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THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION
VOLUME 71 No.10 NOVEMBER 2014
Value the people caring for people. OLDER WORKERS HARDEST HIT CARING VERSUS PROFIT PHONEY WORKCOVER CRISIS Print Post Approved: PP100007890
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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.10 NOVEMBER 2014
Hunter Office 8-14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258
COVER STORY
12 | Short staffing key issue at Ramsay The campaign for improved pay and conditions at Ramsay Health Care is under way after extensive consultation with members. Olga Aleshin RN, St George Private Hospital and Maxine Luke EN, Westmead Private PHOTOGRAPH: SHARON HICKEY
REGULARS
5 6 8 35 37 41 43 45 46 50
Editorial Your letters News in brief Ask Judith Social media Crossword Nursing research online Books Movies of the month Diary dates
PRIVATISATION
22 | Port Macquarie’s privatisation debacle
PRIVATISATION
21 | Thank Medicare for little Jack
For Annie Butler, the birth of grandson Jack brought home the importance of Medicare.
WORKCOVER
26| Compo ordeal began with assault
A vicious attack set off a trek though the harsh NSW workers compensation system for nurse Karen Archer.
COMPETITION
10 | Win a free pair of Propét shoes
LIFESTYLE
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.
28 | Amazing win for male nurses
It’s about the adventure, it’s about the challenge, for Daniel Little and Ryan Thomas. THE LAMP NOVEMBER 2014 | 3
RECRUIT A NEW MEMBER & GO IN THE DRAW TO VISIT
NSWNMA is pleased to announce the NSWNMA’s 2014 – 2015 Recruitment Incentive Scheme Travel Prize
THE WINNER AND A FRIEND WILL BE FLYING OFF TO BEAUTIFUL VANUATU! The prize consists of airfares for two (ex-Sydney) to Vanuatu, staying 5 days in a luxurious 4-star hotel with breakfast each day, a pampering package, champagne and chocolates on arrival. Every member you sign up over the year gives you a ticket in the draw! RECRUITERS NOTE: Nurses and midwives can now join online at
www.nswnma.asn.au! If you refer a new member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entitled to your vouchers and draw/s in the NSWNMA Recruitment Incentive Scheme.
PRIZE DRAWN
30 JUNE 2015
Photograph: Vanuatu Tourism. Authorised by B.Holmes, General Secretary, NSWNMA
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EDITORIAL BY BRETT HOLMES GENERAL SECRETARY
Value the people caring for people Ramsay Health Care has an opportunity in its current enterprise agreement negotiation to reward the nurses and midwives who have been central to its rise to become one of the most successful private health operators in the world.
“I urge nurses and midwives working for Ramsay to join our campaign to improve working conditions, particularly staffing and pay.”
Ramsay Health Care’s motto as espoused by its CEO Chris Rex is “people caring for people”. It is a co-option of the ethos of nursing and midwifery with its implied altruism, humanism and clinical professionalism. This Ramsay Way – “doing the right thing” as Chris Rex also describes it – has been spectacularly successful, with the company recognised as one of the blue chip investments of the Australian sharemarket. It is now one of the top five private health providers in the world. It recently bought the largest private health provider in France, Générale de Santé and has ambitions to be a player in the emerging Chinese market. Its Australian base is forever growing. Its capacity in existing services is relentlessly expanding and there is planned diversification into new services such as private emergency departments. It is one of the private companies ready to pounce on any privatisation of public hospitals and health services. Its ownership and management of the Joondalup Health campus in Perth is touted as the model for all future privatisation. It is one of two contenders for the proposed privatised Northern Beaches hospital in Sydney. It has announced to the shareholders that it expects to make future profits from government privatisation plans. By its own analysis Ramsay’s future is rosy, underpinned by favourable population demographics. The company anticipates strong profit growth over the next 30 years as the “so called baby boomers pass through their health care demanding years” (see story page 18). In short, Ramsay is a highly profitable company in robust health, which places the
company in a strong position to resolve issues raised by our members in their claim for a new enterprise agreement. The NSWNMA has consulted widely with our members working for Ramsay, through face-to-face contact and quantitative and qualitative research done over several months. Our members are crystal clear that Ramsay needs to significantly improve staffing if the high level of patient care that the company is proud of is to be maintained. They tell us that more staff, a better skill mix, more support for beginning practitioners and access to breaks are essential to deliver safe patient care. They also quite reasonably believe that Ramsay can afford to give them a fair pay increase to bridge the pay gap with other private health employers and the public sector. Nurses and midwives deserve to be recognised for their role in Ramsay’s outstanding commercial success, success that has been built on the professionalism and quality of care they provide. I urge nurses and midwives working for Ramsay to join our campaign to improve working conditions, particularly staffing and pay. Our experience in the public sector has shown that if we join together and fight we can achieve great outcomes for patients and staff alike. And there is a convincing argument to be made that a private company like Ramsay, whose financial success is linked to the quality of care it provides, will benefit from “doing the right thing” by its nurses and midwives.
THE LAMP NOVEMBER 2014 | 5
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YOUR LETTERS
L ET T ER OF T H E M ONT H
Why we need penalty rates This letter was sent to Liberal Democrat Senator David Leyonhjelm and is republished in The Lamp. Dear Senator Leyonhjelm, Interesting that you think the minimum wage is so high! How do you think you would go trying to raise a family, pay a mortgage (or even save enough for a deposit), pay for a car, etc. on the minimum wage? I know I wouldn’t like to be trying – nor is it something I would want for my children. I like your quoting of figures and percentages comparing our minimum wage to other countries around the world. Shouldn’t you be proud of the fact that in Australia we do get a decent pay for a decent day’s work? Shouldn’t we be trying to share our prosperity around instead of benchmarking against other countries’ minimum wages? Wouldn’t it be better if Australia led the way in making the wealthy corporations pay their way and share the wealth we have on offer, instead of widening the gap between rich and poor as you propose? Thousands of people would love to work – for a decent wage, not for a few dollars more than they could get on the dole. How would you like to work for $20 an hour? Seems like you are on the side of big business that would love to employ people for less and make them work any hour or day of the week for the same rate of pay. How about their family life? Or are bigger profits for big business all that matter to you? How long do you think people would stay on a below-minimum wage before they realised they were better off on the dole with rent assistance, a health care card, subsidised child care etc and then maybe having to pay for childcare at a higher rate than what they would be earning? If you back this legislation [changes to the Fair Work Act] you will be responsible for creating a whole new class of underdog. I do not look forward to an Australia like this for my kids or anyone else if this bill goes ahead. I hope that voters in New South Wales turn out in force at the next election to show you how much this bill will be disliked by the average Australian, if it gets through parliament. Shaen Springall RN, Goonellabah 6 | THE LAMP NOVEMBER 2014
Amazing nurses run a great race Recently Daniel Little and Ryan Thomas appeared on The Amazing Race TV series. Both Daniel and Ryan are RNs and this was featured in the program. They went on to win. Congratulations to them. What they have also achieved is to promote nursing as a profession. They have shown the world that nurses can be adventurous people, not always a perceived nursing image in the general community. They have also inspired other nursing staff to think about life, adventure and possibilities and it’s been wonderful to follow them in the series. Well done to two fine nurses! Lynda Mitchell RN, Hunters Hill Workers compensation for ageing nurses It is a fact that our nursing population is ageing. Would you let me know what, if anything, the Association is doing regarding workers compensation for this group of nursing staff? I am 65, working an 0.7 position in a mental health facility, and have reason to believe I am not covered by workers compensation if injured at work due to my age. I am no longer covered by my superannuation fund for income protection and have approached three insurance companies regarding this and their cut-off age is 60/65. Deanne Buckley RN, Mount Warrigal NSWNMA RESPONDS The retiring age refers to the age at which the person would, subject to satisfying any other qualifying requirements, be eligible to receive an age pension under the Commonwealth Social Security Act 1991. Currently the retirement age is 65. Workers compensation legislation in New South Wales refers to varying entitlements for injured workers up to, at and beyond retiring age. Currently, the legislation means that either: 1.Weekly workers compensation payments (make-up pay) for a worker who sustains a workplace injury at any time prior to reaching retirement age will cease on reaching retirement age (currently 65). 2.Weekly workers compensation payments for a worker who sustains a workplace injury at, or any time after retirement age will cease 12 months after the date of injury, or 3.Weekly workers compensation payments for a worker who sustained an injury before 1 October 2012 and within the 12 months prior to retirement age will have the same entitlements as those who were injured at or after retirement age. An injured worker’s entitlement to medical expenses would continue for a further 12 months after the weekly benefits have ceased. There is a significant disparity between these entitlements.Those workers who suffer a workplace injury less than 12 months prior to retirement age are significantly disadvantaged compared to those workers who suffer an injury on reaching retirement age or any time thereafter. The government has attempted to address this disparity but only to the extent as outlined in point three, above. This Association together with other NSW unions has highlighted this inequality and continues to lobby the current state government to address this disparity. In your case, if you were to sustain a work-related injury/illness and, given you have passed retirement age, you would be covered for weekly workers compensation payments for 12 months from the date of your injury and medical expenses would continue for a further 12 months thereafter. The cut-off period for income protection insurance generally reflects the Commonwealth retiring age. The Association is conscious of the fact that a significant number of nurses continue to work beyond retirement age and we, together with the broader union movement, continue to lobby the government to address this inequity.
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YOUR LETTERS
Thank you to the nursing profession The following letter was received from outgoing Governor of New South Wales Marie Bashir.The NSWNMA sent flowers on behalf of members to Professor Bashir to mark the end of her 13-year term as Governor. I was deeply touched when the truly magnificent sheath of flowers arrived at Government House a few days ago and I learned from the beautiful card that they had come from your Association. Thank you for this most gracious thought, which I shall never forget. As I have mentioned across the years, both informally and in formal speeches, so many of the members of the Australian nursing profession have influenced my life profoundly and I shall never cease to be grateful. Occasions which I shall never forget were the nights in labour ward, the evenings on midnight casualty and at all times sharing perspectives from the nursing and patient experience. I would indeed be grateful if you would convey to members of the Association my gratitude for all they do and for their gift of the glorious flowers. Warm regards and best wishes. Professor Dame Marie R Bashir AD CVO Governor of NSW Keep our Northern Beaches Hospital public A version of this letter was originally published in The Manly Daily. Being proud residents of the Northern Beaches we are entitled to a state-of-the-art new hospital to service the needs of our growing community. As a nurse and advocate for safe patient care I am very concerned the NSW government’s plan to privatise our Northern Beaches Hospital will result in inefficiencies, not better health outcomes for local residents and families. We have a robust public health system in NSW and it is worth fighting for. We must ensure every single person has equal access to quality public healthcare. The NSW government cannot continue to try and justify privatising our new hospital as a “sensible, costeffective” approach when clearly privatisation models are only established to benefit profitable private operators and their shareholders. Existing and past models do not have a proven track record for operating in the best interests of patients. We continue to call on the NSW government to reverse this decision and ask the local community to stand together and fight for the retention of quality public health services on the Northern Beaches now and into the future. Lyn Hopper, RN president NSWNMA Manly Hospital branch
letter of the
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Every letter published receives a $20 Coles Group & Myer gift card.
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.
Australian Nursing and Midwifery Federation NSW Branch
Financial Report The Australian Nursing and Midwifery Federation NSW Branch Financial Report for the year ended 30 June 2014 is available on the members’ only page at www.nswnma.asn.au. Members without internet access may obtain a hard copy of the report by applying in writing to: Brett Holmes, Branch Secretary Australian Nursing and Midwifery Federation, NSW Branch 50 O’Dea Avenue Waterloo NSW 2017
THE LAMP NOVEMBER 2014 | 7
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NEWS IN BRIEF
West Africa
Ebola wins while world dithers New modelling from the US Centers for Disease Control and Prevention (CDC) shows that reported cases of Ebola in Liberia are doubling every 15 to 20 days, while those in Sierra Leone are doubling every 30 to 40 days.
COUNTRIES WITH EBOLA CASES 1–10 11–100 101–500
Britain
If conditions continue without scale-up of interventions the number of cases in West Africa will rapidly reach extraordinary levels, says the CDC, which gives a worstcase scenario of 1.4 million cases by January 20, 2015. However, the findings also indicate that the epidemic can be controlled. As part of a prevention initiative local health workers in Uganda were trained to recognise the virus and stop it from spreading, meaning that a 2011 Ebola outbreak was stopped after just a single case. The New York Times newspaper described the current global response to the epidemic as “a gross failure”. “It’s a classic case where early action could have saved lives and money. Yet the world dithered,” it said. Joanne Liu, president of Doctors Without Borders, told a UN conference that the promised surge of support to combat the epidemic had not happened. “Pledges of aid and unprecedented UN resolutions are very welcome. But they will mean little, unless they are translated into immediate action,” she said. “Fear and panic have set in, as infection rates double every three weeks. “Mounting numbers are dying of other diseases like malaria, because health systems have collapsed. Today, Ebola is winning,” she said.
