 | 35

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ASK JUDITH I am on workers compensation and normally consult a particular doctor at the local medical centre who signs my WorkCover medical certificate; however this doctor is on leave. My employer’s insurance company has advised that I need permission from them before asking another doctor at the same medical centre to sign my next WorkCover medical certificate. Do I really need permission to change the nominated treating doctor?

In most cases you will need to advise the insurer of a change of nominating treating doctor, however, as per section 47 (4) of the Workplace Injury Management and Workers Compensation Act 1998 you can nominate a medical centre as your nominated treating doctor. It states in part: “A medical practice can be nominated as treating doctor … Such a nomination operates as a nomination of the members of the practice who treat the worker from time-to-time and a reference … to the nominated treating doctor is a reference to those members of the practice.”

This means that if you nominate the medical centre you are nominating all the doctors at the centre to sign your WorkCover medical certificates.

Lost my set days after 10 years I am an EEN working in a public hospital and have been working set days for 10 years. My new NUM has rostered me on different days meaning I have had to rearrange my regular personal commitments. What are my rights?

Unfortunately, working set shifts for a regular period does not result in the entitlement to continue to work those set days, unless these days are part of a written contract such as an employment contract or a written agreement with a manager who is authorised to agree to set shifts. If this roster change has resulted in

an adverse effect on your personal commitments I recommend that you discuss this with the NUM in the first instance, to enable her to alter the roster to meet your needs in line with service requirements, where appropriate. Further I advise you to check your employment contract for provisions that may allow you to enforce set days.

Fell ill while on leave I work in the public sector and recently went on annual leave. Unfortunately I fell ill for four of those days and wonder if I can have my annual leave re-credited?

The short answer is no. NSW Health Policy Directive PD2006_089 states: “Periods of less than one week shall not be recredited for an employee who is sick while on annual leave.”

For periods of sick leave in excess of one week or more I refer you to subclause (vi) of clause 37, Sick Leave, of the Public Health System Nurses and Midwives’ (State) Award 2011: “Subject to the provision of a satisfactory medical certificate and sick leave being due, annual leave or long service leave (extended leave) shall be recredited where an illness of at least one week’s duration occurs during the period of annual or long service leave: Provided that the period of leave does not occur prior to retirement, resignation or termination of services, and provided further that the employer is satisfied on the circumstances and the nature of the incapacity.”

Confused priority for redeployment I am an injured nurse working in the public health system. My doctor has advised me I will not be able to return to my previous position, but I have not yet been issued a final certificate. The insurance doctor’s report also states I will not

return to my previous position and she advises I will need to apply for other positions. I have found a suitable advertised position with my employer, but management says I do not have priority for redeployment as I don’t have a final certificate. I have heard that my employer has a responsibility to find me a suitable position that accommodates my restrictions. Is this true?

Employers do have an obligation to make every effort to accommodate injured workers and find them a more suitable position. Section 49 of the Workers Compensation and Injury Management Act 1998 places the onus on the employer to provide suitable employment for injured workers. The alternate employment should be “as far as reasonably practicable, the same as, or equivalent to, the employment in which the worker was at the time of the injury”. Further, section 3.2.1 of the Department of Health Policy Directive Recruitment and Selection Policy and Business Process – NSW Health Service 2011_032 states in part: “Where occupational illness or injury prevent a member of staff from returning to the duties of his/her existing position, workers compensation legislation requires that, as far as practicable, every effort is made to place the staff member into another more suitable position of similar grading, classification and remuneration”.

The policy goes on to say “the possibility of placing such staff to vacant positions, either temporarily or permanently, should be explored prior to opening the position to competitive recruitment”.

Therefore, your employer should seek clarification from your nominated treating doctor as to your prognosis, and the recruitment process should be placed on hold while your status is established. If your employer should withdraw your suitable duties, or threaten termination of your employment, without complying with the above requirements, please contact the Association for further assistance.

Nursing Unit Manager – Maternity Services Location: Coffs Harbour Health Campus Enquiries: Joanne Uttley, (02) 6656 7024 or email Joanne.Uttley@ncahs.health.nsw.gov.au Ref ID: 201904 Closing date: 1 September 2014

Apply online at: nswhealth.erecruit.com.au

N43663

Need to nominate a new doctor?

