THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION
VOLUME 71 No.11 DECEMBER 2014–JANUARY 2015
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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.11 DECEMBER 2014–JANUARY 2015
Hunter Office 8-14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 8595 1258 For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017
COVER STORY
12 | RN aged care role under threat
Produced by Hester Communications T 9568 3148
The NSWNMA intends to campaign to preserve the critical role of RNs in aged care, now under threat due to changes to federal aged care laws.
Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au
Louise Stammers, RN PHOTOGRAPH: SHARON HICKEY
REGULARS
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Editorial Your letters News in brief Ask Judith Social media Crossword Nursing research online Books Movies of the month Diary dates
PRIVATISATION
20 | ED nurses rally for ratios
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
RATIOS
18 | Group action wins better pay at Whiddon NSWNMA General Secretary Brett Holmes says union membership jumped more than a third and branch numbers increased from two to six.
G20
28 | Unions advocate for fairer tax at G20 While the global political glitterati shared the limelight with some compliant koalas at the G20 leaders conference, other voices were in Brisbane advocating for fairer public policy.
COMPETITION
36 | 2014 Christmas giveaway
EBOLA OUTBREAK
30 | Public emergencies need public 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.
Ebola 2014 has dramatically highlighted the need for strong public health systems and strong governments to run them. THE LAMP DECEMBER 2014–JANUARY 2015 | 3
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EDITORIAL BY BRETT HOLMES GENERAL SECRETARY
We must insist on RNs in aged care 24/7 Recent legislative changes have threatened the role of RNs in aged care and there are implications for the wider nursing profession.
Aged care residents and their families expect, and are entitled to expect, that they will receive specialised care overseen and delivered by an RN.
We are becoming accustomed to policy changes in health being dictated by a drive for profit or cost cutting. When these changes are analysed against their impact on the whole health system they rarely make sense. In fact they often defy logic. We have seen this with the floating of a GP co-payment. What would seem, to be a small and innocuous increase in the fee to visit your GP, would in fact lead to a greater financial burden on patients and ultimately the public health system. The poor and disadvantaged will postpone treatment, inevitably leading to more public hospital presentations at far greater financial cost to the health system. In a nutshell: worse health outcomes at greater cost to the health budget. Recent changes to aged care legislation contain the same, flawed logic. Changes to the federal Aged Care Act could have a knock-on effect in New South Wales, effectively removing the requirement to have an RN in aged care facilities around the clock (see page 12). Some aged care providers will no doubt see this as an opportunity to reduce costs and sidestep regulatory oversight. The biggest losers will be aged care residents, their families and the public health system. Aged care residents and their families expect, and are entitled to expect, that they will receive specialised care overseen and delivered by a registered nurse. Any loss of RNs in aged care will further undermine a resident’s access to end-of-life and palliative care, management of acute incidents and episodes and pain management. The consequence for our public hospitals, especially emergency departments, would be serious and significant. Our emergency departments are already at a tipping point. This has been the motivation behind our ongoing campaign to win ratios of 1:3 in EDs.
Although EDs are already stretched to the maximum they face the prospect of being further overwhelmed if the GP co-payment is implemented. This has been highlighted by health economists and confirmed through modelling carried out by NSW Health (see page 21). The loss of RNs in aged care would increase this pressure as residents present to our public hospitals with ailments that could easily be treated by an RN on duty in their own facility. This threat to the role of RNs in aged care should concern the whole nursing profession. Replacing RNs with lesser skilled staff sets a precedent that will be welcomed by governments responsible for public hospital budgets and private hospital operators eager to increase profits. I urge all nurses and midwives to support our colleagues in aged care. The integrity of our profession is at stake. NORTHERN BEACHES HOSPITAL UNDERMINES PUBLIC HEALTH The Baird government’s decision to give the private sector operator Healthscope the contract to build and run the new Northern Beaches Hospital is disappointing. It confirms that the state government has an agenda to privatise more public hospitals throughout the state, including Maitland and Byron Bay, regardless of the consequences for patients, families or staff. The NSWNMA has campaigned hard against the privatisation of the state’s public hospitals, not just on behalf of our members but on behalf of the community. We will not stop. Privatising public hospitals is appalling public policy and we will continue in our efforts to educate the public about the seriousness of these threats to the future of public health services.
THE LAMP DECEMBER 2014–JANUARY 2015 | 5
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
YOUR LETTERS
L ET T ER OF T H E M ONT H
Bottled water makes planet sick I was delighted to see the advert in the November Lamp about greening your hospital. My biggest issue presently is why NSW Health is giving bottled water to patients when Sydney drinking water is perfectly safe? I believe the bottles just end up in general waste and the whole thing from production to end product is not environmentally friendly. I presume we are using bottled water because the government does not want to employ staff to take jugs of water to the wards – although that is only speculation on my part. I hope I am not the only person concerned about this issue. Removing bottled water would surely be a big step in making our hospitals greener. Michelle Kerr, RN, Asquith NSWNMA responds The NSWNMA has become a member of the Global Green Healthy Hospitals (GGHH) Network.Via the GGHH web platform we can access tools, case studies and detailed information from nurses and other experts all over the world and pass these on to members.The Association advertised in the November Lamp to find members who would like to receive a new e-newsletter covering environmental health issues. Email lamp@nswnma.asn.au if you are interested.
Thanks for DVD prize I was pleasantly surprised to receive the ANZAC Girls DVD from the last Lamp competition. I learned of many of the characters from the history of nurses at war. I shall share these DVDs with nurses in the family (Mum and my sister) and friends. Thank you very much. Sharon Emerson, CNE, Jindera
Honouring a friend in daily work December 9, 2014 is the 20th anniversary of the death of nurse Sandra Fiona Hoare. Sandra was a young, intelligent, vibrant nurse commencing her career at Walgett Hospital when she was abducted and brutally murdered while working a Sandra Hoare night shift. She was 21. Sandra was my best friend. It was her lifelong dream to be a nurse. As a registered nurse I take pride in my position and honour her memory daily in the work that I do. Toni Taylor, RN,Tallebudgera Valley, Queensland Proud to be a member Our Association makes me proud to be a member. They are really leading the way to a more equitable future and they’re walking the walk, not just talking the talk, as evidenced in the Robin Hood Tax tour that went up the coast to the G20 in November. Angie Gittus, RN, Nimbin
HAVEYOURSAY Send your letters to: Editorial Enquiries email lamp@nswnma.asn.au fax 9662 1414 mail 50 O’Dea Avenue, Waterloo NSW 2017 Please include a high resolution photo along with your name, address, phone and membership number. Letters may be edited for clarity and space. Anonymous letters will not be published.
Every letter published receives a $20 Coles Group & Myer gift card.
letter of the
mon th The letter judged the best each month will be awarded a $50 Coles Myer voucher. “Whatever your next purchase, remember Union Shopper. After all, who can think of a reason NOT to save.”
unionshopper.com.au • 1300 368 117 THE LAMP DECEMBER 2014–JANUARY 2015 | 7
NEWS IN BRIEF
Britain
Agency spend bleeds NHS dry NHS spending on agency nurses and other staff has skyrocketed to more than £5.5 billion in the past four years and continues to rise amid a recruitment crisis in the British health service. According to the Observer newspaper budgets for temporary staff this financial year have been blown apart with spending in some parts of the NHS running at twice the planned figure. Reliance on agencies – at a cost of up to £1800 per nurse per day – comes as the number of nurse training places in England has been cut. According to latest figures there were 7000 fewer qualified nurses in August 2013 than in May 2010. Figures released by the British government show that, despite repeated pledges to cut spending on agency staff, the cost to NHS foundation trusts have increased by around 20 per cent for each of the four financial years of the Conservative government. Trusts are now facing what Monitor, the health services regulator, calls “unprecedented financial pressure” due to their reliance on expensive agency staff. Dr Peter Carter, general secretary of the Royal College of Nursing, told the Observer: “These spending figures beggar belief and are the result of truly incompetent workforce planning. Nursing staff are sometimes seen as an easy target for cost savings, only for the NHS to find itself dangerously short staffed and having to plug the gap.”
NHS workers’ Strike, Monday 13 October. PHOTO: UNISON
Britain
First strike in three decades More than 400,000 English health staff including nurses and midwives walked off the job for the first time in 32 years in October, in a dispute over pay. The four-hour stoppage was called after the health secretary Jeremy Hunt denied health workers a one per cent pay increase, which had been recommended by the National Health Service (NHS) pay review body. Unison, the union with the most NHS staff involved in the strike, hailed the action as “an incredible success”. Members from seven unions took part. The initial day of action was followed by a work-to-rule policy for the rest of the week, with 2600 senior hospital doctors belonging to the Hospital Consultants and Specialists Association joining the action. Unions are now considering whether further action should be extended to a day-long stoppage or to increase the impact by calling on different groups of staff to go on strike at different times during a 24-hour period. Paul Foley from Unison told the Guardian newspaper: “If Jeremy Hunt doesn’t talk to the unions there will be another strike in November. We want a one per cent pay rise for all staff, and we’re asking for the living wage to be the lowest entry point.” Rachael Maskell, head of health at the union Unite, said: “We will definitely be taking further industrial action if the government doesn’t put more money on the table.” 8 | THE LAMP DECEMBER 2014–JANUARY 2015
“THESE SPENDING FIGURES … ARE THE RESULT OF TRULY INCOMPETENT WORKFORCE PLANNING.”
NEWS IN BRIEF
Britain
Calorie count on alcohol? Beer, wine and spirits are fuelling the obesity epidemic and should be labelled with the calories they contain, say British public health experts. The Royal Society for Public Health polled 2000 people to find out what they knew about the calories in alcohol and found that the vast majority had little idea. More than 80 per cent did not know, or incorrectly estimated, the calorie content of a large glass of wine. And almost 60 per cent did not know how many calories were in a pint of lager. But there was support for the information being made available, with 67 per cent saying they would welcome calorie labels on the packaging of alcoholic drinks. A large, 175ml glass of 13 per cent ABV (alcohol by volume) wine contains 160 calories, a bottle of alcopop contains 170 and a pint (568ml) of four per cent ABV beer contains 180. Currently alcohol is exempt from calorie counts because labelling is only required for food. Health experts were in favour but the alcohol industry was resisting the proposed change.