Australia
Poor care in privately-run NHS hospital
Health spending has fallen
Patients are being neglected, hygiene is inadequate and staffing problems are affecting care at the only NHS hospital run by a private company, according to a British health service watchdog. In 2012, Hinchingbrooke Hospital in Cambridgeshire became the first hospital in the NHS to be managed by a profit-making firm, when it was taken over by Circle under a 10-year contract worth about £1bn. About 160,000 patients a year are treated at the hospital. Examples of poor care provided to patients found by the Care Quality Commission (CQC), an independent health care regulator in Britain, were: The use of sedation without best interest decisions in place. Very variable standards of hand washing among staff in the A&E department and some wards. Caring for patients in an “undignified and emotionally abusive manner”. In a scathing letter to the hospital’s chief executive Hisham AbdelRahman, the CQC said: “… we were also concerned as to the lack of recognition of the level of concerns when raised with yourself and the length of time taken to grasp the seriousness of the situation for patients.” The letter, which was quoted in the Guardian added: “… there were also concerns that the current culture within the organisation does not lend itself to enable concerns, particularly related to nursing and caring issues, to be easily raised. The response seen and otherwise noted suggested a blame approach, rather than that of a supportive and patient-focused approach.”
Despite claims by the Abbott government that health spending is out of control and unsustainable, new figures show that health spending has grown at its slowest rate in 30 years. Figures released by the Australian Institute of Health and Welfare (AIHW) show that expenditure on health reached $147.4 billion in 2012/13, up 1.5 per cent from the previous year. As a percentage of GDP, spending came to 9.67 per cent in 2012/13, up from 9.55 per cent in the previous year. “This is the lowest growth the AIHW has recorded since it began the Health Expenditure Australia series in the mid-1980s,” AIHW director David Kalisch said. The average annual growth over the past decade was 5.1 per cent. On average $6430 was spent on the health needs of every Australian each year – $17 less per person than in the previous year. The report shows government spending on health overall fell by 0.9 per cent in 2012/13, largely as a result of a 2.4 per cent drop in federal government funding. The main reason for the decrease in government spending was reductions in spending on the Pharmaceutical Benefits Scheme, public health, dental services and e-health.
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8 | THE LAMP NOVEMBER 2014
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NEWS IN BRIEF
Germany
Anti-stress law under consideration The German government has commissioned an in depth study into work-related stress and its economic costs with a view to implementing an “anti stress” law proposed by the German metalworkers union. The union’s draft law includes a demand that employees be protected from being “permanently reachable by modern means of communication” such as email or mobile phone, according to the Guardian. According to a recent study by German psychotherapists, psychological illness is to blame for 14 per cent of missed working days in Germany – a 50 per cent increase in 12 years. Every second early retirement is caused by psychological illness. Another recent EU-wide study claimed that Germans worked an average of 2.8 hours of unpaid overtime a week, more than any country on the continent, except Greece. Several European countries, including Austria, Denmark and the Netherlands, already legally oblige employers to assess workplaces for the risk of psychological stress. Austria introduced an anti-stress law in January 2013, requiring all employers to have their workplace environment and atmosphere assessed for stress factors by an occupational psychologist. Conditions such as working hours and intrusion into private lives are likely to be included in an assessment. Belgium and the Netherlands recently moved to explicitly list burnout as one of the health risks from which employers are obliged to protect their workers.
The draft law demands that employees be protected from being permanently reachable by modern means of communication.
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. THE LAMP NOVEMBER 2014 | 9
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NEWS IN BRIEF
COMPETITIO ON
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Five (more) reasons against a GP co-payment Stephen Leeder, editor-in-chief of the Medical Journal of Australia, argues in the online blog Croakey that there are five particular reasons not to impose a GP co-payment.
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First, the co-pays on prescription drugs stop poorer people from accessing them. Ask GPs. Extending co-pays to general practice compounds rather than solves this problem. Second, seeing a doctor for a health worry is different to filling a script. A consultation with a doctor may dissipate the worry without further cost or action. Third, a timely, uninhibited consultation for the first symptom – chest pain, let’s say – of a serious problem, may save a life and nip the progress of a disabling illness. Co-payments diminish easy access for less affluent Australians to general practice. Fourth, a consultation may lead to preventive changes – quitting smoking, behaviour modification, stopping unnecessary medications – that are positive investments, not sunk costs. Co-pays that inhibit preventive consultations diminish the chance of a healthy life. Fifth, many GPs in poorer parts of the country who bulkbill, do not have the financial systems to raise fees. The logistics of collecting and remitting a co-payment could drive them out of business. In August, finance minister Mathias Cormann suggested that supporting a co-payment on pharmaceuticals but not on GP visits was “irrational”. “Maybe the co-pays on pharmaceuticals are a public policy error that permits gouging of pharmaceutical prices and diminishes the search for efficiency in drug supply. Rather than asking where else we can impose a co-payment, the question should be, we don’t have copayments on general practitioner bulk-billed consultations, so why should we have them on prescribed pharmaceuticals?” replied Stephen Leeder.
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NEWS IN BRIEF
Britain Australia
Care workers strike over reduced pay
Tunnel project threat to public health
Fifty carers for people with disabilities took strike action for more than seven weeks after their employer — Care UK — took over an NHS service and reduced pay by up to 35 per cent. The privatisation of services for the disabled in Britain is a cautionary lesson for New South Wales with the proposed privatisation of Ageing, Disability and Home Care (ADHC) services here. According to the Guardian, Care UK, whose former chairman Lord Nash is now a government minister, took over services for people with severe learning disabilities in Doncaster, South Yorkshire, this year, cutting the wages of staff who had been on NHS terms and bringing in 100 new workers on £7 an hour. Care UK reports in its latest accounts that public funds accounted for 88 per cent of the company’s revenues in the year ending September 2013.Yet it also admits to using “tax-efficient” financial structures involving the Channel Islands. Care UK has not paid a penny in corporation tax since the private equity firm Bridgepoint Capital bought it in 2010. Dave Prentis general secretary at Unison, the public sector union organising the strike, said: “Damaging government policies are starving local councils of the funding needed to deliver vital local services. The dispute with Care UK is a result of Doncaster council’s cost-cutting contract and private-sector greed. The result is damaging the service to vulnerable people and hitting the pay and conditions of the workforce, leaving them struggling to make ends meet.”
The Public Health Association of Australia (PHAA) is urging the New South Wales government to carefully evaluate the proposed NorthConnex tunnel project in Sydney, to reduce serious potential health risks stemming from the current design. “While PHAA supports efforts to reduce the impact of heavy freight transport vehicles and their emissions on Pennant Hills Road, we are concerned that the NorthConnex tunnel will produce unfiltered emissions in residentially dense areas of Sydney. These emissions have the potential to threaten the health of school children, the elderly, patients in hospitals and other residents,” Dr Peter Tait, convener of PHAA’s Ecology and Environment Special Interest Group said.
China
The mental illness stigma
“The tunnel is being designed as an infrastructure link for heavy freight transport vehicles that will emit concentrated diesel emissions: these emissions have been classified by the World Health Organisation as cancer causing. “The planned emission stacks for the NorthConnex project are currently sited in valley locations in residential areas, where it is likely that concentrated emissions will not disperse well. There is no proposal for filtration. These stacks will therefore expose large populations to emissions.” PHAA has recommended to the NSW government that it consider alternatives to the current design, including relocation of emission stacks to non-residential areas and incorporation of a well-designed filtration system.
Stigma and shame still feature highly in attitudes towards mental illness among the Chinese public, including family members of patients, according to a survey conducted by one of the country’s leading psychiatric hospitals. The survey was conducted at Guangzhou Psychiatric hospital, one of China’s largest. Researchers surveyed 87 doctors and 162 nurses, 137 family members of people with mental illness, and 150 members of the public. According to China Medical News they found that medical staff tended to have enlightened views about mental illness – that it has biopsychosocial causes and may best be dealt with incommunity treatment. However relatives of patients and the public tended to hold the traditional view that mental illness was something that should be treated in institutions and that patients do not belong in the community. There was also support for involuntary treatment of mental illness. In rural areas there were superstitious beliefs that mental illness might be caused by curses, devils or bad luck. The researchers said the negative attitudes held by family members might arise because they lived in close proximity to people with mental illness and had to cope with them in isolation, as there was little community or health service support for mental illness. “Families shoulder much of the burden of mental illness alone,” they wrote. The findings support provision of respite care for mentally ill people in China “that gives family members some distance from the problems of their relatives and support in their care.” THE LAMP NOVEMBER 2014 | 11
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COVER STORY
Short staffing key issue at Ramsay The campaign for improved pay and conditions at Ramsay Health Care is under way after extensive consultation with members.
NSWNMA General Secretary Brett Holmes said the most common issue raised by Ramsay nurses and midwives, during the extensive consultation that preceded on the the compilation of the log of Members have now voted ay ms Ra the for s claims, was short staffing and im cla of log ment. ree ag skill mix. se pri ter en re Ca h Healt for “Ramsay is a highly profite bs we Check the NSWMNA itable company and members s. im cla of t a comprehensive lis were clear that strong profits www.nswnma.asn.au should be matched by staffing levels that don’t cause nurses and midwives to be overstretched on flat out shifts,” he said. “Members also said they want a fair pay increase to be on par with As The Lamp went to print talks to other leading private hospitals and negotiate a new agreement to imto keep up with the cost of living. prove the pay and conditions of The campaign committee believes nurses and midwives were about to that a five per cent per annum pay begin between the NSWNMA and claim is fair.” management at Ramsay Health A NSWNMA survey with a Care. very strong statistical sample found This followed an overwhelming that the key issues for Ramsay vote in favour of a log of claims nurses and midwives were: that contains claims for fairer staffing Staffing that delivers safe and a five per cent per annum pay patient care including staffing increase. numbers, skill mix, support for
S TO P P R E S S
•
beginning practitioners and access to breaks. Fair and safe rostering practices including an eight-hour break after being recalled to work, before working another shift; a heavy reliance on “on call” to complete duties; and pressure from management to swap shifts during quiet periods. Reasonable access to professional development. Brett Holmes says nurses and midwives deserve praise for their role in Ramsay Health Care’s outstanding commercial success. “Ramsay is one of the most successful companies in Australia and critical to that success has been the high quality of care provided through the impeccable professionalism of their nurses and midwives,” he said. “If Ramsay is to maintain its leading market position management must recognise the need to reinvest some of their profits in meeting appropriate staffing levels and paying their staff fairly.”
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“Ramsay is one of the most successful companies in Australia and critical to that [is the] … impeccable professionalism of nurses and midwives.” — Brett Holmes, NSWNMA General Secretary
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Olga Aleshin RN, St George Private Hospital with Maxine Luke EN, Westmead Private
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COVER STORY
Understaffing puts strain on all Olga Aleshin RN St George Private Hospital maternity ward “The main objective of this campaign is to improve staffing at Ramsay. When we have too few nurses on duty, the workload is heavy and stress levels are very high. All the nurses and midwives I work with care about our patients and our managers try their best to manage workloads. With adequate staffing we all feel very satisfied at the end of the shift, because we feel we’ve had time to talk to our patients and help with their emotional needs as well as their medical and clinical needs. When we are understaffed it really does put a strain on everyone, though we all work hard to maintain a positive attitude. We make sure that we prioritise the patients who need the most care but sometimes it feels difficult to provide the full, holistic care patients require. Education should also be prioritised to enable nurses to be kept up to date with the latest policies and developments in nursing and midwifery. Our educators try their best with the resources they have. Customer service is also an important aspect of the nursing and midwifery field. Every patient should feel they are looked after and safe. It is important for the success of any business to make sure of this so that we can give the customers the sort of care they expect. During the discussions on the new enterprise agreement I’ve heard that private hospitals around Australia are improving pay rates and Ramsay are in a good position to follow suit. The Lamp seems to have less information about private hospitals compared to its coverage of the public sector. The private sector should not be overlooked. It’s important that the union continues to inform and encourage members in the private health sector to actively participate in discussions about the new agreement. I hope the company appreciates that we all try our best and will respect our desire to provide safe patient care to everyone.”
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“EVERY PATIENT SHOULD FEEL THEY ARE LOOKED AFTER AND SAFE.”
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Key elements of the Ramsay claim FAIR STAFFING LEVELS
• • • • •
Implementation of key ACORN standards in operating theatres. Regular discussions about workloads at ward/unit/team meetings. Nurse/midwife in charge to be supernumerary to clinical nursing /midwifery numbers at all times. Babies to be included in patient numbers for determining staffing. Improved access to mentoring, support and education for beginning practitioners.