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

NSW Health Service: employer of choice

THE LAMP SEPTEMBER 2014 | 37

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

Nursing: inflexible and hostile to mothers www.nurseuncut.com.au/aprils-story-nursing-is-inflexible-and-hostile-to-mothers/

Former ICU nurse and mother of two small children April Abbott was shocked at the inflexibility she faced when returning to work.

“You couldn’t pay me” – Finn’s new grad diary www.nurseuncut.com.au/you-couldnt-pay-me-to-return-to-student-nursing-finns-new-grad-diary-4/

Halfway through her new grad year Finn feels stressed but reckons it’s nothing to the stress of being a student nurse.

Podcasts: Professional Day www.nurseuncut.com.au/podcasts-from-nswnma-professional-day-2014/

Hear Jane Caro on the modern face of sexism, Lisa Wilkinson on her “brilliant career”, economist Peter Martin on the federal budget, and more from our Professional Day speakers.

Nursing in Bougainville www.nurseuncut.com.au/anthony-with-medecins-sans-frontieres-in-bougaineville/

Nurse Anthony Flynn discusses his work in the Bougainville Province of Papua New Guinea as Medical Head of Mission with Médecins Sans Frontières.

Podcasts: Aged Care Nurses Forum May 2014 www.nurseuncut.com.au/podcasts-aged-care-nurses-forum-may-2014/

Palliative care in aged care, career pathways in aged care and more from the inspiring speakers at our May forum.

Women Want to Know about alcohol and pregnancy www.nurseuncut.com.au/women-want-to-know-about-alcohol-and-pregnancy/

A new program helps health professionals approach the subject of alcohol consumption with pregnant women.

New on SupportNurses YouTube channel Street theatre with Uncle Sam Free Trade could rob us of the PBS and Bananas in Pyjamas. > youtu.be/oyEKbvvQupY Northern Beaches community meeting Premier Mike Baird was a surprise guest – we hope he heard our message. > youtu.be/anf2ZwaVdDc

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.

38 | THE LAMP SEPTEMBER 2014

WHAT

SOCIAL MEDIA

Keep me logged in

Forgot your Password?

NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Registration for AiNs? A report into the sexual assault of older women has called for the mandatory registration of all aged care workers, including AiNs.

Hostile territory for mothers

April, a mother of two young children, was shocked by inflexibility in the workplace when returning from maternity leave. She argues nursing must become friendlier to mothers.

Thanks!

We often get comments on Facebook from members of the community wanting to thank nurses. Here are two examples.

At last.

Absolutely horrifying for the victim who is already vulnerable, perpetrators should get tougher sentences and longer/heavy jail terms. Their crime/s should not be erased from their employment records Licensing for AiNs way overdue. This was a big part of the Because We Care campaign.

Many good nurses are lost from the system because they just can’t justify arranging and paying for childcare that they may or may not use. … I would love to see change so my daughters experience a much less hostile workforce when it is their turn to juggle family and career.

I am a student nurse who at 40 is changing careers to become a nurse. At the start of my degree I was appalled – we were told “if you are looking for flexibility then you are in the wrong industry”.

Why should you be able to choose what shifts you work because you’re a mother?

As a NUM of a small unit, I try! I remember those difficult days when I had three little children and juggling shiftwork. I am happy to be flexible about starting times, a quick duck out to special events, lots of things. Set shifts have proven very difficult with other staff.

And I do have to consider the impact. It is a hard one.

I’m astounded by the comments that are pretty much implying there’s no place for mothers in nursing! Yes it’s a 24/7 rotating roster job, however the majority of nurses are women who will have babies at some stage and may need support from their workplace in order to juggle work while caring for their babies. If all the mothers had to leave nursing due to inflexibility then you would really know what “unfairness” meant because you would be doing double shift after double shift because there would be no staff !

Requesting flexible work arrangements due to caring for children is one of the National Employment Standards.

Like it or not, this issue needs to be addressed, because it isn’t going to go away and no amount of “suck it up, that’s the job” attitudes will help.