Australia
Unions push for domestic violence leave
“Evidence shows that having an income gives women choice, stops them becoming trapped and isolated in violent and abusive relationships …”
Unions are pushing to give millions of Australian workers access to domestic violence leave. ACTU President Ged Kearney says paid domestic violence leave is designed to support victims of domestic violence and help them keep their jobs. “Having a job is critical if women are to leave a violent relationship. Domestic violence is not – and should not – be a private matter that is dealt with behind closed doors,” she said. The ACTU is making a claim to the Fair Work Commission for 10 days paid domestic violence leave for permanent staff and 10 days unpaid leave for casuals to be included in all industrial awards. Ged Kearney says one in three Australian women experience physical or sexual violence by an intimate partner. “Having access to domestic violence leave means victims have time to attend court appearances and related appointments, seek legal advice and make relocation arrangements. “Evidence shows that having an income gives women choice, stops them becoming trapped and isolated in violent and abusive relationships and enables them to care for their children and provide them with a safe home environment.” Australian Bureau of Statistics figures show that two thirds of the 400,000 plus people who experience domestic violence each year are in paid employment. THE LAMP DECEMBER 2014–JANUARY 2015 | 9
NEWS IN BRIEF
ComSafe Training Services Workplace Emergency Response Professionals
Australia
Call for disclosure on doctors’ payments The Australian Competition and Consumer Commission (ACCC) has called on Medicines Australia to include a provision in its code of conduct that would see doctors disclosing their participation in any payment deals with pharmaceutical companies. The code sets the standards for the marketing and promotion of prescription pharmaceutical products in Australia. “The ACCC supports the introduction by Medicines Australia of a regime to provide transparency about payments provided to individual doctors by drug companies,” ACCC commissioner Sarah Court said. The Consumers Health Forum (CHF) told the online health blog Croakey that it welcomed the move. CEO of CHF Adam Stankevicius said: “If a doctor is accepting payments or perks from drug companies for participating in ‘educational’ events, patients should be able to ascertain this. Doctors and companies have been coy about these ‘transfers of value’, but patients should not be left in the dark as to whether the drug they are prescribed comes from a manufacturer who has given money or other benefits to their doctor.” In the United States pharmaceutical companies spend more than $6 billion a year promoting their products via pharmaceutical reps. Drug company payments are now publicly available in the US due to a provision in President Obama’s healthcare reforms, designed to bring greater transparency to the relationship between doctors and the pharmaceutical industry. According to a World Health Organisation report, pharmaceutical company representatives are frequently the only source of drug information in developing countries; and in some countries there is one rep for every five doctors.
Britain
Labour introduces anti-privatisation bill As the NHS lurches from one crisis to another in reaction to the Conservative government’s disastrous health reforms, the opposition Labour Party is to introduce a bill that would reverse the measures that have opened the British health service to the mercy of private operators. According to the Guardian the bill would “exempt the NHS from the EU-US trade treaty known as the TTIP [Transatlantic Trade and Investment Partnership], repeal the ‘section 75’ rules that force compulsory tendering of all NHS contracts, remove the freedom that allows NHS hospitals to earn up to 49 per cent of their income from treating private patients and restore the Secretary of State’s responsibility for the NHS”. The bill was to be voted on as The Lamp went to print. Labour’s shadow health secretary Andy Burnham challenged government MPs to support the bill and “admit that their health reforms had been a mistake”.
NEWS IN BRIEF
World
Index of ignorance A fascinating poll that tests the public’s understanding of the statistics behind the daily news in countries including Australia, has come up with a disturbing finding: people are nearly always wrong about almost everything. And while Australians displayed high levels of ignorance about the issues that shape political opinion, they were a lot less ignorant than most. Of the 14 countries polled Italy ranked as the most ignorant, Sweden the least. Australia came out relatively well, ranked the sixth most accurate on the “index of ignorance”. Some illuminating findings were: • Australians polled thought that Muslims make up 18 per cent of the Australian population, whereas the actual figure is two per cent. • They thought that 23 per cent of working age Australians were unemployed and looking for work, when the actual figure is six per cent. • When asked what percentage of girls aged 15 to 19 give birth each year, Australians said 15 per cent: when in fact it is two per cent. • Each country had its particular blind spot. Germans thought teen pregnancy in their country was 35 times worse than it actually is. • Australians also mistakenly believe the murder rate is rising.
Australia
ACTU defends industry super The Australian Council of Trade Unions has come out in support of not-for-profit industry super funds following reports the Financial System Inquiry is being lobbied by big banks to consider rolling back union involvement in the funds. Former CEO of the Commonwealth Bank David Murray chairs the Financial System Inquiry, which was established by the Abbott government. ACTU assistant secretary Tim Lyons says that workers’ retirement savings should be protected from predatory and profit-driven banks. “Australians should be very concerned about the desire of the big banks to get hold of superannuation,” he said. “The Financial Services Inquiry was established to look at competition, consumer protections and choice in financial services. “The FSI is not a plaything of the major banks and must not be hijacked by them and their financial planners, who are desperate to get their hands on ordinary workers’ superannuation. Industry funds have outperformed retail funds and the ‘no commission’ model continues to embarrass the finance sector and the banks. The argument that industry funds have a conflict is laughable considering they are run entirely to benefit members.” Tim Lyons says superannuation is a workplace entitlement fought for and won by union members. “A decent retirement income was not available to ordinary workers before legislated workplace superannuation. The Australian industry funds are some of the strongest, best performing and best governed in Australia and our savings system is the envy of many other countries.” Mr Lyons says the ACTU and unions will fight to keep superannuation default funds in industrial awards and enterprise bargaining agreements to protect workers’ rights and entitlements.
Tim Lyons, ACTU assistant secretary
“AUSTRALIANS SHOULD BE VERY CONCERNED ABOUT THE DESIRE OF THE BIG BANKS TO GET HOLD OF SUPERANNUATION.” THE LAMP DECEMBER 2014–JANUARY 2015 | 11
COVER STORY
RN aged care role under threat The NSWNMA intends to campaign to preserve the critical role of RNs in aged care, now under threat due to changes to federal aged care laws that impact on state legislation.
THE PUBLIC HEALTH ACT EXISTS TO protect the public and that means the law should insist RNs are available in clinical roles in our nursing homes 24/7, says NSWNMA General Secretary Brett Holmes. “Aged care employer organisations are always calling for ‘flexibility’ in staffing, which is just code for reducing costs and getting rid of regulation,” he said. “But that existing regulation is about protecting residents – a very vulnerable sector of our community – and the law that insists on RNs to be available around the clock should be maintained in the interests of the aged.” Currently there is a requirement in the New South Wales’ Public Health Act that all nursing homes have an RN on duty 24/7. There are also requirements for appointing a director of nursing. The act also defines which facilities are classified as “nursing homes” in New South Wales: these make up about half of
the 885 aged care homes in the state. When the federal Aged Care Act was changed earlier this year it had a knockon effect to NSW legislation, and it’s now in the hands of the NSW government to preserve the role of RNs in our aged care facilities. They have enacted an interim amendment, which maintains the status quo, while they consult and decide. “Losing this would be just one more blow to aged care nurses trying to deliver expert clinical care on site. It would lead to unnecessary trips to emergency departments and more admissions to our already over-stretched hospital wards,” said Brett Holmes. “It will further undermine residents’ access to end-of-life and palliative care, management of acute incidents and episodes and pain management. “This specialised care should be overseen and delivered by registered nurses, with support where needed from other services.”
12 | THE LAMP DECEMBER 2014–JANUARY 2015
Stand with aged care RNs The threat to RNs in aged care could have broader consequences for the nursing profession. To find out more and to register your support for RNs working in aged care visit the NSWNMA website at www.nswnma.asn.au/insist-on-aregistered-nurse-247-in-aged-care/
Impact of federal law change on NSW Changes to the Commonwealth Aged Care Act on July 1, 2014, removed the distinction between “high care” and “low care” in the aged care sector. Until this date the NSW Public Health Act required that “a registered nurse is on duty in the nursing home at all times” and defined which aged care homes were nursing homes. The changes to federal law have implications for state law, potentially eliminating the requirement to have an RN on duty at all times in a nursing home. Following pressure from the NSWNMA the NSW Minister for Health, Jillian Skinner, announced an amendment to the Public Health Act that maintained the status quo and the legal requirement for an RN in nursing homes, while consultation took place with stakeholders. The NSW Poisons and Therapeutics Goods Act also uses the same definition of a “nursing home” to regulate the handling of Schedule 4D and Schedule 8 medications in a nursing home. This remains in force.
EDs bear the brunt non-metropolitan area there was a Data gathered by the Emergency lack of skilled and/or registered Care Institute, a research body staff in some aged care facilities to funded by NSW Health, highlights cope with resident needs. the high proportion of older people attending emergency “Many aged care facilities operate departments, including a significant with high numbers of unskilled number from residential aged care staff. Many low care facilities do facilities that lacked the capacity to not have an RN on site after hours deliver the necessary clinical care. or equipment to care for people who are immobile or acutely The data was collected as part of unwell.” the Aged Care Emergency Model of Care, a pilot project that aims to The institute also noted the reduce the impact of aged care varying capacities of residential patients on EDs. aged care facilities (RACF) to deliver clinical care. The institute found that at one major metropolitan emergency “The ability of staff to manage department, 38 per cent of residents within the facility varies presentations were patients aged significantly as the capacity and over 70. Half of these presentations staffing within RACF, including the – 8690 – came from residential presence and number of RNs, aged care facilities. differed between the level of care,” it said. The institute noted that in one
THE LAMP DECEMBER 2014–JANUARY 2015 | 13
COVER STORY
Residents risk dying in pain Louise Stammers, RN IF SOCIETY WANTS QUALITY CARE FOR THE ELDERLY THE STAFF SKILL MIX IN NURSING HOMES MUST INCLUDE AN RN AVAILABLE AT ALL TIMES TO ASSESS THE CHANGING NEEDS OF RESIDENTS, SAYS LOUISE STAMMERS, REGISTERED NURSE AT BUCKLAND NURSING HOME, SPRINGWOOD.
The backbone of palliative care Jenny McKenzie, NP PROPOSED CHANGES TO THE LAW TO REMOVE THE REQUIREMENT FOR RNS TO BE EMPLOYED AROUND THE CLOCK IN NURSING HOMES ARE “SHORT SIGHTED AND SCARY” SAYS NURSE PRACTITIONER JENNY MCKENZIE.
14 | THE LAMP DECEMBER 2014–JANUARY 2015
“It’s scary that we may no longer get the staffing to adequately look after elderly people,” says Jenny, a nurse practitioner in palliative care for Wagga Wagga Health Services, providing in-reach consultancy to acute services and community-based care. “I think changing the law would be very short sighted on the part of the policy makers.” She describes RNs as the backbone of palliative care. “RNs do the assessments; they are the centre point for communicating with the medical staff who generally don’t have the flexibility and time to sit down and have a conversation about end-of-life choices. “You can’t provide good quality care without an RN in a nursing home around the clock. Who else is going to give the S8 medications? Who is going to do the assessments and tell the doctors when someone’s health deteriorates? “I do a lot of work in-reach into an acute hospital and I’ve seen many sad cases of people in their eighties and nineties being sent in because their care facility doesn’t have the capability to do a proper assessment due to poor staffing. “Sometimes we are able to help them to return to the facility with a good supportive palliative plan. “At other times their advanced care directive is ignored and it is an awful cascade of acute care that turns into a disaster. They end up dying in hospital and that’s a tragedy.”
Louise warns that without an RN around the clock there is a risk that high-care residents will die in pain and hospital emergency centres will be overloaded by unnecessary admissions. “If a resident’s indwelling catheter blocks and there is no RN on duty, to either change it or unblock it, that resident will end up in hospital ED. That will put the resident under more stress and worsen their health. “If a tube-fed resident’s tube dislodges unexpectedly and there is no RN on duty to replace it immediately, the resident will end up in ED. If the transfer takes too long difficulties may arise for re-inserting the tube. “Several of our residents have an advanced care order that states they are not for active treatment of conditions for which no positive outcome can be expected, and not
for hospital transfer for those conditions. They have a standing order for morphine injection should it be needed. “If the resident is suddenly and unexpectedly in acute pain – which is part of their untreatable condition – and there is no RN on duty, do they die in pain because no one is around to initiate morphine injections? Do they suffer the distress of a hospital transfer when that was not wanted? “We also need to ask whether those who are not qualified RNs are able to assess the changing condition of their residents. Are they capable of intervening quickly enough to prevent a condition worsening and needing hospital attention? Are they willing to take that responsibility? Are they able to explain a resident’s condition to anxious family?”