BALANCING LIFE AND WORK
• • • • • •
Night shift should not precede days off unless eight-hour sleep time provided. Roster to be displayed in a convenient place for all. No time limit on when employees can arrange a shift swap. Roster changes to occur by agreement. Long service leave accrual to increase to two weeks per annum after 10 years. Improved paid parental leave of 26 weeks and two weeks partner leave.
RECOGNISING EDUCATION, SKILLS, EXPERIENCE
• • • •
Five per cent increase to wage and allowances for each year of the agreement, commencing 1 January 2015. Incremental pay progression to occur automatically following each 1976 hours of experience. Improved incremental classification structure for CNSs, CNEs and CNCs. Access to five days paid study and Continuing Professional Development leave per year.
A SAFE WORKPLACE
• • •
Consecutive eight-hour break after being recalled to work or payment for the next shift at double time. A limit to the number of quick shifts in a seven-day period. Adequate meal breaks and rest pauses for all time worked including overtime. THE LAMP NOVEMBER 2014 | 15
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COVER STORY
Profit motive cranks up pressure The drive for profitability at Ramsay Health Care is intense, it puts pressure on staffing levels and, according to a comprehensive NSWNMA survey, it’s nurses and midwives who suffer. We are familiar with how public sector budget pressures continually force nurses and midwives to do more with less, but NSWNMA research shows that similar pressures in the private sector are cranking up stress levels. Phrases such as “non stop” “overwhelming” “no quiet days” and “missing breaks” were a constant refrain from Ramsay nurses and midwives asked about the pressures of their job. The search for profit and efficiency was consistently cited as a driver of understaffing and workload stress. “The public system is pressured by funding cuts. We are pressured in exactly the same way but by the profit motive,” said one respondent. Many said that management expected them to just deal with these extra pressures. “If you can’t handle the workload you’re considered to have a time management problem,” said one nurse. Staffing is seen as the number one issue. Respondents consistently said there were not enough staff members; that rosters didn’t allow for something going wrong; and that there was not enough back up. “I am overstretched” “rushing from patient to patient” and the “whole shift is non-stop” were other frequent refrains. Patient safety was a constant concern. “They wonder why there are falls,” said one nurse. “We are on the limit,” said another. Poor roster practices were seen as adding extra stress on nurses and midwives. Respondents said staff were moved around a lot, often at the whim of the doctors and there were not long enough breaks between shifts. The lack of staff meant there was limited time with patients and less care, patients were being rushed out and many feared the rushed environment could lead to mistakes or falls.
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Better staffing a priority Maxine Luke EN Westmead Private theatres “Nurses at Westmead Private have had two meetings about the upcoming enterprise agreement negotiations. More nurses seem to be getting involved in discussions about the agreement this time around. There seems to be a general view that achieving better staffing should be given priority in the agreement. Unlike the public health system we don’t have ratios written into our agreement. In theatres when there’s a shortfall, because someone is sick for example, staff are often asked to work overtime to fill the gap. It happens quite a bit and nurses are getting tired and burnt out as a result. We need to focus on ensuring a reasonable workload, patient safety and making sure there are enough people to do the job without putting undue stress on staff. Having one extra nurse on the roster would give people time to have breaks they would otherwise miss such as morning tea or lunch. Of course it costs money to put someone on for a short shift to cover breaks and make sure nurses can take time for morning tea and lunch. However it also costs money to pay overtime at time-and-a-half or double time. Availability of rosters is another issue. I’m fortunate because I always work the same roster, but nurses generally need to see rosters further in advance so they get enough notice of their shifts.”
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What Ramsay nurses and midwives had to say “Working in a private hospital, clients expect more from you as they feel they are paying for it, plus they assume you are being paid more than public hospital nurses. They are always shocked when you point out that you are actually paid less.” “Improved wages, staffing levels and benefits will help keep staff in the private environment.” “The present agreement regarding a manageable workload is totally ignored by Ramsay management. There are often late roster changes directed at junior staff or vulnerable AiNs. Staff are pressured to take annual leave if the ward is quiet. If more staff are requested we are told ‘the budget does not allow this’ and staff will be incredibly busy and stressed.” “The workloads we are working at now are totally unsustainable. Management is more interested in money rather than staff issues. I feel they have a ‘there is the front door attitude’ and you either you put up or shut up.”
“HAVING ONE EXTRA NURSE ON THE ROSTER WOULD GIVE PEOPLE TIME TO HAVE BREAKS THEY WOULD OTHERWISE MISS.”
“I want to learn as a new nurse but no one has the time to help. So I would love to see improvements made to the wards in our hospital in relation to staffing.” “The present ratios don’t allow us enough time to spend with patients. In mental health this is really important. We often just seem to be there to give out medications and manage doctors’ rounds.” “Ramsay say they are a familyfriendly business but have fallen short of this in our hospital at times, which is saddening as it has the potential to be a great workplace.”
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COVER STORY
Caring nature translated to profit Ramsay Health Care is a fantastically profitable blue chip Australian company with enviable prospects — well capable of paying its employees fairly and staffing its hospitals appropriately. In a recent interview, respected financial commentator Alan Kohler introduced Ramsay CEO Chris Rex with a glowing appraisal of the company’s economic performance in the past decade: “Ramsay has been a wonderful investment for those willing to stick with it over the past 10 years – compound annual growth rate of 24 per cent, since you took over a few years ago, 27 per cent, and since 2012 the stock has tripled. A fantastic performance. And now you are the biggest private hospital operator in France,” he said. Ramsay recently became the largest private health provider in France when it purchased Générale de Santé with its 115 facilities and 15 per cent of that market. Chris Rex told Kohler there were four pillars to Ramsay’s impressive growth and its rosy future prospects: “What has driven growth over the past 10 years will drive growth over the next 10, 20 even 30 years. It is really the demographic change that is taking place in most countries around the world. The so-called baby boomers [will] pass through their health care demanding years over the next 30 years or so. There is an inexorable demand curve that goes up every year.” “Reinvesting – in Australia alone we are spending around $200 million a year adding to capacity, adding operating theatres, adding beds, adding various consulting suites, whatever, in order to facilitate that organic growth.” “The developing economies [around the world] largely have publically paid and publically provided health care services. They are starting to look at their ability to maintain that kind of system given the demands that the ageing population will bring and are increasingly looking to get the private sector to be more and more involved and that again is certainly what we have
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taken advantage of – not taken advantage of, that’s not the correct word – but being involved in an increasing way over the past 10 years or so and I see that inevitably growing over the next 10 or 20 years.” “And the final part is acquisitions. Over the past 10 or 15 years we’ve made a number of, hopefully, successful acquisitions. We’ve just made another large one in the past couple of months. I can see us continuing to acquire other businesses, not just in our existing markets but, as I described before, hopefully in new markets over the next 10 years or so as well.
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PEOPLE CARING FOR PEOPLE Chris Rex says that central to the company’s success is a corporate philosophy – the Ramsay Way – “which I think captures the drive, the enthusiasm and also the caring nature of the people who work in the health care sector. That has been the backbone of not just what we’ve done but also how we’ve done it.” He went on to describe this philosophy as “about doing the right thing. Our motto, if you like, is ‘people caring for people’. We care for patients obviously and it’s incredibly important for a healthcare business to be obsessive about maintaining high quality care for patients, but equally we care for our people, the people who make this company great. “When people actually see managers within the organisation, board members or the chairman clearly exhibit those behavioural traits, everybody sees a company they believe as having the same values as those working at the bedside or any other part of the hospital. It’s a very dynamic process but one that requires a lot of human interaction to believe in the things that we espouse.”
A highly profitable company
Health Care runs 69 • Ramsay private hospitals and more than
• • • •
80 day surgery facilities in Australia. The company posted a net profit of $303.7 million in the financial year just ended, a 14% increase on the previous year. Revenue for the same period was $4.91 billion, a 17.6 % increase on the previous year. Ramsay’s Australian and Asian business grew by 10.5%. Ramsay forecasts profit growth of between 14% and 16% in the next financial year.
A global behemoth in private health
Health Care operates 151 • Ramsay hospitals and day surgery
• •
facilities across Australia, the UK, France and Asia. With its recent French acquisition Ramsay became one of the top five private hospital operators in the world. Ramsay has just bought France’s leading private healthcare company, Générale de Santé, with 75 centres and 19,000 employees. The French arm has annual revenue of 1.7 billion euros ($A2.46 billion).
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Short staffing takes its toll Janette Meakin RN Figtree Private Hospital ICU and NSWNMA branch secretary “In this enterprise agreement the big issue for me is improving staffing. The number of staff you have affects the emotional wellbeing and safety of both staff and patients. Figtree staff all work really hard but when you’re time poor, mistakes can be made. If nurses do not have enough time to take their breaks they can’t look after themselves and their patients as well as they would like. That eventually takes its toll on staff health and morale. Improved staffing levels would have flow on benefits across the board – including for the hospital’s budget. Inadequate staffing might look like a cost saver in the short term but in the long term it hurts the business. When nurses get so busy and stressed that they get sick it costs the company more, because it has to pay overtime and find relief staff. We have to work together with the company to find some happy medium and come to an agreement for everyone’s benefit. In the current enterprise negotiations I think the union is making as powerful a case as it can. It would make it easier if more people joined the union and we had a stronger collective voice.”
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NORTHERN BEACHES HOSPITAL PRIVATISATION FORUM
Money to be made from the sick and dying When profits are put before health, care will suffer and patients will pay more said NSWNMA General Secretary Brett Holmes at a recent community meeting. THE PRIVATE SECTOR HAS A ROLE AS AN alternative choice for the provision of health care; however its expansion must not be at the expense of publicly provided services available to all. And that is what is at stake. Which public services will be compromised in order to ensure that private corporations continue to make a profit? We currently have mandated nurseto-patient ratios in our metropolitan and larger regional hospitals.We know for a fact that neither of the private operators who are shortlisted for the Northern Beaches Hospital project will commit to ratios. Even our members who work for these private corporations give us feedback that making a profit is the top priority. And believe me there is a lot of profit to be made out of the sick and dying. You need only look to the United States. They have a health system predominately run by for-profit corporations with a safety net for the very poor and the aged. They have one of the most expensive health systems in the world, with some of the worst health outcomes internationally. The successful corporation chosen for the Northern Beaches Hospital will be locked into a 20-year contract with the state. Similar public-private partnership agreements in the past haven’t even made it that long before the states had to buy them back due to mismanagement. Research indicates that more than half of these projects fail. What then is the justification to hand over
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two highly regarded public hospitals to a single private operator? Profits of course. Where do these profits go in a privatised system? They go to the private operator who ultimately decides how the money is spent.The private operator reports to its shareholders about these funds, not to the government, or to you the taxpayers. The head of Medibank Private has stated that he thinks patients with private insurance should be given priority above public patients without insurance, for emergency services. In a privatised hospital, which can offer both private and public EDs, this is like money for jam. Next thing you know, the insurance companies will be deciding who pays and who doesn’t, what should be included and what shouldn’t – just like the managed-care system in the US. As individuals we are spending more on health; this is a real hit to the hip pocket. Soon we could be in the position of having to make the same difficult choices that people make in America; foregoing care for ourselves in order to provide for our children. It is the Association’s belief that profiting from publicly funded money, and reliance on private health and insurance, will be a recipe for disaster and will only lead to strife and a further hit on our personal hip pockets. It’s our belief that we can deliver health at a high standard without the profit motive. Don’t let them Americanise our health system.
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Thank Medicare for little Jack For Annie Butler, assistant federal secretary of the Australian Nursing and Midwifery Federation, the birth of grandson Jack brought home the importance of Medicare.