I would like to thank the staff at Manly Hospital for the great care they took in providing me with a comfortable, friendly stay. I have spent several times in private hospitals doing the same procedure and found the out of pocket expenses crippling, so this time I opted for public and can say I will never use a private hospital again. I believe it is a crime that any government would allow the new hospital on the Northern Beaches to be private.

After my husband was recently hospitalised we got to see firsthand how hard nurses work.

They had little time for toilet or meal breaks and were constantly on their feet. As my husband works in Emergency Services we are aware of the differences in pay. It opened our eyes to how hard nurses work and that they should be offered more remuneration and resources!

PHOTO GALLERY

An anti-bullying seminar run

by NSWNMA in the Blue Mountains was popular with aged care nurses.

Liverpool Hospital branch members want to save Medicare.

Canowindra nurses held a ratios info stall in their main street.

Northern Beaches nurses had a message for the Premier: Keep our new hospital public!

THE LAMP SEPTEMBER 2014 | 39

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Across 1. The production of sensation, especially of nervous erethism (16) 9. Discriminating; singling out in preference (9) 10. A structure or part resembling an arm or leg (4) 11. A water-soluble vitamin of the B complex found in various animal and plant tissues (6) 12. Resting metabolic rate (1.1.1) 13. To separate; disunite (5) 14. Orotic acid (1.1.1) 15. Genitourinary (1.1) 16. Buttocks (5) 18. Dissolution of bone (10)

19. The vertebral columns (9) 22. A sensation of rotation or movement of one’s self (subjective vertigo) or of surroundings (7) 23. A linear projection or projecting structure; a crest (5) 25. Sinus tachycardia (1.1) 26. Nauseousness (12) 30. Recurrent equine uveitis (1.1.1) 31. Toxic shock syndrome (1.1.1) 32. A heartbeat occurring before its normal time in the rhythm of the heart and followed by a compensatory pause (12) 33. The inability to identify any part of the body, either one’s own or another’s body (16)

Down 1. Orthopaedic inflammation of the anserine bursa (8.8) 2. Pertaining to induration or hardening (9) 3. The ankle joints of quadrupeds (5) 4. An infant who has died before birth (9) 5. Inflammation of the omentum (9) 6. A prohibition; a ban (7) 7. Pertaining to an object that has the shape of a spine or thorn (7) 8. The state in which mental

processes take place without conscious perception (16) 10. Lithium (2) 15. Revolves around a fixed point or axis (7) 17. Occuring after (10) 20. Ethylenediaminetetraacetic acid (1.1.1.1) 21. Containing little or no fat (4) 24. The back (6) 25. A group of six (6) 27. The skin covering the cranium (5) 28. A group of red acidic xanthine dyes (5) 29. Ends (5)

THE LAMP SEPTEMBER 2014 | 41

EDUCATION@NSWNMA

WHAT’S ON SEPTEMBER 2014

ALL OUR COURSES CAN NOW BE BOOKED

——— • ———

Are you meeting your CPD requirements – ½ day 10 September Batemans Bay 25 September Dubbo 12 November Broken Hill 20 November Grafton 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 11 September Batemans Bay 26 September Dubbo 13 November Broken Hill 21 November Grafton 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 ——— • ———

Practical Strategies to Manage Stress and Prevent Burnout – 1 day 29 October NSWNMA, Waterloo

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

Basic Foot Care for Nurses – 2 days 29-30 October Ballina

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

To book online please visit our website, www.nswnma.asn.au/education.

For more information about specific courses phone Matt West on 1300 367 962.

NURSING RESEARCH ONLINE

One of the key issues that arises for NSWNMA members dealing with disciplinary and professional practice matters is documentation. This month Nursing Research Online takes a look at current articles in the area of nursing and midwifery documentation Why Document?

Nursing & Midwifery Council of NSW When an enrolled nurse, registered nurse or midwife commences employment, the importance of documentation is incorporated into the workplace orientation. The responsibility of ensuring that your documentation is of a high standard is extremely important for self-employed nurses and midwives.

Individual patients, or women and their families, have the right to question the care that has been provided.