“If the resident is suddenly and unexpectedly in acute pain – which is part of their untreatable condition — and there is no RN on duty, do they die in pain because no one is around to initiate morphine injections?”
THE LAMP DECEMBER 2014–JANUARY 2015 | 15
COVER STORY
Unnecessary use of hospital ED Sheila O’Mara, RN REMOVING THE REQUIREMENT FOR AN RN TO BE EMPLOYED AROUND THE CLOCK IN NURSING HOMES WILL HAVE A SERIOUS IMPACT ON PUBLIC HOSPITAL EMERGENCY DEPARTMENTS WARNS TWEED HOSPITAL ED NURSE SHEILA O’MARA.
Nursing homes in the Tweed Hospital area of northern New South Wales and Southeast Queensland already make unnecessary use of the hospital’s ED, she says. She fears some nursing homes may take advantage of any relaxation of the requirement to employ RNs, to reduce their hours or eliminate them entirely. “Quite a few nursing homes in our area are increasingly sending residents into emergency for things such as a blocked catheter and even to administer Panadol. “These could be quickly attended to at the facility if an RN was on duty. “It might only take us five minutes to unblock a catheter and we can send the resident straight back to the nursing home if the ambulance can wait. “But that ties up an ambulance unnecessarily and takes us away from emergency duties. “If a resident gets a headache in the middle of the night and there is no RN on duty, facilities will sometimes send them to hospital by ambulance. They have to be seen by a doctor and it can take hours until an
ambulance becomes available to take them back to the facility. “Aside from the medical consultation there is a lot of extra care involved. You can’t very well send the patient to the ward while you’re waiting for transport, so they stay in the ED which impacts on our workload as well. “If they are bedridden we have to put them in our EMU (emergency medical unit) ward until an ambulance becomes available. “That’s a huge waste of resources – all because the nursing home won’t employ anyone to administer simple pain relief.” Sheila says that apart from a drain on hospital resources and public funds, residents are distressed when unnecessarily brought to hospital. “Being taken out of their familiar environment and having to hang around in hospital is just not fair on elderly residents. “Some doctors in sheer frustration have called the nursing home to ask why a patient has been brought into ED unnecessarily. The answer always is, because we have no nurse on duty.”
“That’s a huge waste of resources — all because the nursing home won’t employ anyone to administer simple pain relief.”
16 | THE LAMP DECEMBER 2014–JANUARY 2015
Uncomfortable without an RN Ron Hardy, AiN RON HARDY, AN ASSISTANT IN NURSING FOR 17 YEARS, APPRECIATES KNOWING HE CAN RELY ON THE HELP AND ADVICE OF A REGISTERED NURSE AT HIS AGED CARE NURSING HOME.
Ron says AiNs regularly seek the advice of RNs on medicines and injuries. “For example, medicine sometimes arrives from the chemist that doesn’t match what is on the order chart. We ask the duty RN to check it and decide what can be used and what needs to be ordered. “Being able to get backup from the RN means that the AiN does not have to bear the load of making that decision. The RN has the training and hopefully the experience to be able to say ‘this is what we can do to overcome the problem’. “I would feel very uncomfortable dealing with something like that because my training doesn’t extend to those areas. “Likewise if a resident has a fall we need someone trained and experienced to assess them and decide what needs to be done. “If we had no RN it would be up to an AiN, who may only have the basic certificate III and no real experience, to decide if it is okay to get the resident up and move them or to call an ambulance, which should really only be for acute cases. “It is a lot of stress on us AiNs to have to make a call like that when there’s no RN there to back us up.” Ron says an RN is also sometimes needed to talk to relatives who have questions and demands relating to a resident’s care. “The RN can step up with the qualifications and the authority to explain that the care someone is receiving is in accordance with their care plan as ordered by the doctor. Families are far more likely to listen to an RN than to an AiN.”
“if a resident has a fall we need someone trained and experienced to assess them and decide what needs to be done.”
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COVER STORY
Group action wins better pay at Whiddon NSWNMA General Secretary Brett Holmes says union membership jumped more than a third and branch numbers increased from two to six during a campaign to win pay rises at the Whiddon Group of aged care homes. of a three per cent pay increase from 1 October 2013. The company originally offered an inferior deal that reduced entitlements to parental leave and long service leave and paid only a two per cent increase per annum. After the NSWNMA’s bargaining committee said this was unacceptable Whiddon responded with a final offer of 2.75 per cent per annum and no reduction in conditions for existing employees. The bargaining committee accepted this offer and it was put to a vote of members. The endorsed agreement includes a number of non-wage improvements including a workloads clause to make it easier to resolve staffing problems (see box). Brett Holmes says the union was disappointed that the company initially
IT TOOK A PETITION SIGNED BY ALMOST 700 nurses to persuade aged care provider Whiddon Group to negotiate an enterprise agreement with the NSWNMA. Faced with majority workforce support for an agreement and the prospect of having to justify in front of the Fair Work Commission its refusal to bargain, the company entered into talks. After several months of negotiations, backed by membership meetings across its 19 residential care homes, Whiddon and the NSWNMA settled on a deal that was overwhelmingly endorsed by nurses. Nurses at Whiddon’s homes in regional, rural and remote New South Wales now have a two-year agreement that provides increases of 2.75 per cent from 1 October 2014 and 2.75 per cent from 1 October 2015. Allowances will rise in line with wage increases and came on top
refused to renegotiate the expired enterprise agreement. “Nurses shared our disappointment. They were rightfully concerned that the three per cent wage increase paid in 2013 was not secured in a legal document and could be taken away at any time,” he said. “We undertook extensive consultation with members through meetings, teleconferences and a comprehensive survey. “We knew that besides a pay increase our members were concerned about other significant matters such as the inclusion of a workloads clause in the agreement. “Whiddon only agreed to negotiate with the Association after we collected nearly 700 signatures and advised Whiddon we would be lodging a majority support application with the Fair Work Commission.”
The Whiddon Agreement • Pay and allowance increases of 2.75% on October 1, 2014 and October 1, 2015. • A clause to ensure workloads are on the agenda at staff meetings on at least a quarterly basis. • Underpayments to be addressed within seven days of notification rather than next pay period. • Annual leave applications to be processed within four weeks. • Minimum payment for the engagement of part-time workers increased from two to four hours. • Commitment that part-time
• •
• •
employees be offered additional hours before casual employees. Casual loading increased to 25%. Introduction of paid, union representative leave of two days per representative for six NSWNMA representatives and three Health Services Union representatives. All AiNs with a Cert III to be paid as a Grade 2. Community Care Co-ordinator classifications included in the proposed agreement.
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“We undertook extensive consultation with members.” — NSWNMA General Secretary Brett Holmes
Members welcome Whiddon win “We felt we deserved a reasonable pay rise.” — Kearra Lord, EN
KEARRA LORD, AN ENROLLED NURSE and NSWNMA delegate at Whiddon’s Kyogle nursing home, said nurses were very happy with the enterprise agreement. “We fought hard for the 2.75 per cent because we felt we deserved a reasonable pay rise. Our pay rates now compare favourably with what other employers are paying,” Kearra said. She said nurses realised they needed to negotiate an agreement in case the employer decided to do away with established working conditions. “Without an agreement our working conditions were not set in stone and could be withdrawn at any time. “Negotiating the agreement was a long process but it was handled really well by the union. “Union membership increased during the negotiations and more than half the staff at Kyogle are now members. Only a handful of nurses were in the union four years ago.” Kearra said the agreement would give more casuals the opportunity to go permanent.
KAREN FLAHERTY, NSWNMA BRANCH secretary at Whiddon’s Belmont facility during the negotiations said nurses wanted an agreement to protect conditions such as penalty rates. “Nurses were worried that their penalty rates were in jeopardy because of the federal Liberal government.They now know their penalty rates and other conditions are stable and protected for the next two years.”
Karen, an assistant in nursing, said Belmont staff members were keen to include a workloads clause in the agreement. Previously only two AiNs were being placed on the roster to care for 53 residents from late evening to early morning. “On one recent Sunday I was the only AiN on duty for three hours in the middle of the day, caring for 33 residents. “The girls are always working short staffed and they hope the workloads clause will help to get extra permanent staff or agency nurses.” Karen says nurses also welcome the requirement that management promptly attend to underpayments, which she says happen too often. “In the past, if we went to the bank on pay day and found an underpayment we would have to wait until the next fortnightly pay to be reimbursed.” She said more than two thirds of nurses at Belmont had joined the NSWNMA. “The numbers went up during the campaign for the agreement, partly because nurses found out the union covers members for accident journey insurance.”
“Nurses were worried that their penalty rates were in jeopardy because of the federal Liberal government.” — Karen Flaherty, AiN
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RATIOS
ED nurses rally for ratios Emergency departments are still the focus of the Association’s push for improved nurse-to-patient ratios. NURSES ARE TAKING ACTION AT EIGHT big hospitals to step-up the NSWNMA campaign for ratios of one-nurse-to-three patients in emergency departments. As this issue of The Lamp was going to press nurses had held rallies and other actions at Westmead, Royal North Shore, Blacktown, Gosford, Campbelltown and John Hunter hospitals, with activities planned for Prince of Wales and St George hospitals. Association action, including a statewide strike in 2010, forced the New South
Wales government to accept ratios for most units of metropolitan hospitals, written into the Public Health System Nurses’ and Midwives’ State Award 2011. As a direct result of this win at least 1580 additional nursing positions were created in the NSW public system between March 2011 and June 2013. The Association is continuing to push for ratios to be introduced in smaller hospitals and specialty health services such as EDs, paediatric wards and community health services.
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NSWNMA Assistant General Secretary Judith Kiejda says the actions of members at the eight, targeted hospitals showed yet again how committed nurses and midwives are to safe patient care and a well-resourced public health system. “These actions are important to make the public aware of what their local nurses are up against when trying to deliver safe patient care in emergency departments,” Judith said.“Despite recent health funding cuts in the federal and state budgets our members know there is a pressing need
NSW Health: GP co-pay will swamp EDs
“We sometimes have patients in the waiting room and on ambulance stretchers for up to six hours on a night shift, because all ward beds are full.”
A leaked NSW Health report reveals that an extra 500,000 people per year will flood state emergency departments if the Abbott government’s GP co-payment is implemented. Modelling carried out by NSW Health found a potential increase of “in the vicinity of 500,000” presentations at an extra cost of $80 million a year. This would be a 27 per cent increase in presentations to EDs.