Annie, her daughter and little Jack
LITTLE JACK’S MUM, MY DAUGHTER, IS A TYPE 1 diabetic – this means she has the
sort of system that most Americans have to deal with. We simply could not have afforded the range of treatments needed for my daughter to stay healthy and to have a healthy baby.We could not have afforded the private health insurance that would have been needed. Because they are profit driven, private health insurance companies are tempted to ‘cherry pick’ meaning people like my daughter, with a chronic condition, have to pay more or have their treatment options restricted because their condition can make them more costly to insure. This is why the issue of a GP co-payment is so very important. It’s not about the amount: it’s because it will be mandatory and because private health insurance companies will be allowed to offer coverage for services they have not been allowed to cover before. They will be able to control who gets care and who doesn’t, just as happens in America, not based on what care you need but what care you can afford.
type of diabetes that usually starts in childhood and requires lifelong therapy. She needs several insulin injections every day to stay alive. But with guidance and oversight from expert health professionals she can lead a full and healthy life. And, because we live in Australia, this is what she does. She was diagnosed when she was 10. This meant an initial hospitalisation and ongoing care through the diabetes centre at the Children’s Hospital at Westmead. We could not have asked for better care. She had access to experts: doctors, dietitians and the incredibly important, diabetes educators. When she turned 18 her care was transferred to the adult centre, with access to the same support and still, most critically, the diabetes educators. In between she needed to see the GP for referrals, scripts and of course have ongoing blood tests and pharmacy visits for her insulin and supplies. Because of her access to all this care
her condition has been stable and she has remained well. Partly due to her chronic condition she wanted to have a baby early, while she was fit and young. Pregnancy can be a risky business for type 1 diabetics, but my daughter had access to all the expert care she needed: specialists, doctors, diabetes educators and the truly magnificent midwives. The birth was tough, she needed expert help and the little fella needed some prompting to get going in this big world – but when needed the care was extraordinary and seamless. Through all of this we have never been asked do you have insurance? Or how much money do you have? Not once. We have only ever been asked – what’s wrong? What’s your condition? What care do you need? We have only ever used Medicare. And it’s only now that I really understand what this means and how much I have to thank simply for being Australian. This care would not have been available to us in a private health system, the
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NORTHERN BEACHES HOSPITAL PRIVATISATION FORUM
Port Macquarie’s privatisation debacle CNS Lynda Binskin experienced the failed privatisation of Port Macquarie Base Hospital. Here she tells a cautionary tale with relevance to the new Northern Beaches hospital.
T W E N T Y Y E A R S A G O T H E P O RT Macquarie Base Hospital opened. New hospitals open every now and again but this time it was different. This was a hospital owned and operated by a private consortium that had been contracted to care for public patients. Port Macquarie base remained under private operation for more than 10 years and that time was bad for patients, bad for the community and bad for the staff that worked there. Originally a brand new, publicly-owned and operated hospital was promised to the people of Port Macquarie: $4 million dollars was spent in the planning. Somewhere along the line the Liberal/National government decided that 22 | THE LAMP NOVEMBER 2014
“The Port Macquarie privatisation experiment was bad for everyone. The people of the Northern Beaches have a lot to be worried about.”
the public model was too expensive and a public private partnership was decided on. The community was galvanised into action. There were public meetings and marches. Busloads of people made the trip to Macquarie Street to try to change the government’s mind.The local council held a referendum that delivered a strong ‘No’ vote against privatisation. But all to no avail.A steering committee was formed and tenders were called. Before the community knew it, Health Care of Australia was announced as the private operator. Service agreements and contracts began to be negotiated. There seemed to be lots of wheeling and dealing behind closed doors and the public was never sure of the
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“Less than seven years after the privatised hospital opened its doors things really began to unravel.” — Lynda Binskin Northern Beaches hospitals forum
details due to commercial sensitivity or commercial-in-confidence. Plenty of promises were made by the government of the day and there was a huge publicity campaign to reassure the community. We were told we would receive a state-of-the-art hospital.The people of Port Macquarie were told that there would be safeguards in place. There would be a reporting system and clinical indicators such as pressure sores, medication errors and surgical wound infections would be monitored. An independent board was set up to oversee the operation of the hospital. Problems became apparent early on. The structure was not built to Australian hospital standards, which meant smaller rooms, narrow corridors and fixtures that could be removed and used as weapons. The hospital leaked atrociously and there were ongoing issues with the air conditioning. But structural issues were not the only problem. From the outset it was clear that profit was the driving force behind the privatised model. Staff members were indoctrinated into the structure of the parent company, Mayne Nickless, and advised how important it was to keep the shareholders happy. This was a shock to nurses and midwives who are in the business of keeping patients happy, not shareholders. Hospital management had Key Performance Indicators to meet and these had to be communicated to head office in Melbourne every day. Over time, Health Care of Australia decided that registered nurses were too expensive to employ and a move was made to replace RNs with Assistants in Nursing. Nurses, midwives and the public protested and held meetings on the road adjacent to the hospital. There were photos of protesting nurses in the local paper and on TV.
Staffing was cut to the bone and it wasn’t just nurses and midwives who bore the brunt. Port Macquarie Base was a 160-bed facility, yet Health Care of Australia saw fit to employ only one social worker. Other allied health personnel such as physiotherapists and speech therapists were also thin on the ground. Less than seven years after the privatised hospital opened its doors things really began to unravel. The parent company underwent restructure with the operator changing names; Health Care of Australia became Mayne Health. CEOs came and went: six in seven years. The director of nursing left without explanation but with much speculation. Elective surgery waiting lists blew out to become among the worst in New South Wales. None of this was good for patient care or staff sanity. There was no accountability and no transparency.The independent board set up to oversee the operation of the hospital became more of an advisory body. What had happened to the pilot hospital that the rest of Australia was apparently looking to copy? It had been a dismal failure. In 2005 the hospital was bought back by the Labor state government. This was not a clear-cut process. Pathology and medical imaging remain under private operation, with their contracts requiring regular renegotiation and review. The hospital had major headaches renegotiating doctors’ contracts. The Port Macquarie privatisation experiment was bad for everyone. I believe the people of the Northern Beaches have a lot to be worried about. There needs to be clear accountability for the care of our public patients. Profits should never come before care. Health care in this country is a right not a privilege.
History of a privatisation farce In 1994 a Liberal/National coalition government led by Nick Greiner entered into a 20-year agreement with a private operator for the Port Macquarie Hospital to be built, owned and operated. The initial operator was Health Care of Australia, which was taken over by Mayne Health, which in turn sold its hospitals to Affinity Health. The state government took legal action against Mayne for breach of contract in relation to the proposed transfer of the hospital to Affinity. Under the privatisation contract the government paid the private operator to treat public patients. The NSW Department of Health had to pay a monthly “availability” charge to the hospital for a period of 20 years, estimated to total more than $243 million, plus capital servicing and other service charges. In 1996, the NSW auditor-general cited the hospital as an example of the public sector being left to shoulder burden and risk, saying: “The government is, in effect, paying for the hospital twice and giving it away.” Problems that plagued the Port Macquarie hospital under private ownership included funding for elective surgery running out before the end of the financial year and very long waiting lists for surgery. A Buy Us Back campaign run by a community-based action group and nurses and midwives lobbied strongly for a return to public ownership, which eventually happened in February 2005.
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PRIVATISATION
Peace of mind shattered by privatisation The state government’s announcement that Ageing Disability and Home Care (ADHC) will not provide disability services beyond 2018 came as an unwelcome bolt from the blue for Leonora Jackson.
FOR A TOTALLY DEPENDENT PERSON like Nicholas Jackson, a public choice in disability services is essential, says his mother Leonora. “I was petrified, really, really concerned. My first cynical thought was ‘here goes the government wiping its hands of its responsibility’,” she said. “I think government should be accountable and responsible for those people in our society who are least able to fend for themselves. I think that is how our society should function.” Leonora’s son Nicholas is a contented client of ADHC’s Grosvenor facility in Summer Hill. Nicholas has quadriplegic cerebral palsy and is totally dependent. “He has a peg feed, a urinary bag and he’s deaf and dumb but, as you can see by his face, he is able to socially interact very readily with people and his environment,” she said. IMPACT ON FAMILY Nicholas, the youngest of three children, has two older sisters. Leonora was his full-time carer before he entered Grosvenor at 22. “I became a single parent when Nicholas was 13 so I was on my own with Nicholas for nine years. It was so hard. “I used to feed him orally and do everything for him. I had to lift him into the wheelchair and onto the shower bed. I had to totally look after him in every respect. Taking him out was difficult, loading him into the van, making all the decisions that had to be made with all the issues that came up. “It was extremely difficult to maintain the family. Through government 24 | THE LAMP NOVEMBER 2014
assistance I was getting every third weekend respite. Then that stopped and I was getting every seventh weekend respite.This had consequences for the girls as I could only take them out when Nicholas was in respite. There was a lack of time I could focus on them because of the demands of care. “I found I had to wake up every two or three hours at night because he was groaning. He would need rolling. He was in discomfort. I had continually broken sleep. When he got older I couldn’t cope. I couldn’t physically or emotionally cope any longer,” she said. CARE AND STIMULATION Leonora can’t speak highly enough of the positive impact that life at Grosvenor has had on Nicholas and her whole family. “It has been brilliant. Nicholas is a very sociable being. When he came here to Grosvenor he was surrounded by all this activity – other clients and workers who had so much energy – whereas I was burnt out. I became refreshed so when I came to visit I was energised too,” she said. Leonora says the level of nursing care available at Grosvenor is critical. “For a person like Nicholas the nursing care is extremely important because he is what we call in the old terms a medical model client. He gets pressure sores – he can get them on his feet, his coccyx and his hands. Everywhere. “There is immediacy of care for him here.There is an RN on call 24/7. During the night they can monitor him. At the weekend he often goes out in a group with the other clients.
“There is peace of mind for me because I know he is cared for here. I can see he is liked by the staff. Nicholas, even though he is brain damaged, can indicate whether he is happy or unhappy, if he likes a staff member or doesn’t like a staff member. He is capable of flirting with staff members. When you come here you can see he is happy. It is just beautiful.” DOWN TO THE DOLLAR Leonora says she fears that shifting ADHC to the private sector, without the choice of a public provider, will have a detrimental effect on the care and services available to totally dependent clients like Nicholas. “I don’t believe the quality of the training of staff will be as good because of the cost factor. I think if an NGO gets [the contract] the staff will have to do things like cleaning. Nicholas won’t get the specialised support care that he really needs. “I fear an NGO won’t be able to afford the programs [that are available at Grosvenor] and clients will just sit in a wheelchair and watch TV. It’s not stimulating and not healthy for someone like Nicholas who still knows what is going on. “There are two occupational therapists who work here part time. They know the clients. They know Nicholas inside out. I feel with an NGO there won’t be that speed or access to specialists like OTs, dieticians, physiotherapists or even people who could fix up the wheelchair. “I’m fearful it will come down to the dollar.”
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“I THINK GOVERNMENT SHOULD BE ACCOUNTABLE AND RESPONSIBLE FOR THOSE PEOPLE IN OUR SOCIETY WHO ARE LEAST ABLE TO FEND FOR THEMSELVES.” — Leonora Jackson
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WORKCOVER
Compo ordeal began with assault A vicious attack set off a trek though the harsh New South Wales workers compensation system for nurse Karen Archer.
“I WOULDN’T HAVE MY JOB TODAY IF IT WASN’T FOR THE UNION.”