When a complaint is received either b y the Australian Health Practitioner Regulation Agency (AHPRA), the Nursing and Midwifery Council or the Health Care Complaints Commission (HCCC), the medical records of the individual patient or woman are reviewed, and the documentation entered by the nurses or midwives may be scrutinised. www.hpca.nsw.gov.au/Nursing-and-MidwiferyCouncil/Publications-and-Policies/Newsletter/WhyDocument/default.aspx

Guidelines on Documentation and Electronic Documentation NSWNMA Nurses and midwives, along with other members of the health care team, are responsible for producing and maintaining patient/client health care records (paper or electronic), which enable the provision of effective continuing care. The health care record is not a legal document, but a mechanism that allows the health care team to: communicate effectively; deliver appropriate, individualised care; evaluate the progress and health outcomes of patients/clients; and retain the integrity of health information over time. However, the health care record has the potential to be admitted into evidence, if relevant, in legal proceedings.

Producing the health care record requires comprehensive, accurate, high quality documentation. www.nswnma.asn.au/wpcontent/uploads/2013/07/Guidelines-on-ElectronicDocumentation-and-Documentation.pdf

Health care records – documentation and management Ministry of Health, NSW Policy Directive This standard sets out the requirements for documentation and management for all models of health care records within the NSW public health system. Health care records promote patient safety, continuity of care across time and care settings, and support the transfer of information when the care of a patient/client is transferred e.g. at clinical handover, during escalation of care for a deteriorating patient and transfer of a patient/client between settings. www0.health.nsw.gov.au/policies/pd/2012/pdf/PD2012_069.pdf

Poor records can reflect poor practice This excellent article about documentation from the Australian Nursing Journal is not available online but can be accessed through the NSWNMA Resource Centre.

Linda Starr, Australian Nursing Journal It can take a tragic event to remind us that the way we deliver care may not always meet the acceptable standards set down by the profession, including how we chart the care given.

Documentation is a clinical skill; however the value of the medical record is often underestimated, with charting viewed as an arduous, time consuming administrative task, despite the inherent understanding of the role the record plays in both patient care and defending any claims of poor practice.

During the inquest into the death of Samara Hoy 2011, where a baby delivered by ventouse extraction died, the coroner identified a number of poor practices including a failure to observe policy, poor clinical judgement, lack of leadership and poor documentation. In fact, the notes were so poorly kept the court appointed expert felt “… the medical file was incomplete and inadequately maintained” and the coroner concluded “… the maintenance of the medical records was woefully inadequate … information which was required to be recorded was not recorded’’.

Australian Nursing Journal: ANJ, Vol. 19, No. 10, May 2012: 29

THE LAMP SEPTEMBER 2014 | 43

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.

LIONS NURSES’ SCHOLARSHIP HOLARSHIP Looking for funding to further yo our studies in 2015?

The trustees of the e Lions Nurses’ Scho olarship Foundation invite applicationss for scholarships for 2015.

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

You must currently be registered with w the Nursing and Midwifery Board of Australia and working w within the nursing profession in NSW or the ACTT,, and must have a minimum of three years’ experience in the nurssing profession – the last twelve months of which must have been spent s in NSW or the ACT..

Applicants must also be able to produce p evidence that your employer will grant leave forr the required period of the scholarship.

D t il off eligibility Details li ibilit andd th the 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.

THE LAMP SEPTEMBER 2014 | 45

OBITUARY

Sandra Margaret Wojcinski (née Gouldstone) 1961 — 2014

[e\ My beautiful sister Sandra was the third of four children. Our parents emigrated from England as teenagers after World War II. Sandra attended Earlwood Public School and was accepted into the Opportunity Class in years 5 and 6 at Lakemba Primary School. In early 1979 Sandra met the love of her life, a local boy, Ted Wojcinski, who was to become her husband of 32 years.

Later that same year Sandra passed her HSC at Kingsgrove North High School, just months after the very sudden death of our father at the age of 46.

Although I was four years older than Sandra we both commenced nursing training in February 1980, Sandra at St George Hospital in Kogarah while I went out to the country. For both of us the influence to study nursing came from our father’s sister, Auntie Edna, who for many years was Matron at Orange Base Hospital.