— Susan Barbosa, RN
for ratios of one-to-three to be mandated in EDs.” NSWNMA members held a rally outside Westmead Hospital in western Sydney to raise community awareness of their 1:3 in ED ratios campaign. RN Susan Barbosa says the need for better staffing ratios has increased during the five years she has worked in Westmead’s emergency department. She says presentations at Westmead increase by thousands every year as the western Sydney population expands. “Like every ED we are focused on meeting the national emergency access target of seeing and treating patients in the department within four hours,” she said. “Yet we sometimes have patients in the waiting room and on ambulance stretchers for up to six hours on a night shift, because all ward beds are full. “It can be quite difficult to meet the target and provide the most appropriate care for patients.” In Westmead’s 25-bed acute care area nurse-to-patient ratios are one-to-four, or one-to-four-and-a-half with two nurses sharing the fifth patient.
Find out more Visit www.backyournurses.org or www.facebook.com/safepatientcare for more information about the ED campaign.
“We require a one-to-three ratio to give us to enough time to fully understand and meet the needs of all our patients,” she said. “When you are running between four patients you don’t always have enough time to talk to patients about how their illness is affecting them. Little things can get forgotten and patients can feel neglected if we only have time to attend to the sickest patients. “There are certain things we can’t do for everyone because we are so under the pump. Yesterday, for example, a woman wanted to have a shower because she had soiled herself. I only had time to give her a quick wash in the bed because I had to attend to a new patient who was involved in a motorbike accident. “The department tries to promote teamwork but it’s hard for us to help one another when every other nurse is just as busy as I am.” Susan believes the federal government’s proposed GP co-payment will only increase the pressure on EDs. “Western Sydney has a lot of nonEnglish speaking people of low socioeconomic status who can’t or won’t pay to see a GP when they know the ED is free. “Even now we get a lot of people with minor health issues who should be going to a GP.” Westmead Hospital ED nurses carried banners declaring “Ratios – Put Patient Safety First” at the recent rally. Campaign posters have gone up inside the hospital and ambulance officers have shown their support by wearing campaign badges. “Better ratios will help ambulance crews too because the sooner we can offload their patients the quicker they can get back out onto the road to attend to other emergency patients waiting for them,” Susan said.
The Sydney Morning Herald (SMH) reported that the chief executive of Sydney Local Health District informed NSW Health that a GP co-payment would lead to patients from disadvantaged communities delaying care “resulting in an increase in severity of their conditions” and more ED patients would lead to “delays, overcrowding and increased demands on staff ”. A letter from Canterbury Hospital to NSW Health said the co-payment would deter low-income families with children from attending GP clinics. “This effect has already been demonstrated with families presenting kids with poorly controlled asthma, as parents cannot afford to see a GP for a prescription/medication,” the letter said. The SMH reported that both the Royal Prince Alfred and Concord Repatriation General Hospital said they were already close to capacity. Federal health minister Peter Dutton justifies the co-payment saying Medicare spending is unsustainable, despite research showing that the growth in health spending has significantly slowed. He dismissed the NSW Health report saying it was “cooked up by obvious union sympathisers”.
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RATIOS
Entering new territory with ratios It’s been almost four years since the NSWNMA won nurse-topatient ratios for many units of metropolitan and rural hospitals. Now the Association is building claims for more specialties and you can contribute your views to the process. Throughout the year volunteer members with expertise in their speciality have been meeting in working groups to discuss future claims for ratios. Using the information gained through these meetings, combined with member comments on discussion papers and Association research, NSWNMA officers have drawn up possible claims for consultation with the wider membership General Secretary Brett Holmes says the Association is undertaking a thorough consultation and testing process of the claims through its branches. He said the working group volunteers had been given a difficult job. “In relation to outpatients, for example, a staffing ratio has never been claimed anywhere else in the world. “As groundbreakers – and due to the complex nature and large number of outpatients clinics – extensive work is required to develop an appropriate claim that the Association can fight for in a future public health campaign. For high volume, short stay and day only units, expert members have recommended ratios of 1:4 on morning and afternoon shifts and 1:7 at night, providing for six face-to-face nursing hours. For day only units, they recommend 3.5 nursing hours per patient. “In drug and alcohol outpatients the working groups have told us that best practice staffing arrangements can be achieved with a time-based approach. “They recommend 90 minutes for an initial assessment, 30 minutes for subsequent visits, including case management, and five minutes for dosing visits.This can be converted to a nursing hours model.” 22 | THE LAMP DECEMBER 2014–JANUARY 2015
“The NSWNMA is undertaking a thorough consultation and testing process of the claims.” — Brett Holmes
The four speciality working groups were • • • •
Drug and alcohol services (inpatient and outpatient) Outpatients (including specialty clinics) High-volume short stay and day only units Maternity services (27 sites without Birthrate Plus)
Have your say You can comment by emailing NSWNMA Officers, Liz Robinson at lrobinson@nswnma.asn.au or Mark Kearin at mkearin@nswnma.asn.au
More time needed with patients
“We need to plan for expansion of our service and ensure there is appropriate staff for these new services.” — Andrew Sipowicz
The working groups recommended that staffing for drug and alcohol inpatient services (mainly detoxification and rehabilitation) should mirror mental health inpatient services, due to the high frequency of dual diagnosis and similarities in the multidisciplinary team model and case mix. Andrew Sipowicz, a registered nurse at the Centre for Addiction Medicine on the Cumberland Hospital Campus at North Parramatta, was a member of the Association’s working party for drug and alcohol services. “At present we negotiate staffing through the reasonable workload committee by focusing on various indicators of unreasonable workloads, such as missing lunch breaks, difficulty in replacing sick leave and an increase in some services without a staffing review for new services,”Andrew said. “We have had some wins through the reasonable workloads committee but if we want to do an effective job for our clients we need a clear method of ensuring we have enough staff with the right qualifications for the existing services we provide. “We need to plan for expansion of our service and ensure there is appropriate staff for these new services.” Andrew says mandated staffing levels would help to ensure sufficient face-toface time with clients. “I work in an outpatient detox service where we do assessments, reviews, case management and counselling.This involves discussion with other service providers
both internally and externally. All of our conversations and actions are documented on a computer program. “We are about to go into activity-based funding that requires considerable documentation, leaving less time for face-toface contact with clients. “Our clients can be quite complex in their needs. They often have significant medical issues associated with drug and alcohol use including Hepatitis C and a range of mental health issues. “A lot of our clients have social issues such as limited education, reliance on welfare payments, criminal histories, sexual and physical abuse, homelessness or living in public housing, chaotic family lives, few social supports outside their drug or alcohol–using friends. These issues can often be generational.” The drug and alcohol services working party looked at opiate substitution programs staffed by drug health services, where dosing clinic staff dispense Schedule 8 medications and engage with and case manage clients on a daily basis. “We think that five minutes is the minimum time nurses need to dispense Schedule 8 medications, ensure that clients are not intoxicated, engage with their clients and document the process,” Andrew said. “Our service also has a Hepatitis C treatment clinic, GP liaison service, D&A consultation liaison service and a drug-usein-pregnancy service. They all need to be staffed adequately with provision for staff going on leave.”
Lisa Snell, nurse unit manager at Western Sydney Local Health District’s Centre for Addiction Medicine, says her staff are passionate about ensuring they devote enough time to deal with the complex needs of their patients. “Our nurses want to feel they can give adequate time to a patient attending either a new or follow–up appointment,” she said. “They don’t want to feel under pressure to get a patient with multiple medical, mental health and social problems, out the door as quickly as possible. “You’re looking at a patient group with significant long-term histories that we’re not going to fix in a couple of minutes. We often need to spend considerable time with these people to achieve good outcomes.” Lisa is a member of the NSWNMA working group that has recommended mandatory staffing levels in drug and alcohol inpatient and outpatient services. Lisa says drug and alcohol services in Western Sydney LHD make use of a reasonable workloads committee and her department is currently well resourced compared to many. “However our colleagues in rural and remote areas are nowhere near as well resourced as we are in metropolitan Sydney. “In looking at issues like workloads it is important to look at the specialty as a whole and support your colleagues out in the regions that might not be staffed as well as we are. “It is important to formalise staffing levels so we don’t overwork our nurses and they get enough face-toface time with patients. “Nurses I’ve spoken to are most supportive of our efforts to ensure that our services are not burning people out. We sometimes have difficulty attracting nurses to work in drug and alcohol services so it is important that we look after those who do come here.”
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PRIVATISATION
Caring for our vulnerable: 25,000 sign up in support
More than 500 people from three different unions including the NSWNMA rallied outside state parliament recently to oppose a state government decision to privatise Ageing Disability and Home Care services (ADHC). A petition with more than 25,000 signatures was presented to the parliament, calling for people with disabilities to be given real choice in their care, including the choice of a publicly funded service. Deborah Langbridge (above) an RN at the Kanangra facility and Lisa Kremmer, Acting Assistant Secretary of the NSWNMA, addressed the rally on behalf of nurses and midwives. 24 | THE LAMP DECEMBER 2014–JANUARY 2015
FORCED INTO A LIFE WITHOUT CHOICE Deborah Langbridge RN I began nursing in 1976 and never before has our public health system faced such a crisis as we are experiencing now.
into a life without choice, without a voice to protest and that is why we are here today, to be their advocate, their voice.
I’ve worked in the disability sector for many years and I stand before you desperate and anxious about the future.
The government must be held accountable when these people fall through the cracks. They deserve to stay in their home with the nurses who know them, who have dedicated their lives to the care and continued quality of life of those entrusted to them.
Their homes will close, their future is unknown, life as they know it will be no more. Privatisation of these services fails to meet their needs. The nurses that care and advocate for them will no longer be there. I am talking about people with severe developmental disability and challenging behavior who are going to be thrust into a world of the unknown: unknown surroundings, unknown carers and an unknown future. They have been given no choice, no rights. This is 2014 but this draconian measure feels like 1814 where people who don’t fit into mainstream society are punished and forced
These nurses will also be abandoned. This is an atrocity, a grave miscarriage of justice and inhumane. Please do not let this happen. The state government is failing in its duty of care to these people. We must stand together and fight for those who cannot. A real choice is a publicly owned and funded disability service.
WHO WILL CARE FOR THE PEOPLE NO PRIVATE PROVIDER WANTS? Lisa Kremmer NSWNMA Without your care and compassion, your skills and knowledge, the most complex and profoundly disabled people simply would not survive. Each and every day you make a difference to the lives of people with disability. But Mike Baird and his government don’t care about people with disability and they don’t care about you. As we know, the government has announced that they will have no involvement in disability services by 2018. Fourteen thousand jobs, including 1200 nurses, are to move to the non-government sector in one of the state’s largest privatisations. We are entitled to ask: what is the case for doing this? Where is the case that this will lead to better care and better quality of life for people with complex disabilities? There isn’t one and if the experience in the UK is anything to go by, this will be a disaster. This is about protecting our most vulnerable citizens and ensuring there is public accountability for their care.
This is about holding the government to account: when privatisation fails, when a business decides that they can’t make enough money out of people with disabilities, where will those people go? Who will they turn to? Because the government is turning its back on people with disabilities. Without the government as a provider of last resort, who will care for the people with disability that no private provider wants or can handle? People with disability in government-run services are being given no choice about keeping the excellent care and services they now receive in the place that they currently call home. Nurses and other disability workers are being given no choice about their employer or future careers. This government is showing nothing but contempt for people with disabilities, nothing but contempt for you and nothing but contempt for our world class public services.