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KAREN ARCHER’S LIFE CHANGED WHEN she walked into her ward to find a man menacing another staff member and patients with a steel-capped boot. “I said ‘Oi, what are you doing?’ and he just dropped the boot and ran at me,” said Karen, who was nurse in charge when the attack happened in February 2010. The man charged Karen driving her across the corridor into a steel door surround. “Then he started kicking and punching me – I can’t remember much else,” she said. After a short period of disorientation and possible loss of consciousness, Karen was taken by wheelchair to ED where she was interviewed by police and seen by the house doctor on duty. She says she was not x-rayed or given a CT head scan. Despite being in shock she was allowed to drive home alone – a trip of more than an hour. Karen’s ribs were bruised externally and
of medical expenses until she reached retirement age. Karen’s back injuries triggered an “everyday headache” that has never gone away, along with regular migraines for two years after the assault. “Although the migraines are infrequent now, when they do occur they are debilitating. If I need time off work I have to use regular sick pay. “I have not had a headache–free day since February 2010 but I have learned to live with it.” She also suffered from depression and post-traumatic stress. Karen had six months off work with weekly compensation payments equivalent to an average of her income for the two years before the attack. After six months WorkCover told Karen she had to return to work or lose more money. She was assessed as fit for light duties on restricted hours, though she
“I DON’T BELIEVE ANYONE WHO IS INJURED DOING THEIR JOB SHOULD BE TREATED LIKE A CRIMINAL.” she had excruciating back pain along with a whiplash-like injury to her neck. X-rays and MRI imaging later revealed fractured lower vertebrae and disk bulging and displacement in her upper cervical spine. For Karen the assault was the start of a four-year ordeal through the NSW workers compensation system. She was injured more than two years before the Liberal/National government slashed the scheme. But the 43-year-old single mother remains trapped by the government’s retrospective changes to the law. Her back injury and ongoing neurological symptoms have left her unable to cope with bedside nursing. She is on a temporary contract doing administrative work, but if she can’t continue to get work she will not receive compensation payments. She is no longer entitled to payment of medical expenses. Had the scheme not changed in 2012 she would have been entitled to weekly compensation payments and payment
was still receiving physiotherapy and taking large amounts of pain relief. She went back to work part time – three half-days per week – and received make-up pay from WorkCover to bring her weekly wage up to the same amount she received for the first six months. By April 2011 Karen was back at work full time, though still unable to perform clinical nursing duties or work overtime or do shift work. “I was doing audits on wards but as my hours increased they struggled to find me meaningful work.” In 2012 WorkCover advised Karen that because of the amendments to the law she would lose her entitlement to any workers compensation, including make-up pay, by August that year. In January 2014 the hospital administration threatened to withdraw suitable duties, which would have left Karen without a job. “That put incredible stress and pressure
on me, leading to increasing symptoms and more days off work,” she said. Karen believes the legislative changes and lack of educational and rollout support put the hospital personnel responsible for her case in a difficult situation. “Decisions were made that were extremely stressful and damaging to my healing process. But I do not blame my management or the people in WorkCover. I feel they are victims of these reforms as much as the injured worker.” The NSWNMA represented Karen at several meetings and “were left with no other option than to go into dispute with my employer. “I can’t fault the union – they gave me fantastic assistance,” she says. “I wouldn’t have my job today if it wasn’t for the union.” Karen believes she was fortunate to be injured before the law changed, because the first six months off work on compensation “were imperative to my healing. “Today if someone is injured they are not allowed to take this much time and the financial burdens are far greater. “I don’t believe anyone who is injured doing their job should be treated like a criminal and put in a financial state that will take them years to recover from. “My advice to any nurse is make sure you join the union and get income protection insurance. Do not rely on the workers compensation system.” Karen’s income remains more than $300 per week below her pre-injury rate and the workers comp changes mean she is no longer entitled to have that loss reimbursed. She also has to foot the bills for medical treatment and medicines. With full custody of three teenagers it has been a struggle to stretch her reduced income from one week to the next. “My injuries have affected my children emotionally and financially. They’ve also had to suffer because of what happened to me at work.” Karen doubts that the politicians responsible for cutting workers compensation thought about the impact of their reforms on workers and their families. “The politicians get good salaries and conditions.What grates on me is their lack of insight into ordinary people’s lives.” Karen says she currently has “wonderful support” from her hospital’s management where she remains on contract until June next year. THE LAMP NOVEMBER 2014 | 27
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WORKCOVER
Phoney WorkCover crisis Two years after the NSW Liberal/National government slashed the workers compensation scheme the verdict is in: the cuts were not only harsh — they were unnecessary. The government can clearly afford to reverse its unfair changes. IN 2012 THE STATE GOVERNMENT SHIFTED the financial burden of workplace injury and illness onto injured workers and their families, when it claimed its WorkCover compensation scheme was in deep financial crisis. All but a small number of seriously injured workers had their weekly benefits reduced or stopped – whether they were back at work or not. Their entitlement to medical treatment ceased 12 months after weekly compensation payments finished. The government’s prediction of a $4 billion WorkCover deficit was based largely on temporary low yields from the scheme’s investments, as a result of the global financial crisis. Unions said at the time that the scheme’s finances would recover in line with general economic trends and this has been borne out by a report to a parliamentary committee inquiring into WorkCover. The report was undertaken by WorkCover’s actuaries (financial risk experts) and actuary Michael Playford, of Pricewaterhouse Coopers, told the Standing Committee on Law and Justice that the deficit would have gradually returned to surplus by 2021, even without the 2012 changes. As of May 2014, the WorkCover scheme had a surplus of $1.3 billion and was expected to reach a surplus of $6 billion by 2019. This has allowed the government to cut employers’ WorkCover premiums by
17.5 per cent, while many employees struggle to survive and support their families after being injured at work. The committee called on the government to consider restoring all medical benefits it took away from injured and sick workers in 2012. As a first step medical benefits for hearing aids, prostheses, home and vehicle modifications should be restored for all injured workers for life, the committee recommended. Once these benefits have been restored the government should “promptly review the viability of restoring all lost medical benefits for injured workers” it said. The standing committee includes three government MPs as well as members from Labor and the Greens. Its unanimous report said the scheme’s return to surplus “would have been driven by the recovery in returns on the scheme’s multi-billion dollar investments that since the global financial crisis have been returning to higher, and more normal, levels.” NSWNMA Assistant General Secretary Judith Kiejda says it is significant that even government members of the parliamentary committee agreed the scheme now has enough resources to improve protection for injured workers. “It is time to restore justice and dignity to sick and injured workers,” Judith said. She listed the abolition of journey claims (compensation for injuries during
Unions said at the time that the scheme’s finances would recover in line with general economic trends and this has been borne out by a report to a parliamentary committee inquiring into WorkCover. 28 | THE LAMP NOVEMBER 2014
“It is time to restore justice and dignity to sick and injured workers.” — NSWNMA Assistant General Secretary Judith Kiejda
trips to and from work) and the capping of weekly benefits for all but the most seriously injured workers – whether or not their injuries have been resolved – as among the worst of the government’s reforms. “All these punitive changes were justified on the false basis that the scheme was in crisis,” she said. “Those injured workers fortunate enough to be provided with suitable work by their employer often require ongoing treatment to maintain their ability to work. “However under the current system they often lose access to surgery, remedial and follow-up treatment, ongoing pain relief medication and routine replacement of equipment such as hearing aids.” NSW Greens’ representative on the committee, MP David Shoebridge, said there was “no doubt the scheme can afford to return all medical benefits to injured workers to make sure that people who are injured at work receive reasonable and necessary medical treatment for life. “It is just plain wrong that a worker can have an injury as severe as an amputated foot and, after a short period on benefits, be denied benefit and left to pay for their own prostheses, surgery and other treatment,” he said.
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Changes don’t go far enough Union lobbying and public complaints about the severity of cuts to WorkCover have led the NSW government to make minor amendments to the scheme. The following summarises the recent amendments and main recommendations of the Parliamentary Standing Committee on Law and Justice.
WEEKLY PAYMENTS The government now allows injured workers to continue to be eligible for weekly compensation payments until a disputed work capacity assessment has been resolved. This follows criticism that workers were getting no benefits during the months it took for their disputed claims to be settled. PRE-APPROVAL FOR TREATMENT The parliamentary inquiry recognised that seeking pre-approval for medical treatment was sometimes impractical or unreasonable and recommended that the government amend the scheme to make it more flexible. The government’s 2012 amendments require that the insurer grant prior approval for all medical treatments unless the treatment occurs within 48 hours of the injury or is exempted under WorkCover guidelines. This strengthened the power held by insurers to delay treatment, which in turn could delay a worker’s recovery, make the injury worse and reduce the chances of a durable return to work. It also adversely affected injured workers who required ongoing treatment to maintain the level of fitness needed to keep working. For instance, nurses with back injuries
unable to gain pre-approval from the insurer for treatments, such as physiotherapy, which they require to keep working or to return to work sooner. LEGAL REPRESENTATION The 2012 changes prevent lawyers acting for injured workers in connection with a review of an insurer’s work capacity decision. This has left injured workers “vulnerable and without adequate representation in what is a highly complex area of law,” the committee said. The committee called on the government to consider allowing lawyers to be paid or recover “fair and reasonable fees” for compo work. “The absence of legal assistance for injured workers is grossly unfair and the scheme must urgently be amended to restore the right to legal representation for all injured workers,” Greens MP David Shoebridge said. RETURNING TO WORK In 2012 the government put a cap on the length of time WorkCover would pay weekly payments for all but the seriously injured – whether they had returned to work or not. Prior to this the weekly benefits generally continued until retirement age. The parliamentary committee noted concerns that “some employers failed to
The 2012 “reforms” at a glance compensation for trips to • Workers and from work no longer covered. payments stop at • Weekly two-and-a-half years for most injured workers.
expenses stop one year • Medical after weekly payments cease. sum payments for pain • Lump and suffering removed. attacks and strokes no • Heart longer covered.
PHOTO: BIDGEE
MEDICAL TREATMENT The 2012 reforms restricted the timeframe in which injured workers could access medical treatment. Further, workers suffering industrial hearing loss had their entitlements to lifetime assistance for hearing aids, batteries and repairs reduced to an entitlement of one set of hearing aids and 12 months of batteries and repairs. After the government’s latest changes, seriously injured workers who made claims before October 2012 can once again get hearing aids, prostheses and modifications to their homes and cars until they reach retirement age.This change does not apply to people who made claims after October 2012. To be eligible for medical benefits until retirement age, the injury threshold is lowered from 30 per cent of a worker’s body to 21 per cent.
“The absence of legal assistance for injured workers is grossly unfair.” — Greens MP David Shoebridge understand or adhere to their obligations to provide suitable employment, and that there is a lack of enforcement when employers fail to meet these obligations.” The committee called on the WorkCover Authority to consider introducing incentives to encourage compliance and penalties for non-compliance, along with an education campaign to inform employees and employers of their rights and obligations. The NSWNMA is getting reports of employers deciding that injured nurses who have been given suitable work to accommodate their partial incapacity, often for extended periods of time, are now classed as having a non-work related injury because their benefits have ceased. As a result nurses have been stood down and not allowed to return to work unless they have medical clearance declaring them fit to undertake the full inherent requirement of their pre-injury position. The NSWNMA says this interpretation is incorrect and inconsistent with both workers compensation and industrial legislation. Any nurse put in this situation should call the Association for advice. THE LAMP NOVEMBER 2014 | 29
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LIFESTYLE
Amazing win for male nurses It’s about the adventure, it’s about the challenge and for Daniel Little and Ryan Thomas, winning the latest series of The Amazing Race was about changing misconceptions.
The race’s host, Grant Bowler with Daniel and Ryan
IT’S HOT, IT’S DRY,YOU’RE IN AFRICA AND you’re lost. That’s when your nursing training really comes in handy. The Amazing Race winners Dan Little and Ryan Thomas have worked together for six years in intensive care at Westmead Hospital. “Shiftwork certainly helped in getting prepared for that sort of crazy experience,” Ryan told The Lamp. “There was also the fact that there was a professional working relationship that’s about maintaining calm under pressure to deal with life threatening situations, being able to think on our feet,” he said. Dan agreed: “I don’t think a lot of people in normal life have that experience that’s cultivated in nursing of pushing through in situations where the adrenalin’s pumping and 30 | THE LAMP NOVEMBER 2014
you’re tired and fatigued. So we came in knowing we could work under pressure as a team. But, still, the race is a completely different beast. “It was hell, like a Contiki Tour on crack! “We had one episode in Africa where we went in completely the wrong direction, something Ryan and I tended to do. “We were about an hour behind and knowing you’re last and having to make up time means you can either crumble or you can band together. Ryan and I banded together and we pushed it and we made it through. “But it was a really hard situation and we had to push it physically and mentally. It was hot, it was dry, you’re in the middle of Africa surrounded
by wild animals, and it’s a very gruelling environment.” While the $250,000 prize money that Dan and Ryan will share was a great reward, they both saw The Amazing Race, which screens on the Seven Network, as a showcase to encourage more men into nursing careers. “We’re very conscious of the fact that, in the wider community, there is still a gender stereotype in nursing. The idea that caring is a female characteristic is not something we should take into the future,” Dan said. “We need people to realise nursing is for everyone and men can do it and do a great job at it. We are happy to have been part of showing people that two nice guys can be nurses and that’s not a strange thing.”
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“PEOPLE IN NORMAL LIFE DON’T HAVE THAT EXPERIENCE THAT’S CULTIVATED IN NURSING OF PUSHING THROUGH IN SITUATIONS WHERE THE ADRENALIN’S PUMPING AND YOU’RE TIRED AND FATIGUED.”
The race’s contestants in Uluru THE LAMP NOVEMBER 2014 | 31
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ENVIRONMENTAL HEALTH
Health before coal Recent developments including a Chinese ban on “dirty” coal, a report on the Hazelwood mine fire and a health industry super fund decision to restrict investments in coal, have brought concerns about the effects of coal on health to a wider Australian audience.