Sandra’s daughter Heidi has followed in her mother’s footsteps and is in her final year of nursing at University of Western Sydney.

Sandra and Ted married in October 1981 after Sandra received permission from the Matron of St. George hospital to marry. It is difficult to imagine that, just over 30 years ago, Sandra had to seek permission from her employer before she could marry.

After completing our general training we both decided to apply to do midwifery, however Sandra chose the more practical side of midwifery, giving birth to the first of her four beautiful children, Glen, in 1984, followed by Adam in 1987, Luke in 1989 and Heidi in 1994.

46 | THE LAMP SEPTEMBER 2014

She led by example and her patients’ care was her first priority.

In late December 2012 Sandra was diagnosed with breast cancer, ploughing headlong into the fight of her life. As the months of 2013 slipped by it became more and more evident that this was a battle Sandra was not going to win.

Throughout these busy and hectic years of raising a family Sandra worked three afternoons a week, travelling from Ingleburn to Prince Alfred Hospital to work on the cardio thoracic surgical ward. Sandra particularly loved working on this ward under the guidance of the NUM Judy Foskett, and in spite of the travel continued to work at the PA for nearly 20 years.

In between treatments Sandra worked diligently on a Discharge Planning presentation, which she presented, wearing the outfit of Dorothy from the Wizard of Oz, complete with sparking red shoes. Sandra endured many rounds of chemo and radio therapy, very rarely taking any time off sick, and started work earlier each day to fit in her treatments at the end of her working day.

In 2005 Sandra sought a career change and the opportunity to work closer to home and began working as an EACH (Extended Aged Care Home) Manager with HammondCare. It was during this time that I had the great honour of working with my sister when I also took on an EACH Manager position.

In 2007 Sandra was instrumental in organising the care required for our family to look after our mother during her final months after a long battle with breast cancer.

Sandra continued to remain hopeful although realistic about her prognosis, and reluctantly went on sick leave in early December 2013. Sandra spent her last Christmas in Strathfield Private Hospital.

In early 2011 Sandra became a Discharge Planner at Campbelltown Hospital. In true Sandra-style she continued to put her heart and soul into her work, always advocating for her patients/clients and ensuring they received the best possible care.

In her life, and work, there was no second best for Sandra and the demands of excellence in nursing care and documentation that she required of staff was also what she expected of herself.

The support Sandra and her family received during her last 13 months, from her work colleagues, management, medical, nursing, palliative and breast care staff at Campbelltown and Camden hospitals was outstanding, and helped to make such a rapid and emotional journey for Sandra and all who loved her, just a little more bearable.

On January 20, 2014 Sandra passed away peacefully with her family by her side.

My brave sister fought a short hard battle and is greatly missed by her family friends and work colleagues.

God made us sisters, but our hearts made us friends.

— Yvonne Ward

BOOKS

BOOK ME Clinical Gerontological Social Work Practice Robert Youdin Springer Publishing Company www.springerpub.com RRP $88.00 ISBN 9780826129895 This book has a forward-looking orientation that reflects the reality of social work with older adults throughout the aging life course.

Chronic pain, family and gender differences, and interactions among medical and psychiatric illnesses, medications, and treatments are carefully and extensively discussed. Dr Youdin integrates an advanced clinical social work practice with in-depth knowledge of evidence-based practice as well as geriatric medicine, psychiatry and gerontology.

Clinical Cases: Nursing Care Case Studies Ellie Kirov and Margaret Webb Mosby Australia (available through Elsevier Australia) www.elsevierhealth.com.au RRP $36.32 ISBN 9780729542081 This text can be used in conjunction with Tabbner’s Nursing Care 6th edition as a resource for the Diploma of Nursing. Each case begins with an introduction in which presenting conditions and symptoms are outlined and, as the case progresses, more details of the patient’s condition, tests, medications and other considerations are provided. All cases come together with a conclusion in which patient outcomes are highlighted, followed by a discussion of the key considerations for the case. Multiple choice questions are integrated throughout and rationales provided for all answers.