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PRIVATISATION
The privatisation trail in NSW HUNTER NEW ENGLAND D
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Mental Health: Minister for Mental Health and Lifestyles Kevin Humphries announced last year that pilot mental health services would be put out to tender to private companies to deliver mental health, physical health and drug and alcohol support – Dubbo, Orange, Nepean Blue Mountains, Broken Hill, Nowra, and Cumberland have all been stated to be privatised. Short-stay mental health services now run by private operators Neami – 10 beds at Broken Hill and 10 at Dubbo (where Darling Street sub-acute mental health service was shut down and replaced by the privately-run service). New 20-bed mental health facility at Shoalhaven District Hospital to be managed by private operator.
Medicare Locals: Medicare Locals represent privatisation by stealth, in the guise of primary health care. They move community health services into the competitive market and weaken government accountability through outsourcing service delivery.
Public Health Service: Privatisation of Public Health Food Labs: www.change.org/p/katrina-hodgkinsonthe-minister-for-primary-industries-stop-playing-with-nsw-health Privatisation of cleaning services at RNSH. 26 | THE LAMP DECEMBER 2014–JANUARY 2015
SOUTHERN NSW
Palliative care (all over NSW):
A consortium made up of Hammond Care, Sacred Care will service the local health districts of Centra South Eastern Sydney, Western NSW, Murrumbidge West. South Western Sydney LHD in partnership w cover the LHDs of South Western Sydney, Nepean Sydney, Sydney and Illawarra/Shoalhaven. Silver C patients in Hunter New England, Mid North Coast a
ADHC – all disability services in
Stockton (near Newcastle), Kanangra (Morriset Cen Rydalmere, Bloomfield (Orange), Tomaree (Port Ste
Hospitals and medical services: Northern Beaches Hospital (Sydney north), Maitland new hospital (near Metford), Illawarra Shoalhaven Local Health District’s medical imaging services (south of Sydney). Hawkesbury Hospital, privatised by LNP in 1996, resulting in cutting of “non-Catholic” services (eg. sexual health etc) and very minimal Mental Health services. Contract finishes in 2016.
Byron Central Hospital
NORTHERN NSW
MID M NORTH COAST
The Chris O’Brien Lifehouse is a not-for-profit hospital, but still a private hospital with a collaborative agreement with Royal Prince Alfred Hospital. Public patients are treated publicly in the private facility. Royal Prince Alfred runs imaging within the Lifehouse building. As of 18 November 2013, the Sydney Cancer Centre at Royal Prince Alfred Hospital closed operations from the public hospital, for most of the outpatient clinics including outpatient chemotherapy. The Radiation Oncology Department ceased to operate as a Public Facility and continued operatins with some minor works as the new Chris O’Brien Lifehouse. New Cardiac Cathether Lab at Port Macquarie Base Hospital to be privatised. Privatisation of 2 dialysis chairs and loss of 4 public chairs: closure of 8 public dialysis chairs Manning area (Taree), replaced by six chairs in Forster, only 4 of which are public. Proposal for the private sector to provide surgical services at the new Byron Central Hospital.
Aged care: Proposal to privatise 60 aged care beds at Gloucester
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n NSW:
ntral Coast), Westmead, ephens). THE LAMP DECEMBER 2014–JANUARY 2015 | 27
ROBIN HOOD TAX
Unions advocate for fairer tax at G20
Michael Whaites (NSWNMA), Juliette Ashton (CPSU), Brett Holmes (NSWNMA) and Arthur Rorris (South Coast Labour Council) at the Robin Hood Tax tour.
While the global political glitterati shared the limelight with some compliant koalas at the G20 leaders conference, other voices were also in Brisbane advocating for fairer public policy. With major concerns over the future of essential public services and access to Medicare, unions argue that governments could raise billions of dollars in revenue using a modest levy, of between 0.005 and 0.05 per cent, placed on the trading of stocks, bonds, derivatives, futures, options and credit default swaps. The NSWNMA joined international colleagues from Global Nurses United, representing nursing and midwifery unions from 14 countries and Public Services International, a global trade union federation of public service members, to argue the case for a Financial Transactions Tax (FTT) also known as the Robin Hood Tax. The FTT is gaining momentum as public policy in many parts of the world especially Europe. The European Commission reached agreement with 11 member states earlier this year to develop an Accord that would enable a European Union Financial Transactions Tax from 1 January 2016. France and Italy have already introduced their own domestic financial transactions taxes. NSWNMA General Secretary Brett Holmes says it is possible for governments to implement a Financial Transactions Tax to fund services like public health, aged care and Medicare, while shielding low and middle income earners through other taxation changes. “Instead of trying to slug those already doing it tough by broadening the GST base, we want the government to seriously consider alternative measures, such as a Robin Hood Tax, to address the country’s revenue problem,” he said. “We believe this levy is worthy of consideration rather than shifting public health care to an Americanised two-tier health system, where privatisation will impede access to health care and patients will be forced to question their wealth over their health.”
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The NSWNMA advocated for the Robin Hood tax on a road tour starting in Wollongong and progressing through Parramatta, Gosford, Newcastle, Tamworth, Port Macquarie, Coffs Harbour, Lismore and Tweeds Head before finally arriving in Brisbane for the G20.
NSWNMA representatives with our colleagues from the Queensland Nurses Union at the G20 Roadshow
NSWNMA RHT delegation, South Bank. Brisbane. Left to right: Gary Clark, Connie Cullen, Coral Levett, Michelle Cashman, Mark Murphy, Matt Henderson
Get involved
A global campaign for tax justice with (l-r) Linda Silas (Canadian Federation of Nurses Union), Kenneth Zinn (NNU), Coral Levett (NSWNMA), Deborah Burgher (NNU), Beth Mohle (QNU), Brett Holmes, Abdul Adeniji (President, Association of Nigerian Nurses & Midwives) and Daniel Bertossa (PSI)
The tour gained broad community support with other public sector unions actively supporting the tour. This included delegates from the CPSU who are fighting to stop the privatisation of Medicare, the ASU/USU and the ETU. The Association will continue to build on this support throughout 2015. For more information about how to get involved visit out website at www.nswnma.asn.au/get-involved/taxjustice or phone us on 8595 2153.
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EBOLA OUTBREAK
Public emergencies need public health Ebola 2014 has dramatically highlighted the need for strong public health systems. EBOLA OUTBREAKS ARE PREDICTABLE AND preventable and the virus is not highly transmissible: yet the 2014 outbreak has led to more than 5000 deaths and forecasts of 1.4 million infections by January 2015. Why? This question throws a harsh spotlight on private versus public funding of health, medical research and even the UN’s World Health Organisation (WHO). It has also led to calls for a rethink on how healthcare and research into vaccines are funded. As private individuals with no public oversight become more powerful in deciding where health, aid and research money is being spent, governments that are subject to public scrutiny and accountability may find themselves less able to respond adequately to public health concerns. According to Calestous Juma, Professor of the Practice of International Development at Harvard Kennedy School: “Those who believe the private sector can only function by shrinking the capacity of the public sector may be giving up their ability to protect citizens against public emergencies.” This is being revealed now as America, the most highly-privatised health system in the world, scrambles to prepare for Ebola to arrive on its shores. In late October Reuters Press Agency reported that US health officials were still trying to establish a network of about 20 hospitals nationwide that would be fully equipped to handle all aspects of Ebola care. In 2006, at the end of the Liberian civil war, that country’s healthcare system had fewer than 15 doctors – compared to 3000 at its prime – and was staffed mainly by NGOs and aid agencies that were concentrating on restoring basic health and training to the system. By 2012 the country’s 15 political subdivisions each had a government-run hospital with a Liberian doctor in charge, as opposed to only eight in 2006 and only three Liberian doctors. In contrast, says Professor Juma, the key
to successful containment of Ebola in neighbouring Nigeria was the strength of that country’s public sector. On October 20 Nigeria was declared Ebola free: a country of 174 million people had just 20 confirmed cases and eight deaths, half the fatality rate of other countries involved in the outbreak. Three days after the first case was diagnosed Nigerian bureaucrats working with WHO, Médecins Sans Frontières (MSF), UNICEF and the US Centre for Disease Control (CDC) had established an operations center to respond to the outbreak. The CDC praised the collective effort: “Immediately, the [response centre] developed a functional staff rhythm that facilitated information sharing, team accountability, and resource mobilisation, while attempting to minimise the distraction of teams from their highest priorities” the agency wrote. “Having all the relevant government and international authorities in one place helped streamline decision-making and ensured a rapid, effective, and coordinated response.” ECONOMIC CONDITIONS FOR AN EBOLA OUTBREAK WHO was criticised for its failure to respond to warnings from MSF in April 2014 about Ebola in West Africa. WHO director general Margaret Chan has said that “donor interests” drive her budget. She has also said: “The Ebola outbreak spotlights the dangers of the world’s growing social and economic inequalities.” The Bill and Melinda Gates Foundation contributes $300 million to the WHO budget, more than the United States or the United Kingdom, and has announced it will donate $50 million to the Ebola effort. Charitable giving by foundations is tax deductible. “Philanthropy can be a potent instrument for ‘managing’ the poor rather than empowering them,” the Global Health Watch organisation said in a recent report.
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“Few grants go to civil rights and social movements.” According to the Director of the Centre for Values and Ethics and the Law in Medicine at University of Sydney, Ian Kerridge, and the Clinical Professor in Medicine and Infectious Diseases at University of Sydney, Lyn Gilbert, writing for theconversation. com:“The likelihood of outbreaks of disease due to Ebola and other viruses that jump from animals to humans, increases when people are forced, by poverty, limited sources of protein, global capitalism and neoliberal market policies, into dangerous places and practices to survive. “Unless we confront these structural problems, genuinely consider alternative policies and strategies, such as new forms of taxation and market economics in line with public health goals, pooling of intellectual property to facilitate drug and vaccine development, and different approaches to science and science funding, the problems highlighted by this outbreak will be endlessly repeated. “The most difficult but important step is to critically examine the sociopolitical and economic conditions that create the environment for such outbreaks to occur.”