Hazelwood mine fire. PHOTO: CFA COMMUNITIES & COMMUNICATION
THE HEALTH INDUSTRY SUPER FUND HESTA has become the first major super fund in Australia to restrict its investment in thermal coal across its entire portfolio. “HESTA is of the view that new or expanded coal assets face the highest risk of becoming stranded before the end of their useful life,” HESTA’s chief executive Anne-Marie Corboy said. “It is not prudent, nor in the long-term interests of members, to invest in the expansion of these assets.” In the same week as the decision, which followed similar moves by major investment funds worldwide, China announced a limit on the use of imported coal with more than 16 per cent ash and three per cent sulphur, from January 1, 2015, in a bid to improve air quality, especially in major cities such as Beijing and around Shanghai. Analysts disagree on the effect this will have on the coal export industry and the wider Australian economy. But several say that every step the Chinese government takes to tighten pollution controls is narrowing the cost-gap between coal and alternative energy technologies: which is bad news for coal. 32 | THE LAMP NOVEMBER 2014
LOOKING TO ALTERNATIVES In March 2013 The Lamp spoke to Stockton Centre nurse Cathy Burgess, a member of the Hunter Valley Coal Terminal Action Group, about questionable health and environment assessments related to approval for a fourth coal terminal in Newcastle, known as T4. Subsequently the Independent Commission Against Corruption (ICAC) heard evidence of widespread corruption in relation to T4. The NSW Planning Assessment Commission is holding public hearings into the matter. Cathy says the Chinese ban will have an impact on exports from the Hunter Valley and it is clear from door knocking campaigns that more and more people, including miners, are aware of the health risks posed by coal mining and the need for re-training to work in other industries. “We have a great port and a huge manufacturing base and it wouldn’t be hard for us in Newcastle to retrain our skilled workforce in making renewables because they have a lot of skills anyway.” Earth Worker, a cooperative of trade unionists, environmentalists and small
businesses, last year established its first business venture in Morwell, Eureka’s Future, which manufactures and installs solar hot water systems. Earth Worker’s goal is to address the need for local job creation and training in sustainable industries. “We’re working on getting them up to the Hunter as well,” Cathy said. “It’s a great idea of unions supporting other unions in transitioning workers to another, more secure job.” EVIDENCE BUILDS The recent inquiry into the Hazelwood mine fire in Morwell and a Climate Council of Australia (CCA) report on the effects of coal on human health, both point to factors that urgently need to be addressed. The CCA reported that a review of air pollution and cardiopulmonary disease in Australia found air pollutants associated with an increase in cardiovascular and respiratory mortality and hospital admissions, consistent with international evidence. Coal contributes to four of the five leading causes of mortality in the US –
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POLLUTANTS EMITTED DURING THE HAZELWOOD MINE FIRE INCLUDED CARBON MONOXIDE, PARTICULATE MATTER, NITROGEN DIOXIDE, SULPHUR DIOXIDE, POLYCYCLIC AROMATIC COMPOUNDS, VOLATILE ORGANIC COMPOUNDS, DIOXINS, FURANS AND METALS. heart disease, cancer, stroke and chronic respiratory disease – with 50,000 deaths each year attributed to coal-fired power generation. Globally, air pollution from coal combustion accounts for more than 200,000 deaths per year. A global study of health indicators spanning 40 years and 41 countries estimated that adverse impacts from pollutants produced from coal-fired electricity generation costs Australia $2.6 billion annually. US economists estimate that the cost to health of coal-fired power is between one and six times the value it adds to the economy. The CCA has called for consistent air, water and soil quality monitoring in the vicinity of every coal mine and power station in Australia, and funding for research to evaluate the health, social and environmental impacts of coal in coal mining communities across Australia. CCA also called for proper consideration of coal’s human health risks in all energy and resources policy and investment decisions.
COMMUNITY HARMED An official inquiry into the Hazelwood mine fire found that from February 9 to March 25, 2014, smoke and ash resulted in a number of adverse health effects for the residents of Morwell, in Victoria’s Latrobe Valley, some of whom may continue to be affected into the future. Many people also experienced financial impacts for a range of reasons. The inquiry heard that people with pre-existing cardiovascular and respiratory conditions were particularly susceptible to potential adverse long-term health effects when exposed to ozone, PM2.5 (particulate matter that is 2.5 micrometres or less in diameter) and larger particulates. In particular they are susceptible to an aggravation or progression of their underlying condition, an increased risk of lung cancer and potential effects on coagulation, which could result in an increased risk of arrhythmias, morbidity, hospital admissions and death. There is also a risk that the general population could develop medium to long-term effects from the exposure to PM2.5 and ozone, including but not limited to the development of respiratory conditions, effects
on cardiac conduction, increased risk of heart attack, stroke and lung cancer, long-term cognitive decline and psychosocial effects. Pollutants emitted during the Hazelwood mine fire included carbon monoxide, particulate matter, nitrogen dioxide, sulphur dioxide, polycyclic aromatic compounds, volatile organic compounds, dioxins, furans and metals. Particulate matter is a complex mixture of very small particles and liquid droplets that can combine to make dust, soot and smoke. Exposure to both PM10 (particulate matter that is 10 micrometres or less in diameter) and PM2.5 has been linked to adverse health effects. At Morwell, pollution levels (primarily PM2.5 and carbon monoxide) were significantly above the advisory standard on February 15 to 18, 21 to 25 and 26 to 28. On February 16 the daily average for PM2.5 was approximately 28 times the advisory standard and carbon monoxide levels almost four times the compliance standard. The inquiry also found that State Control Centre’s initial request to the Environment Protection Agency for support and advice came too late and that the EPA was ill equipped to respond rapidly. THE LAMP NOVEMBER 2014 | 33
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ASK JUDITH Only want to work nights I am an RN and have requested to work permanent night duty. Is this allowed? And if so, is there any requirement on me to work day shifts at all, or can I only do night shifts for a set amount of time? Generally, there is nothing to preclude a nurse from doing permanent night duty though it would need to be by mutual agreement between you and your employer. However, it is standard practice that nurses who work permanent night duty are required at some point throughout each 12-month period (anniversary date to anniversary date), to undertake a period of day duty to ensure they attend compulsory in-service training requirements such as fire drills, CPR etc. If you are successful in negotiating to be rostered on permanent night duty, ensure you have a written contract, signed off by a manager with the designated authority, stating that this is a condition of your employment.
Take care on social media Following a discussion with friends, who tell me they have been questioned at work because of comments they made on social media, in particular Facebook, I am concerned. Can management discipline you for expressing a personal view on social media in your own time? The use of social media has seen an increase in the number of nurses being disciplined. The problem arises if they make comments relating to their employer and, in many cases, about their managers and/or colleagues, or comments that can be tracked back to a patient. Many organisations now have policies that relate to the use of the various social media options as well as the Ministry of Health, Code of Conduct policy. I refer you to the NSWNMA policy on our website: www.nswnma.asn.au
• Don’t make disparaging remarks about your organisation, its clients or fellow employees. • Don’t make any remarks that may embarrass your organisation. In particular, do not air grievances. • Don’t identify patients in your care, or post information that may lead to the identification of a patient. • Never take private film or photos, whether on phone cameras or otherwise, of patients in your care. • Always read and comply with your employer’s policy on IT use.
Entitled to day off? I have two part-time positions, each 0.5 FTE (full time equivalent) at the same facility. One position is as an RN the other as a CNE. Would you advise if I am entitled to an ADO (allocated day off) as I have had trouble getting an answer from management? Yes, you are entitled to an ADO under the Public Health System Nurses’ and Midwives’ (State) Award 2011. I refer you to the following clause: 4A. Multiple Assignments Multiple Assignments Within a Single Public Health Organisation Hours, Additional Days Off and Overtime “… (b) The combined total number of ordinary hours worked under an employee’s multiple assignments shall not exceed the hours of work as set out in Clause 4, Hours of Work and Free Time of Employees Other than Directors of Nursing and Area Managers, Nurse Education. (c) Where the combined total number of ordinary hours worked under an employee’s multiple assignments is equivalent to those set out in subclause (i)(a) of Clause 4, Hours of Work and
When it comes to your rights and entitlements at work NSWNMA Assistant General Secretary JUDITH KIEJDA has the answers.
Free Time of Employees Other than Directors of Nursing and Area Managers, Nurse Education, for day workers, or subclause (ii)(a) of Clause 4 … for shift workers, they will be considered as a fulltime employee for the purposes of the Award and: That employee is entitled to additional days off in accordance with subclause (iii) of Clause 4, Hours of Work and Free Time of Employees Other than Directors of Nursing and Area Managers, Nurse Education.”
ADOs during leave? I am a full time RN in a public hospital working eight-hour shifts. I have taken two, three-week periods of annual leave in the past year but was not rostered for ADOs in either of those months. Does this mean I have ADOs in credit? The entitlement is for 12 allocated days off per year as per clause 4 of the Award: 4. Hours of Work and Free Time of Employees Other Than Directors of Nursing and Area Managers, Nurse Education “(iii) (a) The hours of work prescribed in sub-clauses (i) and (ii) of this clause shall, where possible, be arranged in such a manner that in each roster cycle of 28 calendar days each employee shall not work his/her ordinary hours of work on more than 19 days in the cycle. Provided that employees who work eight-hour shifts are entitled to 12 additional days off duty per annum (per NSW Health Policy Directive No. PD2006_094);” What this means is that while there are 13, 28-day roster periods in a year, the entitlement is for 12 ADOs, which takes into account four weeks’ annual leave. A staff member who takes shorter periods of annual leave, or accumulates six weeks’ of annual leave, is also entitled to 12 ADOs per year, irrespective of how they take the leave.
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NSWNMA which can connect nur practical strategies for ving
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SOCIAL MEDIA
WHAT’S
NURSE UNCUT
HOT
A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES
THIS MONTH
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
Nurse Uncut is also on Facebook: www.facebook.com/NurseUncutAustralia and on Twitter @nurseuncut
Alan’s half century www.nurseuncut.com.au/remembering-alan-baird
Alan Baird recently retired after 50 years of nursing, much of it in aged care. A colleague pays tribute to Alan.
How do I cope with trauma? www.nurseuncut.com.au/advice-wanted-how-do-i-cope-with-trauma-as-a-nurse
After a 13-hour shift in Emergency one RN wonders how to cope with the traumatised people she has witnessed.
Trying to move from mental health to general nursing www.nurseuncut.com.au/trying-to-move-from-mental-health-to-general-nursing
Advice sought: Lily wants to move into general nursing but is being told she has no relevant clinical experience.
Stevie’s EN Diary 2 – Popping my nursing cherry www.nurseuncut.com.au/stevies-en-diary-2-popping-my-nursing-cherry
After 18 months of training, Stevie finally hits the ward as an enrolled nurse – and chalks up many firsts.
Nursing home food – would you eat it? www.nurseuncut.com.au/nursing-home-food-is-it-edible
Aged care nurses comment on a complaint to the Aged Care Complaint Scheme about the quality of nursing home food.
Emotional intelligence training www.nurseuncut.com.au/emotional-intelligence-training-in-nursing
A mental health nurse looks at a new approach to dealing with the emotions triggered while working as a nurse.
New on SupportNurses YouTube channel Bob Fenwick Mentoring Grants Program Mental health nurses who were mentors and mentees discuss this valuable program. >> youtu.be/KFpoexmM6_Y #Co-pay no way! This bunch of nurses reckons a Medicare co-pay makes no sense. >> youtu.be/qJQpeS6hDa8
NSWNMA on Instagram! Yes, we’re on Instagram, so share your local photos with us @nswnma and #NSWNMAforce4change.
Follow us on Twitter NSWNurses & Midwives @nswnma Watch us on YouTube SupportNurses Connect with us on Facebook
New South Wales Nurses and Midwives’ Association >> www.facebook.com/nswnma Look for your local Ratios put patient safety first >> www.facebook.com/safepatientcare Branch page on Aged Care Nurses >> www.facebook.com/agedcarenurses our website. THE LAMP NOVEMBER 2014 | 37
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ComSafe Training Services Workplace Emergency Response Professionals
Recruitment POSTGRADUATE DIPLOMA IN NURSING (MENTAL HEALTH) IN CANBERRA
Full Scholarship First Semester 2015 February Intake A scholarship for the Postgraduate Diploma in Nursing (Mental Health) program is offered by the Division (MHJHADS). This is an excellent opportunity for Registered Nurses to build their knowledge and skill base in caring for people experiencing a range of mental health conditions. Successful applicants are employed on temporary contract with paid employment, studying either part-time or full-time. During the program RNs rotate through a range of clinical areas. Eligibility/Other Requirements: • Registered or eligible for registration with the Nursing and Midwifery Board of Australia. • Hold a current driver’s licence. • Have Australian citizenship or permanent residency. For full details of how to apply please contact Jo McDougal, Clinical Support Officer (02) 6205 3661 Closing date 14 November 2014
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SOCIAL MEDIA
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NURSES & MIDWIVES
SAID & LIKED on facebook www.facebook.com/nswnma Mark’s a good earnie
It was a great night and Mark Lennon a very worthy winner! Secretary of Unions NSW Mark Lennon won the Good Ernie for giving female staff two per cent more super than men to acknowledge the structural issues that lead to women having a third less super savings than men when they retire.
Royal Commission into aged care? An inquest into deaths in nursing homes begs the question; is it time for a Royal Commission into aged care?
Profit before health The CEO of St Vincent’s Health warns that private health insurers are primarily concerned with profits, not the health of members.
Privatisation spreads Yet another target for privatisation by Mike Baird’s NSW government: home care for the elderly and disabled!
Dying with dignity The federal Australian Nursing and Midwifery Foundation has warned the elderly are being bullied into euthanasia, while ANMF Victoria supports the Greens’ Dying with Dignity Bill. What do you think?