Transitioning From LPN/LVN to BSN Nancy Duphily Springer Publishing Company www.springerpub.com RRP $64.00 ISBN 9780826121813 This book addresses competence in leadership and management, critical thinking, cultural intelligence, information technology, and professional writing, as well as legal and ethical concerns. It focuses on the role of the RN within an inter-professional team, describes the experience of returning to an academic setting, and the challenges of and strategies for accomplishing a successful role transition. Numerous reflective exercises, case vignettes, and online case studies reinforce the content.

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.

Public Health and Aging: Maximizing Function and Well-Being (2nd ed.)

Steven M. Albert and Vicki Freedman Springer Publishing Company www.springerpub.com RRP $91.00 ISBN 9781849053181 This book promotes the development and maintenance of optimal physical, mental, and social functioning, irrespective of acquired disease and with due recognition of the senescent changes that accompany late life. Updated, revised, and significantly expanded, this second edition contains new chapters that examine chronic disease, long-term care, and ethical issues in public health and aging. The book also serves as a resource to health professionals and students, delineating what measures health care professionals can take to help elderly populations not only maintain but optimise their health.

SPECIAL INTEREST Finding Your Way: A Medical Ethics Handbook for Patients and Families (Revised ed.)

Katrina A. Bramstedt, Ph.D., Hilton Publishing www.hiltonpub.com/bookstore RRP $16.95 ISBN 9780984144730

Most books in the marketplace dealing with this subject are written for medical professionals, academics, or students. That makes this book – a medical ethics book directed squarely at the lay audience of patients and their families confronted by highly complex and difficult medical procedures and issues, such as transplantation or life-and-death decisions – a one of a kinds. Targeted to an American audience its topics, spread across a broad range of medical concerns, will also be relevant to the many Australians dealing with these issues on a daily basis.

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 SEPTEMBER 2014 | 47

MOVIES

movies of the month An intriguing film set amid the wonderful colours of Tangiers and narrated beautifully by a whimsical Omar Sharif, writes Stephanie Gray.

This French-Moroccan film, written and directed by Laila Marrakchi, is set over three days as a family gathers for the funeral and wake of the successful and controversial business mogul, Moulay Hassan (Omar Sharif), in his magnificent mansion on the outskirts of Tangiers, Morocco.

As his devoted wife Aicha (Hiam Abbass) prepares for her husband’s wake in accordance with Muslim tradition, the arrival of their three daughters throws the proceedings into mayhem, each one bringing their own set of dramas.

Sofia (Morjana El Alaoui), the youngest, has a rocky marriage to an American and works as an actress in Hollywood, seemingly always cast as a terrorist. There is tension between Sofia and her sisters, Miriam (Nadine Labaki), an insanely rich housewife and Kenza (Lubna Azabal), a conservative schoolteacher. The three sisters, their stoic, demanding mother, her opinionated uncle and the rest of the characters in this charade, which include, but are not limited to, a secret mistress, a life-long housekeeper, a suicidal loved one, an assortment of kids, and religious figures, inject sparkle and wellpeppered life into the three-day funeral.

Shades of Shakespeare’s King Lear are evident as Sofia and her sisters fight over everything. The cast makes these played out dramas plausible and entertaining.

There are the occasional laughs from these squabbles though the comedy is fairly broad and never dominates a whole scene.

The film is not deep but does touch upon thought-provoking issues and the emotions around familial reactions to death and grieving.

IN CINEMAS SEPTEMBER 18 Stephanie Gray is an RN with Australian Red Cross Blood Services

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

48 | THE LAMP SEPTEMBER 2014

DVD SPECIAL OFFER

WISH I WAS HERE

One hundred years after the start of World War I, this six-part ABC drama examines the experience of nurses working at Gallipoli and on the Western Front.

Drawing upon the diaries, letters and photographs of real nurses, the series depicts war from a female perspective, told through the eyes of women who were trailblazers for their gender and their profession.

Filmed in Adelaide and South Australia, ANZAC Girls charts the ordinary young women who followed their brothers, fathers and lovers into war and who, like the men, were unprepared for the grim reality of industrialised warfare.