After receiving training, volunteers with the Red Cross Society of Guinea prepare to disinfect the hospital of Tahouay in Conakry, following an Ebola outbreak. PHOTO: ©AFREECOM/IDRISSA SOUMARÉ
STOP PRESS US nurses win better protection following strike Californian nurses have won mandatory regulations for optimal personal protective equipment to be worn when treating Ebola patients. This follows a strike by over 100,000 nurses. It was the largest health and safety action in any industry in the US for the last 45 years. For more details on the new California standards see www.nationalnursesunited.org/ blog/entry/ebolapreparedness-what-nationalnurses-united-won-in-california/
Early action saves lives EIGHTY PER CENT OF MEMBERS SURVEYED by National Nurses United, America’s largest union of registered nurses, said they had not been given adequate training to deal with Ebola. The first transmission in the US, to critical care nurse Nina Pham, happened because of lapses in protocols at the private Texas Presbyterian Hospital (TPH) in Dallas. She has since recovered. Thomas Duncan arrived in the US from Liberia on September 20.Three days later he went to TPH Dallas with fever and abdominal pain. He told a nurse he had travelled from Africa but was eventually sent home. Eight days later he returned, this time with extreme vomiting and diarrhoea, and was placed in isolation. He died on October 8. On November 11 it was announced that the last known person in the US with Ebola, Dr Craig Spencer, an American who worked with MSF in Guinea, and who had tested positive on October 23, had recovered after being treated at a specialist unit in New York. But by November 14 a new case had been announced, Dr Martin Salia, an
American resident, who became infected while working in his native country of Sierra Leone. Dr Salia was flown home to a specialised hospital in Nebraska, one of four US hospitals with bio containment units that include advanced features designed to handle dangerous pathogens like the Ebola virus. Isolation units include special air filters, dunk tanks full of antiseptic, dedicated lab equipment and autoclaves to sterilise medical waste before it is transported from a unit. Dr Salia was suffering from advanced symptoms of Ebola when he arrived at the Nebraska hospital, including kidney and respiratory failure. He died two days later. Dr Jeffrey Gold, chancellor of the University of Nebraska medical centre, told the media: “We are reminded … that in the very advanced stages, even the most modern techniques that we have at our disposal are not enough to help these patients once they reach a critical threshold.” As The Lamp went to press Dr Salia was the tenth person with Ebola to be treated in the US and the second to have died.
THE LAMP DECEMBER 2014–JANUARY 2015 | 31
EBOLA OUTBREAK
Protection protocols an Ebola priority There is debate over whether nurses should use full body suits with respirators when treating Ebola patients — Australian authorities believe that following proper PPE protocols is vital to safety. Protection from Ebola
© DAVID GRAY / REUTERS / PICTURE MEDIA
• fuid resistant gown • fluid repellant mask • goggles or a face shield • shoe covers • gloves, or double gloves if there is a lot of fluid. It is crucial that nurses put on personal protective equipment (PPE) properly and remove it carefully, with a buddy system to ensure items are removed in reverse order. Nurses are advised to don equipment methodically and ensure they are comfortable. “There’s nothing worse than having PPE that you feel claustrophobic in and that you pull off as soon as you get the opportunity,” says Lyn Gilbert, director of Westmead’s Centre for Infectious diseases. Lyn Gilbert, director of Westmead’s Centre for Infectious diseases
ONLY THE UK AND SOUTH AFRICAN government health authorities recommend the use of respirators for healthcare workers and laboratory scientists for confirmed cases of viral haemorrhagic fevers including Ebola. Humanitarian aid organisation Médecins Sans Frontières (MSF) is the only international agency currently using them. In New South Wales body suits with respirators are available to nurses at Westmead, the designated hospital for treating Ebola patients. But Lyn Gilbert, director of Westmead’s Centre for Infectious diseases and recently appointed chair of Australia’s National Public Health Partnership, says so far authorities here feel that a fluid resistant gown, fluid repellant mask, goggles or a face shield, shoe covers and gloves, or possibly double gloves if there is a lot of fluid, are the basic requirements.
“This is equipment that an emergency department and all nurses should be familiar with. It’s really a matter of emphasising the importance of putting them on properly and making sure they’re done up as they should be, and in the past that hasn’t always happened.” Professor Gilbert says training in the use of personal protective equipment (PPE) is the most important factor. “The main emphasis we have [at Westmead] is to try to ensure staff are putting on PPE they’re familiar with, that they’re doing things slowly and, particularly, that they feel comfortable. “There’s nothing worse than having PPE that you feel claustrophobic in and that you pull off as soon as you get the opportunity. “The taking off of PPE is the most important time when it has to be done carefully and with a buddy system so
32 | THE LAMP DECEMBER 2014–JANUARY 2015
there’ll always be someone with a person when they come out of a room where the patient was and will talk them through taking off PPE in reverse order. “If there’s new equipment they haven’t used before, they’ll be properly trained and have the opportunity to practice with it beforehand. That’s all in progress now and has been going on for several weeks.” Professor Gilbert says it is always important to ask the travel history of any patient presenting with flu-like systems, although often it isn’t done. “At present there’s so much publicity and so much information that you would hope every emergency triage nurse would ask that question. “In Australia, Ebola is first and foremost being regarded as a public health issue since most private hospitals don’t have emergency departments,” she said.
Australia leans as Ebola spreads In trying to sell his unpopular budget Treasurer Hoe Hockey said he wanted Australians to be “lifters not leaners.” Yet the Abbott government has been a leaner not a lifter during the Ebola crisis. In failing to come to the aid of Ebola victims and join the international community in preventing the spread of the disease to the rest of the world, the Abbott government has failed to lead by example. Public pleas for Australia to send health workers to deal with West Africa’s Ebola outbreak began in September and came from international relief agencies, international allies, peak nurse and medical bodies and the World Health Organisation. After six weeks of asking the government to coordinate an appropriate Australian response, the Australian Nursing and Midwifery Federation (ANMF) ran a fiveday national poll of nurses. It found 350 nurses who were willing to go to West Africa. Ninety per cent of the 1375 that responded to the poll said the Australian government should do more. In September, British Prime Minister David Cameron and US President Barack Obama asked Australia to send personnel. Further urgent requests followed in October. At the same time as the Australian government was refusing to send medical aid to West Africa, tiny Cuba, regarded as a pariah state by the United States and its allies, increased the number of its medical workers in West Africa from 165 to 256. It has trained 460 nurses and doctors to undertake six-month missions. Finally, on November 5, the Australian Abbott government announced an additional $24 million in aid, including $20 million to private provider Aspen Medical to establish a 100-bed treatment centre. Aspen said about 10 to 20 per cent of staff would be Australian. But entry visas from West African countries where Ebola has occurred remain suspended, even though WHO says this will not stop the spread of the disease. On November 15, speaking about Ebola at the G20 in Brisbane, Barack Obama said: “We cannot build a moat around our countries and we shouldn’t try.” Also at the G20, as it seemed Mali could become a new Ebola hotspot, UN Secretary-General Ban Ki-moon said: “Transmission continues to outpace the response from the international community. I urge the leaders of G20 countries to step up.”
Liberia, Kollies Town 2014: Libby Bowell (centre) with the Liberian Red Cross and IFRC health workers at the launch of the Red Cross Community-Based Protection Program in Kollies Town, Montserrado County. PHOTO: ©INTERNATIONAL FEDERATION OF RED CROSS AND RED CRESCENT SOCIETIES
Ebola fear real, but unnecessary When registered nurse Libby Bowell returned from five weeks working in Liberia with the Red Cross, she came back to 21 days of home quarantine and rampant hysteria. “I’ve been on a lot of missions and I’ve not experienced this feeling of ‘you’re not welcome’,” Libby told ABC Radio National’s Fran Kelly. “There hasn’t been a lot of respect shown [in Australia] for those of us who’ve gone there. We’re highly trained health professionals that know exactly how to get Ebola and we don’t get it because we follow the rules. “I knew I was 100 per cent well, because if you don’t have the symptoms you don’t have the disease, and the first symptom is a fever. “I took my temperature every day and I kept a low profile because I wanted this hysteria to go away,” Libby said. Libby told Radio National that while she was permitted to go for walks and could go to the supermarket at night, she was required to report to public health authorities every day. “They were supportive and they lifted my spirits,” she said. “I understand that if people don’t know anything about Ebola then their fear is real. But a lot of what’s been discussed in this country, which has great healthcare facilities, is complete rubbish.” Despite the hysteria Libby said she would return to Liberia if she had the opportunity. “I would go back in a heartbeat. The people are beautiful. They’re human beings, they need our help and I think, yeah, yeah, if I can go, I will go again. “It is the right thing to do – to go and help.” THE LAMP DECEMBER 2014–JANUARY 2015 | 33
ELECTION NOTICE
ELECTION NOTICE Fair Work (Registered Organisations) Act 2009 Nominations are called for the following offices: Federal President, Federal Vice President, Federal Secretary, Assistant Federal Secretary. Written nominations which comply with the rules of the Federation can be made from Wednesday 14 January 2015. They must reach me not later than 12 Noon (A.E.D.T) on Wednesday 28 January 2015. Nominations cannot be withdrawn after this time. Statements: In accordance with Rule 47.4 candidates may submit a 200 word (maximum) statement and a photograph of themselves, in support of their candidature. The statement will be reproduced in a form suitable for posting to voters with ballot material. Statements must reach me not later than 12 Noon (A.E.D.T) on Wednesday 4 February 2015. Statements and photos are preferred by email to vicelections@aec.gov.au ADDRESS FOR LODGING NOMINATIONS AND STATEMENTS By Post: Australian Electoral Commission, GPO Box 4382, Melbourne,Vic, 3001 By Hand: Level 8, Casselden Place, 2 Lonsdale Street, Melbourne By Fax: (03) 9285 7149 BALLOT: The ballot, if required, will open on Friday 27 February 2015 and close at 10:00am on Friday 13 March 2015. Changed Address? Advise the Federation now. NOTE: A copy of the AEC’s election report can be obtained from the organisation or from me after the completion of the election.
Jeff Webb, Returning Officer Tel: (03) 9285 7141 12 January 2015
34 | THE LAMP DECEMBER 2014–JANUARY 2015
Diabetes Education in the Community
Further your career and work practice. Become a ComDiab facilitator and support the growing need for early diabetes education in the community. Receive 45 CPD points with ACN ComDiab is a comprehensive diabetes education program covering diabetes management and the prevention and detection of diabetes related complications. You’ll receive 45 CPD points from the Australian College of Nursing as well as CPD points from ACRRM, APNA, APC and ESSA .
To book online or to find out more visit diabetesnsw.com.au/comdiab or call 1300 342 238
ASK JUDITH Compelled to take leave I am a registered nurse working in theatres in a public hospital. Whenever theatres are quiet my manager rosters me for annual leave for one or two days to cover those quiet times. My manager does not consult me and says I have to take the leave as it is rostered. I am running out of leave and am afraid I won’t be able to have a decent holiday. Can my manager direct me in such a way? No. Even though your manager can direct you to take annual leave they cannot make you take single days off and with such minimal notice unless you agree to it. Clause 30, Annual Leave, of the Public Health System Nurses’ and Midwives’ (State) Award 2011 provides for annual leave to be given and taken in one lump sum or two but for anything less, like single days, it must be with the choice and agreement of the employee. Furthermore in sub-clause (vii) part (c) of clause 30 of the award, when your employer requests that you go on annual leave they should, where possible, give you three months notice from when your leave should commence but cannot give less than 28 days notice.
Payment for cancelled shift I am employed in the public sector on a permanent part-time basis. I was recently rostered to do an additional shift but this was cancelled with only 10 hours notice. Should I receive any payment for the additional shift that was cancelled? Yes you are entitled to a payment under these circumstances. I refer you the Public Health System Nurses’ and Midwives’ (State) Award 2011, sub-clause (xi) of clause 29, Part-Time, Casual and Temporary employees, part (1), Permanent Part-Time Employees: (xi) Where a permanent part-time employee has been rostered to work any additional
shift and is subsequently notified by the employer with less than 24 hours notice that the shift has been cancelled, the employee shall be entitled to payment of four hours pay at ordinary time, ie. at the employee’s base rate of pay.