Yes, long overdue. There is so much wrong with the system. Aged care facilities are understaffed. We are asked to go over and beyond the call of duty. It’s an impossible situation and makes me sad that our elderly should be treated in this way. I blame the powers that be, not the people on the ground trying to do their very best. Well that’s what happens when you have five staff for 65 clients! Run off ya feet. Royal Commissions don’t always result in improvements. These have to be fought for on the job – always! We get nothing from business or governments unless we put real pressure on them. Eventually there will be no nurses willing to work in aged care. Watch out baby boomers. By the time we need care we will be in big trouble because the government doesn’t care about the elderly.
It’s like they’re making money by gambling on people’s health.
A Bupa spokeswoman told Fairfax Media: “Yes, we are interested. From our perspective we are very keen to look at opportunities to diversify our business in health service delivery in Australia.” Wouldn’t it have been refreshing if Bupa had said: “We look forward to providing excellent services to the elderly and disabled”. What the hell are they going to do when everything has been privatised? Why don’t we just call ourselves “little USA”.
Yes, but with strict revision every year and only if the person and their healthcare professionals have exhausted all pathways. They should have rights to die at the time of their choosing. Perhaps they should look at advanced care directives being totally binding … If I go to the trouble of making one and having DNR tattooed on my chest I would hope my wishes were adhered to. Vulnerable people may be bullied into requesting euthanasia. But I think it’s unlikely they’d be able to convince two doctors and a psychiatrist they really wanted to die if they didn’t. It’s about time we had the right to choose ... I’ve seen far too many patients die a miserable death because politicians don’t have the guts to make necessary decisions for our welfare.
PHOTO GALLERY
Disability nurses at Kanangra on the Central Coast need our support for a real choice.
Our planet, our patients, our future – nurses march in New York to demand climate action.
NSWNMA helps the Enrolled Nurses Professional Association celebrate their 21st annual conference – with cake!
Blue Mountains nurses rally to defend Medicare and public health.
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test your
knowledge 1
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8 9
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15
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Across 1. The motor root of a spinal nerve (7.4) 8. An immature ovum (6) 9. Removal of certain parts from a mass (11) 11. Posterior limiting layer of cornea (8.8) 12. Defective formation or growth associated with marked vascular changes (14) 15. Liquid obtained by leaching wood ashes (3) 16. The upper bony part of the nose, overlying the nasal bones (5.6) 19. Electromyogram (1.1.1)
21. A graphic record of the electrical activity of a muscle (14) 23. Mycobacterium tuberculosis (1.1) 24. Without an offspring (9) 26. Aures unitas, both ears together (1.1) 27. A disorder brought on by a deficiency of niacin or nicotinic acid (8) 28. The series of cells that are formed after fertilization within the ovule before formation of the embryo (9) 29. Gold (2) 30. Near death or the natural end of a process (8)
Down 1. Faintness or loss of consciousness due to increased vagus nerve activity (9.7) 2. To arrange or settle by discussion and mutual agreement (9) 3. The act of recovering to normal function following a period of unconsciousness (11) 4. A highly addictive drug from which morphine is prepared (5) 5. An instrument used in measuring tension or pressure, especially intraocular pressure (9) 6. Resembling scirrhous carcinoma (9)
7. Prolongation of the larval form in a sexually mature organism (7) 10. Watery (7) 13. Macula retinae (6.4) 14. Presence of blood or red blood cells in the urine (10) 17. Material used in inoculation (8) 18. A disease-causing microorganism (4) 20. Gram (1.1) 21. External animal parasites (6) 22. Abstract reasoning; speculation (6) 25. Structure rising to a hemispheric center (4) 26. Resembling a wing (4)
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EDUCATION@NSWNMA
WHAT’S ON NOVEMBER 2014
all our courses can be booked online! www.nswnma.asn.au/education ——— • ———
Tools in Managing Conflict and Disagreement – 1 day 13 November Gymea Members $85 Non-members $170 ——— • ———
Policy and Guideline Writing – 1 day 13 November NSWNMA Waterloo
Members $85 Non-members $170 ——— • ———
Are you meeting your CPD requirements? – ½ day 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 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 ——— • ———
Are you meeting your CPD requirements? – ½ day 2 December Broken Hill Members $40 Non-members $85 ——— • ———
Legal and Professional Issues for Nurses and Midwives – ½ day 3 December Broken Hill Members $40 Non-members $85 ——— • ———
For more information about specific courses phone Matt West on 1300 367 962.
Update Me? Would you like to be notified of upcoming NSWNMA seminars? Email your name, member number and preferred email address to: education@nswnma.asn.au with the subject line Update Me.
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NURSING RESEARCH ONLINE
This month the Group of Twenty (G20) will meet in Brisbane to discuss economic growth. Christine Lagarde, managing director of the International Monetary Fund, will attend. Ms Lagarde has made clear her views about government investment in health saying: “Clearly investing in health, investing in education, making sure there are equal opportunities for all is something where public money is needed.” The NSWNMA is part of a global alliance campaigning for tax justice, investment in public services and the imposition of a financial transaction tax on the financial sector. Audio: An interview with the generalsecretary of Public Services International on World Public Services Day, June 23, 2014 A four-and-a-half minute interview with Rosa Pavanelli, general-secretary of Public Services International (PSI). All around the world governments are attacking public services and the workers who help supply them. A number of international trade agreements are jeopardising the right of governments to provide public services instead of corporations. This month the Group of Twenty (G20) will meet in Brisbane to discuss economic growth. The NSWNMA is part of a global alliance campaigning for tax justice, investment in public services and the imposition of a financial transaction tax on the financial sector. From the south to the north, PSI affiliate unions are working together across borders to end tax havens, tax avoidance and corruption, and to bring in progressive tax systems that are properly resourced and enforced. Tax justice enables public spending for the common good and provides the means for economic
self-sufficiency for municipal, regional and national governments. PSI General Secretary Rosa Pavanelli says: “Tax justice is about social justice and fighting inequality. Tax justice is about redistributing wealth by funding the vital public services such as health and education that help end poverty and inequality. Reforming national, regional and international tax systems and removing counter-productive tax incentives will lead to substantially increased budgets for countries to finance the post-2015 agenda and pay for improved public services including education, healthcare, clean water and sanitation, energy, housing, transportation and development initiatives.” www.world-psi.org/en/audio-radiolabourinterview-rosa-pavanelli-world-public-servicesday
Who pays for our common wealth: Tax practices of the ASX 200 This report was produced by United Voice and the Tax Justice Network–Australia, in consultation with corporate tax expert Dr Roman Lanis of the School of Accounting at the University of Technology, Sydney. If the largest Australian listed companies paid taxes at the statutory corporate tax rate of 30 per cent they would produce an additional $8.4 billion in annual revenues. Overall, the effective tax rate of ASX 200 companies over the past decade has been only 23 per cent. Corporate income taxes help pay for our common wealth. Rather than going ahead with unnecessary cuts to health, education and other services, the government should focus its efforts on reforming the corporate tax system. Taxes pay for the infrastructure and services that businesses and communities need to maintain and improve economic and social wellbeing. But to what extent are corporations avoiding their responsibilities and failing to pay their fair share? Tax dodging by multinational corporations has generated significant attention and public opinion on the issue has shifted. Although not widely reported, Australian corporations also appear to avoid tax obligations. Corporate income tax, after individual income tax, is the second largest source of government
revenue. This report looks specifically at the tax practices of the ASX 200, Australia’s largest publicly listed companies. The Tax Justice Network–Australia issued the report to stimulate a broader discussion about the moral responsibility and economic imperative of Australia’s largest corporations to be more transparent about their tax practices. While most individuals pay their fair share, some corporations bend the rules to lower their tax obligations and the rest of us pay the price. www.unitedvoice.org.au/news/who-pays-ourcommon-wealth
The Robin Hood Tax: Turning a crisis for the banks into an opportunity for the world The 2008 economic crisis has left the world trillions of dollars poorer and people fed up with bankers’ wasteful ways. The crash left a $65 billion dollar hole in the budgets of the world’s 56 poorest countries: countries that are now cutting expenditure and removing subsidies for essentials like food, fuel and electricity. Yet a tiny tax of, on average, 0.05 per cent on the financial sector could generate $400 billion dollars if applied globally. That’s enough to protect schools and hospitals. Enough to build new lives around the world and to deal with the new climate challenges we’re all facing. Political figures and influential people have already come out in support of a tax on the millions of transactions that take place every day between financial institutions. Who’s calling for this tiny tax? Charities, green groups, trade unions, celebrities, religious leaders and politicians. World leaders – President Hollande of France and Chancellor Merkel of Germany, among others. Businesspeople – financier George Soros, entrepreneurs Warren Buffet and Bill Gates, among others. Economists – Nobel Prize winners Joseph Stiglitz and Paul Krugman and 1000 other economists from across the world. We are part of a movement of campaigns in more than 25 countries around the world representing more than 220 million people. www.oxfam.org/en/campaign-with-us/robinhood-tax/whos-behind-it
THE LAMP NOVEMBER 2014 | 43
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BOOKS
BOOK ME SPECIAL INTEREST The Discontented Little Baby Book Dr Pamela Douglas University of Queensland Press www.uqp.uq.edu.au RRP $29.95 ISBN 9780702253225 Addressed to new mothers, The Discontented Little Baby Book draws on detailed case studies and a wide range of research to recommend and explain the “cued care” approach to managing babies with cry-fuss problems that extend beyond the first 16 weeks of life. It covers a variety of possible causes for continued crying and fussing, in particular sensory boredom and sleep pattern disturbances but also hunger, reflux, allergies, milk and formula feeding issues. Arguing that the delayed response philosophy can result in “serious communication confusion” between parent and baby, the author sets out some alternative responses to the typical “impose order” advice. Simple strategies for psychological resilience, based on cognitive behavioural therapy techniques, are also provided for parents struggling to manage their own emotional reactions to caring for a discontented baby.
Whole Person Caring: An Interprofessional Model for Healing and Wellness Lucia Thornton Sigma Theta Tau International Honour Society of Nursing www.nursingsociety.org RRP $44.95 ISBN 9781937554996 The model described in Whole Person Caring is a framework derived from theorists in the fields of nursing, sociology, exercise physiology, stress management, nutrition, psychology and more. It aims to unite the various disciplines within western medicine as well as provide practical and useful tools for helping people create healthier and more wholesome ways of being. The author argues that a “choice point” has been reached in health services and nurses are in a unique position to play a major role in transforming the system towards the new healing paradigm. Carefully structured around the key concepts of holistic medicine, the book is designed to guide individuals and organisations toward health and wellness through focusing on mental and spiritual as well as physical aspects of care.
Cancer on Trial: Oncology as a New Style of Practice Peter Keating and Alberto Cambrosio University of Chicago Press (through Footprint Books) www.footprint.com.au RRP $52.95 ISBN 9780226143040 Cancer on Trial presents a thoroughly researched history of the field of oncology and the emergence of randomised clinical trials. While such trials have become standard cancer treatment practice, in the 1960s they prompted a storm of controversy and animosity from doctors. The book examines in detail the VAMP trial for children with leukaemia, the ECOG 0971 breast cancer trials and the so-called “magic bullet” Gleevec pills, with a view to how they revolutionised the study of biomedicine globally. It discusses how the field grew through interdisciplinary and transnational research project groups and the rise and significance of statistics and molecular biology. It offers considerable insight into current “onco-political” debates about the successes and failures of cancer therapies, the role of public and private research, and the promises and perils of personalised medicine.
The Dark Side of Nursing Ingrid Teresa Pryde Balboa Press www.balboapress.com RRP $15.81 ISBN 9781452512396 The Dark Side of Nursing combines an in-depth academic study of bullying – the “dirty secret of nursing” – with a powerful personal story. Richly supported by statistical data, legislation, current news stories and personal accounts from other victims, the author details her own experience of bullying while a nurse at an Australian hospital and the meetings, reports, letters, formal complaint and investigation that followed. The book is written in an engaging, easy-to-read style that includes useful references. It describes practical strategies for coping with and reforming bullying behaviour in the workplace and explores the concept of “selfdifferentiation” as an antidote to the extreme emotional disturbances that can surface during bullying incidents. The author realistically reflects on the personal growth she achieved, while acknowledging that not all the adverse effects on her life could be happily resolved.
NEW!
The NSWNMA Library Catalogue is now online! Visit www.nswnma.asn.au/libraryservices-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.
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 NOVEMBER 2014 | 45
Red Hot Clearance
SALE
NSWNMA merchandise is not only stylish and comfortable, it is affordable and sold at cost to members. To order, fax the order form to Glen Ginty, (02) 9662 1414, email to: gensec@nswnma.asn.au or post to: NSWNMA, 50 O’Dea Ave, Waterloo NSW 2017 Merchandise order forms also available on
www.nswnma.asn.au
White Collar Rugby Shirt
Denim by g Collar Rut Shir , L, Sizes S, M L X X , L X
Sizes M, XL, XXL
ORDER FORM White Collar Rugby Shirt +$5 postage &
handling. Bulk orders will be charged accordingly.