Beginning in the heady pre-Gallipoli days in Egypt, moving through the devastation of that campaign and the utterly unexpected casualty count, through the bitter months on the barren island of Lemnos, to the long hard years of the war in Europe and the Western Front, ANZAC Girls is personal, intimate and raw.

In this film grandiose dreams are confronted with a reality that is much less appealing, writes Chris Benellie Ladera.

The film begins with Aiden Bloom daydreaming, seemingly absent from the chaos occurring at his breakfast table.

Aiden is a 35-year-old family man; a struggling actor on the verge of failure as he rushes to yet another audition.

On the way he drops his children at their private school, where he learns that the tuition fees, promised by his father, are in arrears. He is soon confronted by the news that his father Saul (Mandy Patinkin) is ill and unable to further support his grandchildren’s education.

Aiden’s dreams of making it in Hollywood appear to be falling apart as his responsibilities as a father become apparent. Despite this he is supported by his wife Sarah (Kate Hudson), who is the family breadwinner.

Aiden decides to home school his children and an unexpected coming of age, albeit late, story unfolds.

I Wish I Was Here is directed and co-written

by Zach Braff, who also plays Aiden, and comes a decade after his well-received indie film, Garden State. The movies share the same wit and charm; both are heart-warming and engaging. Like Garden State, I Wish I Was Here has an excellent soundtrack.

Despite some shortcomings the film has heart and will satisfy those who enjoyed Garden State.

It also benefits from its cast; Kate Hudson shines as the family’s matriarch, while young actors Joey King and Pierce Gagnon exuberate the innocence of youth as their children, Grace and Tucker.

There is authenticity in this film: it encourages viewers to live a life that is colourful, and shows us that adventures and heroes can be found in the ordinary.

IN CINEMAS SEPTEMBER 18 Chris Benellie Ladera is an RN CCU at St Vincent’s Hospital

METROMEMBER GIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to Wish I Was Here thanks to Transmission Films. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

RURAL MEMBER GIVEAWAY Email The Lamp by the 15th of this month to be in the draw to win a dvd of Anzac Girls 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 SEPTEMBER 2014 | 49

conferences, seminars, meetings

DIARY DATES

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.

Nursing and Midwifery Unit Managers Society of NSW Annual Conference 17 October Ettalong Beach www.numsociety.org.au Professional Association of Nurses in Developmental Disability Areas 2014 Conference 15-16 October Parramatta www.pandda.net Blacktown and Mount Druitt Hospital Nursing and Midwifery Research and Innovation Symposium 23 October Caroline O’Donnell 0422 006 786 Michelle Nehmer 0439 266 642 APNA Continuing Education for Nurses in General Practice 24-25 October Sydney www.apna.asn.au/nigp Bones on the Beach Orthopaedic Conference 25 October Wollongong karin.tarne@sesiahs.health.nsw.gov.au RPA Midwifery Conference 2014 Complex Care in Midwifery 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 Midwives on the Tweed 11th Annual Education Day – Galloping Forward 7 November Tweed Heads midwivesonthetweed@iprimus.com.au High Dependency Nursing Conference Beyond the basics 7 November Westmead Ryan.Thomas@health.nsw.gov.au 6th Australian Rural and Remote Mental Health Symposium 12-14 November Albury www.anzmh.asn.au/rrmh/

NSW 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 Meeting the Challenge 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

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Cystic Fibrosis Nurses Education Day 14 November Westmead Sharon.simonds@health.nsw.gov.au Spotlight on Liverpool lives A talk by Dr Jennifer Harrison 13 November 2014 Liverpool City Library 10.30am-12.00pm Diabetes and Diabesity Update Day 15 November Sydney www.dnsw.eventbrite.com.au 1300 136 588 2nd National Play Up Convention Creative Ideas in Ageing 24-25 November Sydney

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

INTERSTATE Third National Elder Abuse Conference 3-4 September Perth www.elderabuse2014.com/index.html ACSA National Conference Coming of Age, Redefining Age 7-10 September Adelaide www.acsaconference.org.au Australian Disease Management Association 10th Annual National Conference 11-12 September Melbourne www.adma.org.au/images/ConferenceFlyer2014. pdf