Problems with pregnancy I am employed in the public sector on a permanent part-time basis and am experiencing difficulties with my pregnancy. My GP advises that I cannot continue to work in my current role. Do I have an entitlement to request light/suitable duties? Yes you do. As per clause 34, part (a) Maternity Leave, sub-clause (x) of the Public Health System Nurses’ and Midwives’ (State) Award 2011 (x) Transfer to a More Suitable Position Where, because of an illness or risk associated with her pregnancy, an employee cannot carry out the duties of her position, an employer is obliged, as far as practicable, to provide employment in some other position that she is able to satisfactorily perform. This obligation arises from section 70 of the Industrial Relations Act 1996. A position to which an employee is transferred under these circumstances must be as close as possible in status and salary to her substantive position. You may also request to elect to use any available paid leave or to take sick leave without pay as per sub clause (ix) of clause 34, part (A) Maternity Leave (ix) Illness Associated with Pregnancy If, because of an illness associated with her pregnancy an employee is unable to continue to work then she can elect to use any available paid leave (sick, annual and/or long service leave) or to take sick leave without pay. Where an employee is entitled to paid maternity leave, but because of illness, is on
NSW Nurses & Midwives’ Association In association with the Australian Nursing & Midwifery Federation
MEMBERSHIP FEES 2015 Classification
Year
Quarter
Month Fortnight
Registered Nurse Registered Midwife
$691.00
$172.75
$57.58
$26.56
Enrolled Nurse
$588.00
$147.00
$49.00
$22.60
Assistant in Nursing+ $484.00 Residential Care Nurse
$121.00
$40.33
$18.60
MEMBERSHIP FEES ARE TAX DEDUCTIBLE *All membership fees include GST +Trainee AiNs have their fees waived for the period of their traineeship ABN 63 398 164 405
When it comes to your rights and entitlements at work, NSWNMA Assistant General Secretary JUDITH KIEJDA has the answers.
sick, annual, long service leave, or sick leave without pay prior to the birth, such leave ceases nine weeks prior to the expected date of birth. The employee then commences maternity leave with the normal provisions applying. Apply for the above award provisions in writing and be sure to include a copy of your doctor’s certificate stating your illness or risk.
Contract to reflect actual hours I have been working full time as an enrolled nurse in a rural public hospital for almost two years but my contract is for only two days per week or 32 hours per fortnight. It has been great to get the extra work but I can never plan my finances because I don’t always know if I will be given the extra shifts. Am I entitled to ask for my part-time hours to be increased in line with the hours I am actually working? Yes you are. Under award provisions for permanent part-time employees you can request to have your hours increased to reflect the average hours you have been working. As stated in clause 29, part (1) Permanent Part-Time Employees, sub-clause (xii) of the Public Health System Nurses’ and Midwives’ (State) Award 2011, you must request to convert your contracted hours of work to reflect the actual hours including the extra hours you have worked in the past 12 months. The extra hours you have worked for this provision to apply cannot be in circumstances where you were filling in for periods of leave, however if the hours are vacant hours then management must give strong consideration to permanently increasing your hours. Put your written request to your manager and include the average hours you have been doing for the previous 12 months as hours per fortnight.
ADVERTISE IN THE LAMP. REACH OVER 60,000 NURSES AND MIDWIVES. To advertise please contact Patricia Purcell 02 8595 2139 // 0416 259 845 // ppurcell@nswnma.asn.au
THE LAMP DECEMBER 2014–JANUARY 2015 | 35
COMPETITION
from th e nswnma NSWNMA wishes all members a Merry Christmas and offers you the chance to be part of this year’s Christmas giveaway. SYDNEY FESTIVAL AND ACCOMMODATION PACKAGE
HOLIDAY READING Photo Chris Herzfel
Win tickets to some amazing shows at Sydney Festival 2015 plus a two-night stay for two at the Mercure Sydney with breakfast.
Credit Kris Washusen
ENJOY A FREE BUFFET BREAKFAST THIS SUMMER when you book until 31 January 2015 (for stay from 1 December 2014 – 31 January 2015). To book, call 9217 6666 or go to www.mercuresydney.com.au MASQUERADE 9–17 January Sydney Opera House In a wondrous world of riddles and hidden treasure, bumbling Jack Hare is on a race against time to deliver a message of love from the Moon to the Sun. Far, far away in a world just like ours, a mother cheers her son Joe with the tale of Jack Hare’s adventure. But when Jack’s mission goes topsy-turvy, Joe and his mum come to the rescue, and the line between the two worlds becomes blurred forever. sydneyfestival.org.au/masquerade A SIMPLE SPACE s n *ANUARY s Festival Village, Hyde Park Accompanied by a live musician and armed
with nothing more than brute strength and catlike agility, seven intrepid acrobats laugh at the rules of gravity and pull off the riskiest, most daring acrobatic feats. Voted “Best Circus” at the 2014 Adelaide Fringe Festival, this multi award-winning show has captivated sold-out festival audiences around the world. sydneyfestival.org.au/simple KISS & CRY n *ANUARY Carriageworks Kiss & Cry is a sweeping cinematic romance with a twist: its stars are a duo of dexterous, dancing hands, moving with grace and precision onscreen through a series of miniature landscapes. Shot and projected onscreen simultaneously, a sensual small-scale ballet comes to life before your eyes. sydneyfestival.org.au/kiss © Maarten Vanden Abeele
Escape to your home away from home in the heart of Sydney city. Mercure Sydney is centrally located and within walking distance of the best attraction, shopping, eating spots and public transport links.
Our prize include: two tickets to Masquarade (7 January), or two tickets to A Simple Space (14 January), or two tickets to Kiss & Cry (24 January at 2pm). Major prize winner also gets a two-night stay for two at Mercure Sydney and a double pass to see one of the three Sydney Festival events of your choice. The other two winners win a double pass each to one of the other two performances. Entrants need to indicate what performance they wish to see on the back of the envelope.
Kick back and relax with a four-book gift pack from Penguin. We have two sets available which include: BUSH NURSES by Annabelle Brayley With tales from Birdsville to Bedourie, Oodnadatta to Uluru, you’ll be amazed at the courage and resourcefulness of these nurses who have been the backbone of medical practice in remote Australia for more than a hundred years. MOONLIGHT PLAINS by Barbara Hannay A breathtaking novel about finding love against all the odds that will keep you captivated from beginning to end. THE SUNNYVALE GIRLS by Fiona Palmer When a letter from 1946 is unearthed in an old cottage on the property, the Sunnyvale girls find themselves on a journey into their own hearts and across the world to Italy. Their quest to solve a mystery leads to incredible discoveries about each other, and about themselves. HORSE RESCUE: Inspiring stories of second-chance horses and the lives they changed by Joanne Schoenwald Horses are powerful beyond their physical measures. Through their unique bond to people, horses have the ability to heal, teach, and change lives. A person might rescue a horse, but so often it ends up being the other way around. And sometimes the deepest transformations come when we least expect them.
HOW TO ENTER To be in the draw for one of these fabulous prizes, write your name, address, membership number, and the prize name you want to win (a separate entry/envelope is required for each prize), on the back of an envelope and mail to: NSWNMA Christmas Giveaway, 50 O’Dea Ave, Waterloo NSW 2017 IMPORTANT: Only one entry per member for each competition will be accepted. Entrants must indicate which prize and/ performance they would like to win on the back of the envelope. Competition entries from NSWNMA members only. All entries must be in by Wednesday 17 December 2014. The prizes will be drawn on 17 December 2014. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW permit no: LTPM/14/00042.
ENJOY A RELAXING HUNTER VALLEY HOLIDAY
HOLIDAY VIEWING Thanks to Roadshow Entertainment, The Lamp has five packs of three DVDs to giveaway. GRACEPOINT When a young boy is found dead on an idyllic beach, a major police investigation gets underway in the small California seaside town where the tragedy occurred. Welcome to Gracepoint, a new 10-episode event series based on Broadchurch, UK’s critically acclaimed hit crime drama. DEATH COMES TO PEMBERLEY There is perhaps no greater love story than that between Elizabeth Bennet and Fitzwilliam Darcy in Pride and Prejudice. But what happened after they were married? In P.D. James’ enthralling sequel, you will discover that life at Pemberley held many surprises ... THE CRIMSON FIELD Go behind the front line and discover the true bravery and sacrifice of the nurses, medics, volunteers and doctors who tend the wounded and risk everything to save even just one single life. These compassionate professionals work tirelessly to heal the bodies and souls of men who manage to get out of the trenches alive.
The Lamp is offering members the chance to win a 2 nights stay mid-week at Tuscany Wine Estate Resort, Hunter Valley, complete with full cooked breakfast and a 3 course dinner at The Mill Restaurant* The 4-star Tuscany Wine Estate offers an intimate mix of Italy and Australia, with views second-to-none in the Hunter Region, 2-hours from Sydney. The property has it’s own cheese factory on-site, an outdoor swimming pool, tennis court and the extra benefit of being able to bring along your furry friend#. BOOK NOW TO TAKE ADVANTAGE OF THEIR FABULOUS SPRING/SUMMER PACKAGE! For only $230, you get a two-nights midweek
stay for 2 people with full-cooked breakfast each morning plus $30 food credit from The Mill Restaurant (per day); complimentary glasses of wine in The Brokenback Bar when spending more than $45; 30% discount off wine tours and massages; complimentary Wi-Fi; complimentary upgrade to Vineyard View room and late checkout to midday upon request. Kids stay for FREE! Stay an extra night for only $110 more. This package is valued over $500. To book go to www.tuscanywineestate.com.au or call 4998 7288 and quote: NURSES. *
Subject to availability. #There are a limited number of rooms available and a fee associated for bringing a dog; must be declared on booking.
CALLING ALL SOCCER FANS! Australia will come alive for the ‘festival of football’ this January, as spectators fill the stands and more than 500 million people watching around the world. The AFC Asian Cup is the biggest football tournament ever to come to our shores. Sydney and Newcastle will feature 11 games, including both Semi Finals and Final. Asian heavyweights Japan and our Socceroos are among the teams playing at Stadium Australia and Newcastle in their quest for the AFC Asian Cup. Soccer fans will be pleased to hear that The Lamp has four family passes, two for a
Newcastle match and two for a Sydney event. Booking is available from www. afcasiancup.com/tickets and tickets start from $15 for adults and $5 for children.
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SOCIAL MEDIA
NURSE UNCUT
WHAT’S
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
Lymphoedema – the need for a public clinic www.nurseuncut.com.au/lymphoedema-the-need-for-a-public-clinic
Three women from the Lymphoedema Action Alliance, including a community nurse, speak about this debilitating and isolating condition.
Stevie’s EN diary: Ebola – in PPE we trust www.nurseuncut.com.au/stevies-en-diary-ebola-in-ppe-we-trus
Everyone’s talking about Ebola, including new grad EN Stevie. There’s a fine line between blind panic and being prepared.
My Blue Mountains bushfire experience www.nurseuncut.com.au/my-blue-mountains-bushfire-experience-2013-2014
Last October a mental health nurse wrote about her bushfire experience. Now, a year on, she shares a photo essay of changes since the fire.