Size: M XL Quantity:
$
15 each NSWNMA Linen Tea Towel
XXL
Denim Collar Rugby Shirt +$5 postage &
handling. Bulk orders will be charged accordingly.
Size: S M Quantity:
$
10each NSWNMA $ Watches 50each
• Avalon Watch • 2 year guarantee • Seiko Japan on watch parts and 3 hand movement workmanship • Long life battery • Mesh stainless steel band
L
XL
XXL
NSWNMA Navy Canvas Duffle Bag $25 +$5 postage & handling. Bulk orders will be charged accordingly.
Quantity: NSWNMA Linen Tea Towel $10 +$3 postage & handling. Bulk orders will be charged accordingly.
Quantity: NSWNMA Watches $50 +$5 postage & handling. Bulk orders will be charged accordingly.
Quantity:
Small
Large
Total cost of order $ NAME
NSWNMA Navy Canvas Duffle Bag
Australian Nurses & Midwives
$
25each
Large main zippered compartment; cotton webbing heavy duty double carry handles, removable adjustable shoulder strap, 1 side end slip pocket.
ADDRESS POSTCODE PHONE (H) (W) (MOB) METHOD OF PAYMENT Cheque Mastercard Bankcard Money Order
Visa
NAME OF CARD HOLDER EXPIRY DATE
/
CARD NUMBER SIGNATURE
merchandise advert.indd 1
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MOVIES
movies of the month An apartment in the Marais arrondissement of Paris comes with complications and family secrets, writes Stephanie Gray. Mathias (Kevin Kline) is a 50something failure. He is thrice divorced and, not coincidentally, has written three unpublished novels. The death of his father – who has otherwise given all his money to charity – has opened the door to potential prosperity. His father has left him the keys to a beautiful Parisian apartment, but there is just one problem: the 90-year old who has lived there for 70 years and has no plans to leave. Mathilde (Maggie Smith) is living under a viager (pron. vyajay), an ancient French system for buying and selling apartments. Mathias does not get possession of the apartment until Mathilde dies. Mathilde also stuns him by telling him that, to abide by the rules of viager, he must pay her a monthly fee until she dies, or risk losing the apartment. Freshly arrived from New York City, Mathias has based his future plans on the apartment. Broke, with no plane ticket home and nowhere to stay, Mathias had hoped to sell the apartment and then begin figuring out the next step in his life. Mathilde is kind enough to allow him to stay until he sorts himself out and even invites him to join her for her impromptu evening dinners! Mathias finds himself caught up in the obligations of the viager. He must find a way to earn some cash and also find someone to take over the viager. As well as trying to resolve his financial difficulties, Mathias must also deal with Mathilde’s protective and prickly daughter Chloe (Kristin Scott Thomas). Chloe’s life seems to echo Mathias’ own, as she engages in a messy affair with a married man and begins to wonder about her past. With the apartment in the middle, the trio soon learn that the connections between them go beyond a piece of paper. Stephanie Gray is an RN with the Australian Red Cross Blood Services IN CINEMAS November 13
METROMEMBERGIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to My Old Lady thanks to eOne Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win! THE LAMP NOVEMBER 2014 | 47
It’s time
to scrub up for 2014! Order your NSWNMA campaign scrub uniforms for conference and rally times, and make an impression! The NSWNMA campaign uniform range endorses a modern appearance and offers both comfort and durable features, while still embracing NSWNMA image. The new range consists of a Unisex Scrub Top and Unisex Classic Pant. Both made from 65% polyester, 35% cotton. This fabric blend is durable and of superior quality. The scrub campaign uniform also has number of functional features, including jet pockets, pen partition, drawstring front on pants and brushed fabric coating for added comfort.
ORDER FORM
Scrub top and pant are $20 each incl GST.
SCRUB TOP
Merchandise order forms also available on
www.nswnma.asn.au
Sizes range from XS-4XL to ensure various body shapes and sizes are catered. Most importantly, the range has been designed to ensure a comfortable fit every time.
SCRUB PANTS
To order, fax the order form to Glen Ginty, (02) 9662 1414, post to: NSWNMA, 50 O’Dea Avenue, Waterloo NSW 2017 or email gensec@nswnma.asn.au
Size (cm)
XS
S
M
L
XL
2XL
3XL
4XL
Half Chest Circumference
53
56
59
62
66
69
73
77
Half Hem Circumference
54
57
60
63
67
70
74
78
General Guide for Female
8/10
10/12
12/14
14/16
16/18
18/20
20/22
22/24
Half Waist (Relaxed)
29
33
37
40.5
43.5
46.5
50.5
54.5
Half Waist (Stretched)
47
51
55
58.5
61.5
64.5
68.5
72.5
Half Hip
55
59
63
66
69
72
76
80
Out Seam Length
103
105
107
109
111
112
113
114
NSWNMA Scrub top $20. Quantity: Size: XS S M L XL 2XL 3XL 4XL NSWNMA Scrub pant $20. Quantity: Size: XS S M L XL 2XL 3XL 4XL Total cost of order $ Please include postage and handling of $5 per order. NAME ADDRESS
POSTCODE PHONE (H) (W) (MOB)
METHOD OF PAYMENT Cheque Mastercard Bankcard Money Order
Visa
NAME OF CARD HOLDER
CARD NUMBER
EXPIRY DATE
/
SIGNATURE
Scrub advert-NSWNMA-April14.indd 1
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MOVIES
movies of the month
NIGHTCRAWLER This film will keep you gripping the edge of your seat, writes Sarah Jones, wondering just how far would you go for a story? Lou Bloom (Jake Gyllenhaal), a thief and a liar, stumbles across a car accident late one night just after being turned down for a job. This is where he meets Joe Loder (Bill Paxton) a freelance crime journalist, a “nightcrawler” by trade. Nightcrawlers canvas the streets hoping to catch an accident, the bloodier the better. Loder films accidents, up close and personal then sells the footage to the highest bidder. Lou decides this will be his new career path and as the movie progresses we see him become more confident in his work, striving to get the best shot no matter how wrong or dangerous the situation may be. He meets Nina (Rene Russo) a down on her luck news director on the graveyard shift at a local television network. Nina is impressed with Lou’s footage but craves more violence and gore. This pushes Lou to strive to please Nina in any way he can. He hires Rick (Riz Ahmed) a desperate man who is out of work, as his intern. Rick is naive and Lou has a way with words; he is able to manipulate Rick and Nina into doing exactly what he wants. Nightcrawling is a cut throat business, figuratively and literally, and Lou Bloom fits into this world with ease. Jake Gyllenhaal is almost unrecognisable as Lou Bloom, his face gaunt, his shoulders hunched and an eerie, haunted look in his eyes.
DVD SPECIAL OFFER
Heartbeat series 17 Gyllenhaal is fantastic as Bloom, he immerses himself into the character almost to the point where you feel you are watching a documentary. Nightcrawler is the first feature length film of director and writer Dan Gilroy who does a brilliant job at capturing the murky underbelly of Los Angeles and making it shine. Sarah Jones is an RN at Nepean Hospital IN CINEMAS NOVEMBER 27
Series 17 is the penultimate series of the hugely popular English ensemble drama Heartbeat. Solving crimes and dealing with medical dramas in sleepy North Yorkshire during the sixties, when counterculture sometimes clashed with the traditional bobby on his beat, made an entertaining conflict. Add a nostalgic soundtrack and you begin to appreciate why Heartbeat’s popular combination of crime and medical storylines, charismatic regular characters and music kept fans rapt for two decades, attracting an audience of 14 million at its peak. Devoted Heartbeat fans will love this complete DVD set of Series 17.
METRO MEMBER GIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to Nightcrawler thanks to Madman Entertainment. 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 Heartbeat thanks to Roadshow Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!
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DIARY DATES
conferences, seminars, meetings diary dates is a free service for members. Please send event details in the format used here: Event name, Date and location, Contact details; by the 5th of each month. Send your event details to: lamp@nswnma.asn.au Fax: 02 9662 1414 Post: 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space.
Cystic Fibrosis Nurses Education Day 14 November Westmead Sharon.simonds@health.nsw.gov.au 2nd National Play Up Convention Creative Ideas in Ageing 24-25 November Sydney Diversity and Inclusion in Action Dementia Symposium 14 November Batemans Bay RSL www.trybooking.com catherine.crowe@gsahs.health.nsw.gov.au Nurses Christian Fellowship Professional Breakfast 15 November Penrith www.ncfansw.org Diabetes and Diabesity Update Day 15 November Eveleigh www.dnsw.eventbrite.com.au or 1300 136 588 St George Hospital – Code Red Dinner 19 November Sandringham www.fight4stgeorge.com Third Annual Crown Princess Mary Cancer Centre Symposium 21 November Parramatta www.sydneywest.org.au/symposium ANNA NSW and RPA Neuroscience Education Symposium 21 November Sydney www.eventbrite.com.au/e/anna-nsw-rpaneuroscience-education-symposium-tickets-8 552208887 Nurses Christian Fellowship Christmas BBQ 1 December Waverton www.ncfansw.org School Nurses Association of NSW General Conference 19-20 January 2015 Sydney www.trybooking.com/104577 president.sna.nsw@gmail.com The MHS Summer Forum Men’s Mental Health: Building a Healthier Future 19-20 February 2015 Crows Nest www.themhs.org
NSW 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 Developmental Disabilities, Challenging Behaviour and Mental Health Conference 7 November University of Sydney www.sydney.edu.au/healthsciences/cdrp/events/current-events.shtml NSW Urological Nurses Society Professional Development Day Clinical Update in Uro-Oncology 7 November Burwood RSL 9990 4148 or urological_nurses@hotmail.com www.nswurologicalnurses.com Midwives on the Tweed 11th Annual Education Day Galloping Forward 7 November Tweed Heads Bowls Club midwivesonthetweed@iprimus.com.au High Dependency Nursing Conference Beyond the Basics 7 November Westmead Hospital Ryan.Thomas@health.nsw.gov.au Connecting for Successful Aging Forum 12 November Kingsford 9382 3753 or ACPSforum@gmail.com 6th Australian Rural and Remote Mental Health Symposium 12-14 November Albury www.anzmh.asn.au/rrmh Spotlight on Liverpool lives A talk by Dr Jennifer Harrison 13 November Liverpool City Library 10.30am-12.00pm
Australasian Cardiovascular Nursing College 9th Annual Conference 13-14 March 2015, Coogee www.acnc.net.au DANA Many Faces of Addiction Forum 13-14 August 2015 Sydney www.danaconference.com.au
No 2 Bullying Conference 29-30 June 2015 Gold Coast www.no2bullying.org.au
INTERNATIONAL
The MHS Conference Best Practice into Reality 25 - 28 August 2015 Canberra www.themhs.org
International Conference on Infectious and Tropical Diseases 16 -18 January, 2015 Phnom Penh, Cambodia www.ictid.webs.com Asia Pacific Hospice Conference Transforming Palliative Care 30 April - 3 May 2015 www.2015aphc.org
INTERSTATE
REUNIONS
Keeping Patients Safe 3 December Brisbane events@qnu.org.au National Nursing Forum Staying ahead of the game 2-4 November Adelaide www.acn.edu.au/forum_2014 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 World Indigenous Health Conference 2014 15-17 December Cairns www.indigenousconferences.com Australian and New Zealand Addiction Conference 4-6 March 2015 Surfers Paradise www.addictionaustralia.org.au
Waikato Polytechnic Nursing Graduates of 1987-1989 reunion 1-2 November Hamilton, New Zealand Molly Forbes 0403 904 650 mollywoppie@gmail.com West Metropolitan Group School of Nursing - Westmead Hospital (1979 intake) 8 November Sydney Meg Board (nee Adcock) 0416 005 650 mboard@bigpond.net.au Hastings District Hospital - 20-year reunion 29 November Port Macquarie Karen Slater 0408 984 864 k.c.slater@bigpond.com St. Vincent’s Hospital HIV Inpatient Unit 17 South 30th Anniversary Commemoration 28 November John McAllister john.mcallister@svha.org.au
ACT
diary dates is a free service for members.
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SITTING PRETTY? REVIEWERS WANTED. Join our movie review team – share your opinions with your fellow Association members and see free screenings of next month’s new release films! Email lamp@nswnma.asn.au to join our Nurse Reviewer email list and receive notification of upcoming screenings.
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HE038_Lamp_271014.qxp_HE000_Lamp_2014 27/10/2014 2:00 pm Page 52
At First State Super we believe Australians who choose careers looking after others
Consider our product disclosure statement before making a decision about First State Super. Call us or visit our website for a copy. FSS Trustee Corporation ABN 11 118 202 672 ASFL 293340 is the trustee of the First State Superannuation Scheme ABN 53 226 460 365.
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