PHAA 43rd Annual Conference 15-17 September Perth 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 ACMHN 40th International Mental Health Nursing Conference 7-9 October Melbourne (02) 6285 1078 www.acmhn2014.com events@acmhn.org Aged Care Nurse Managers Conference 30-31 October Melbourne www.totalagedservices.com.au/index.php?q=a cnm-conference.html Dementia and Community Care Conference 2014 30-31 October Melbourne www.totalagedservices.com.au/index.php?q=d cc-conference.html

PHAA 2nd National Sexual and Reproduction Health Conference 18-19 November Melbourne phaa.net.au/NSRH2014Conference.php 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

INTERNATIONAL 3rd World Congress of Clinical Safety: Clinical Risk Management 10-12 September Madrid, Spain www.iarmm.org/3WCCS Nurses Christian Fellowship International PACEA Conference Compassion The Cornerstone of Care 10-14 October Nadi, Fiji pacea-region@gmail.com 4th International Conference on Violence in the Health Sector 22-24 October Miami, Florida, USA www.oudconsultancy.nl/MiamiSite2014/index .html International Conference on Infectious and Tropical Diseases (ICTID) 16 -18 January, 2015 Phnom Penh, Cambodia www.ictid.webs.com

REUNIONS Mater Graduate Nurses’ Association Annual Reunion 19 October 2014 North Sydney Joan Taniane 0401 344 363 joans2458@yahoo.com Rydalmere Hospital Staff Reunion Celebrating 200 years.

24 October Janice Sillett (02) 9842 2404 Janice.Sillett@facs.nsw.gov.au Sandra Burgess (02) 9334 0581 Sandra.Burgess@facs.nsw.gov.au 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 Hospital reunion and dinner to follow 25 October 1pm Little Bay Margaret Vincent (Dewick) 0413 293 812 margie.v@optusnet.com.au NEC Prince Henry/POW Hospitals Oct 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 of 1987-1989 1-2 November Hamilton, New Zealand Molly Forbes 0403 904 650 mollywoppie@gmail.com

diary dates is a free service for members.

NURSES AND MIDWIVES: IT’S IMPORTANT TO NOTE

You must be a

FINANCIAL MEMBER of the NSW Nurses and Midwives’ Association to ensure your entitlement to: » All Association services » Accident Journey Insurance » Professional Indemnity Insurance.

All these services are only available to members who are financial members. Make sure your membership remains financial by switching from payroll deductions to Direct Debit.

UNSURE IF YOU ARE FINANCIAL? IT’S EASY! Ring and check today on 8595 1234 (metro) or 1300 367 962 (rural).

Download, complete and return your Direct Debit form to the Association.

www.nswnma.asn.au Authorised by B.Holmes, General Secretary, NSWNMA

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$43,990 DRIVE AWAY

*Free Apple iPad valid with every vehicle sold and delivered between the 1st - 30th of September, 2014. This ad must be presented at time of purchase to be eligible for offer. Not available in conjunction with any other offers. Not redeemable for cash. †3.9% comparison rate for approved personal applicants and 3.9% annual percentage rate for approved business applicants of Nissan Financial Services (Australian Credit Licence Number 391464) only. Excludes Government, Rental and National Fleet customers. Maximum term of 36 months. 3.9% APR. Conditions, fees and charges apply.

WARNING: This comparison rate is true only for the example given and may not include all fees and charges. Different terms, fees or other loan amounts might result in a different comparison rate. Comparison rate for the purpose of the National Credit Code is based on a 5 year secured loan of $30,000 although this offer relates to a 36 month term only. Offer valid on new 2013 build Juke ST manual models, 2013 build Altima ST auto models, new Pathfinder ST 2WD auto models, 370z Coupe manual models ordered and delivered between 1/7/14 and 30/9/14. Nissan reserves the right to vary, extend or withdraw this offer. Not available in conjunction with any other offer. All other offers end 30/9/14. ^To Approved Purchasers. MD20305 YPA4621 ONLY 4 MINS FROM PROSPECT HWY TURN OFF ON THE M4

NISSAN

02 8884 4477 | 37 Blacktown Road | Blacktown www.landernissan.com.au

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