Medicare: not free and not in crisis either www.nurseuncut.com.au/medicare-is-not-free-and-its-not-in-crisis-either
We’re told the “age of entitlement” is over, but why aren’t we entitled to a decent public health service? Annie Butler of ANMF examines some of the arguments.
How long do you get for handover? www.nurseuncut.com.au/how-long-do-you-get-for-handover
A multi-purpose service nurse is limited to 15 minutes handover for all her patients. How much time do you get?
Why privatisation is relevant to nurses and midwives www.nurseuncut.com.au/why-privatisation-is-relevant-to-nurses-and-midwives
Brett Holmes responds to an article in the Daily Telegraph that accused the Association of being too concerned with anti-privatisation.
New on SupportNurses YouTube channel A mother speaks about privatisation Leonara speaks candidly about her fears for her son’s future. > youtu.be/4lrNfuaYBYE Nurses react to the Healthscope announcement Northern Beaches nurses visited their MP Mike Baird’s office. > youtu.be/Tt66zq8C-TI
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 DECEMBER 2014–JANUARY 2015 | 39
SOCIAL MEDIA
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NURSES & MIDWIVES
SAID & LIKED on facebook www.facebook.com/nswnma Stand up for ratios
Good effort but what about 1:4 for rural hospitals? Ratios would improve patient safety and outcomes. I’m working elsewhere today, but I’m there in spirit.
Emergency nurses at Campbelltown made a stand for a ratio of 1:3 in EDs.
Unhealthy reaction We had an avalanche of comments in response to a story about Lismore nurses who were annoyed when the LHD chief executive blamed elevated sick leave rates on the “unhealthy lifestyles” of staff members – no mention of workloads or shiftwork.
PHOTO GALLERY
Our Robin Hood Tax roadshow met with an enthusiastic reception in Lismore.
Perhaps we don’t have time for exercise or to prepare healthy meals when we work doubles, quick shifts and night shift without adequate staffing. Maybe we are all too exhausted to give up what little sleep we get to go to the gym. Our halos don’t protect us from poor working conditions, rude and uncaring executives, infectious people and the general problems of life in the real working world. If you have a less than robust immune system due to shift work then hello, you are more prone to get sick. Given we are not meant to bring our germs to work if we are ill, what on earth do they expect! I have a suggestion. All hospital executives should be required to work a rotating roster. They will now work a combination of morning, evening and night duty – including quick shifts. They will no longer have an office but will take a corridor spot in a different ward each shift. They will not have secretaries or helpers on most of their evening shifts or any of their night shifts because there should be fewer interruptions at night and they should be able to do more work without assistance as a result. Also if any of the ADONs have any executive type issues after hours they will refer them to the executive on duty rather than have it wait till morning. Perhaps we are reacting as a group because there is some truth to what he is saying and we don’t want to hear it. Employers are not obliged to hand everything to us on a platter; we also have a level of responsibility in looking after ourselves. Shift work, workloads, what we deal with at work can all have an effect for sure. However within that we have a choice – a choice in how we live, care and support ourselves so we are less likely to be impacted upon by our work environment. Maybe he should put his money where his mouth is and do a week as a nurse with the same crappy quick shifts and verbal abuse nurses cop. While he’s at it he should work a couple of doubles, get out an hour after his shift ends and not get paid for it, skip tea and meal breaks and hold on to his bladder till he’s about to burst, meanwhile, give the patients the same dedicated care nurses give their patients. They also need to take into account us nurses are aging. Do these people have any idea what it is like to be 50 and a shift worker with sometimes unrealistic workload expectations? Chronic understaffing is at the heart of this. Shift work, long hours and no time for proper meal breaks are related to obesity, sleep issues and diabetes; don’t have a go at nurses, give them better working conditions and education! Last time I went to the staff canteen at Canterbury Hospital the food available was greasy and fried. A few sad looking salads and unappetising sandwiches completed the picture. Go to Royal North Shore: there is a food court with sushi, so it can be done. And being exposed to people’s trauma and pain eventually starts to rub off unless there is clinical supervision! Nobody I know gets that.
Emergency Department nurses from Royal North Shore Hospital saw red over ratios.
Student nurses from the University of Western Sydney were at the Stockton Centre to witness the valuable work done by disability nurses.
These members enjoyed a branch lunch at an aged care facility in Kyogle.
THE LAMP DECEMBER 2014–JANUARY 2015 | 41
SURPRISE NSWNMA LINEN TEA TOWEL
your colleagues this Christmas
$10 each
KEEPCUP Australian Nurses & Midwives
$12
NSWNMA WATCHES
$50
each
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NSWNMA merchandise is not only stylish and comfortable, it is affordable and sold at cost to members. TO ORDER: Fax the order form to (02) 9662 1414, email to: gensec@nswnma.asn.au or post to: NSWNMA, 50 O’Dea Avenue, Waterloo NSW 2017 Merchandise order forms also available on
www.nswnma.asn.au
NSWNMA KeepCup $12 +$3 postage & handling*. Quantity: NSWNMA Linen Tea Towel $10 +$3 postage & handling*. Quantity: NSWNMA Watches $50 +$5 postage & handling*. Quantity:
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Across 1. Transverse grooves on the fingernails following severe illness (4.5) 9. The separation, by tearing, of any part of the body from the whole (8) 10. A large, deep skin abscess formed by a group or cluster of boils (9) 11. Nothing, zero (3) 12. Calx (4) 13. A stone, calculus, calcification (5) 14. Swelling (11) 15. Sleep apnoea (11.5) 21. Parenteral nutrition (1.1) 22. To release a patient from care (9) 24. Lacking normal pigmentation (6)
25. A burning pain, often with trophic skin changes, due to peripheral nerve injury (9) 27. An alcoholic solution of a chemical or drug (8) 28. Fully developed and mature (5) 29. A medical imaging technology (1.1.1) 30. Necessarily; without alternative; required (8) 31. A local anaesthetic (9)
Down 1. Shaped like a rod (8) 2. To supply (blood) with oxygen (6) 3. Whiteness of the hair (12) 4. Excessive urination at night (8) 5. Caesarean delivery followed by careful closure of the uterine wound by three tiers of sutures (7.9) 6. Without concealment; openly (8) 7. Lack or loss of strength and energy; weakness (8) 8. Ossicles, small bones (8) 16. The portion of the oesophagus below the diaphragm (9) 17. A nurse classification (1.1)
18. Lactogenic hormone (9) 19. Bladder-like (9) 20. Dynamometer (9) 23. A strictly regulated therapeutic program such as a diet or exercise schedule (7) 26. Grooves, trenches, or furrows (5)
THE LAMP DECEMBER 2014–JANUARY 2015 | 43
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INTERNATIONAL MIDWIVES’ DAY & INTERNATIONAL NURSES’ DAY 2015
Short Story & Poetry Competition respect t elate te tai
inspire e promote Nurses and midwives have unique stories to tell celebrate
Nurses and midwives have long talked about the amazing, uplifting and special moments they experience in their work. These stories inspire the nurses and midwives who hear them, as well as some who, after hearing such poignant stories, decide to take up the profession. So without breaching confidentiality, let’s celebrate
International Midwives’ and International Nurses’ Days 2015 by sharing our stories in prose or poetry.
uplift motivate First State Super is once again proud to help celebrate this inaugural short story and poetry competition by sponsoring the FIRST PRIZE OF $2000, and the 2 RUNNER-UP PRIZES OF $500. These prizes will be awarded to members or associate members of the NSWNMA who can tell an entertaining and inspiring story that promotes the wonderful work of nurses and midwives. As well, readers will have an opportunity to select the winner of the READERS CHOICE AWARD OF $500 sponsored by the NSWNMA. Authorised by B.holmes, General Secretary, NSWNMA
DEADLINE Entries close 5 pm Friday 20 March 2015 WINNERS Winners will be notified on 12 May 2015. Readers Choice winner will be notified on 12 June 2015. 44 | THE LAMP DECEMBER 2014–JANUARY 2015
Start working on your story now! Find out how to enter at www.nswnma.asn.au
NURSING RESEARCH ONLINE
The Ebola outbreak in West Africa elicited a humanitarian response from doctors and nurses worldwide, while the Abbott government distinguished itself among advanced economies with its slow and miserly commitment of $20 million to a private, for-profit provider to establish a 100-bed treatment facility. It is a frightening situation but it is vital that we are guided by the facts. This month Nursing Research Online looks at the Ebola crisis.
after the patient; one staff member or team to make sure staff in the emergency department are briefed; one physician to liaise with public health authorities and other relevant departments; and one group to oversee the hospital response. theconversation.com/how-would-australianhospitals-respond-to-a-case-of-ebola-33203
Fast-spreading killers: how Ebola compares with other diseases Mick Roberts, Professor in Mathematical Biology at Massey University The West African outbreak of Ebola has claimed more than 4800 lives and this number is sure to rise. There is understandably a lot of fear about Ebola, but how does it actually compare with other fast-spreading infectious diseases? theconversation.com/fast-spreading-killershow-ebola-compares-with-other-diseases32944
Health workers demand clarity over number of Australian volunteers at Sierra Leone treatment centre
Ebola virus disease Fact sheet N°103 updated September 2014 World Health Organisation Ebola virus disease (EVD) first appeared in 1976 in two simultaneous outbreaks: one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name. The current outbreak in West Africa (first cases notified March 2014) is the largest and most complex Ebola outbreak since the virus was first discovered. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (one traveller only) to Nigeria and by land (one traveller) to Senegal. The most severely affected countries, Guinea, Sierra Leone and Liberia, have weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO DirectorGeneral declared this outbreak a Public Health Emergency of International Concern. www.who.int/mediacentre/factsheets/fs103/en/
How would Australian hospitals respond to a case of Ebola? Allen Cheng, Associate Professor in Infectious Diseases Epidemiology, Monash University Australia has a system of “designated hospitals” for Ebola. All patients with confirmed Ebola will be transferred for management at these specialised centres, based mostly in capital cities or regional centres with international airports. For other hospitals preparedness focuses around identifying patients with possible Ebola infection and confirming (or more likely, excluding) this diagnosis. Hospital emergency departments routinely ask that patients who have returned from overseas travel within the last month identify themselves to staff. This is relevant for a number of contagious infections, including measles, avian influenza, the Middle East Respiratory Syndrome coronavirus (MERS-CoV) and Ebola. Patients with any symptoms of suspected infection, who have recently travelled overseas, are immediately placed in a single room to be further assessed. For patients with suspected Ebola four groups of hospital staff are activated: one team to look
ABC News November 6, 2014 Health workers are demanding more clarity about the number of Australian volunteers who will be involved in the Ebola treatment centre Australia is funding in Sierra Leone. The government announced it would commit up to $20 million in funding for private company Aspen Medical to run the 100-bed Ebola treatment clinic, which was being built by the United Kingdom and would employ about 240 staff. Aspen Medical said it expected the number of Australian volunteers at the hospital to be “significant” but Prime Minister Tony Abbott said most of the staff would be locally engaged. Federal Secretary of the Nursing and Midwifery Federation Lee Thomas said hundreds of Australian nurses wanted to volunteer and they would be needed: “It is completely impossible for locally-educated health practitioners in West Africa to cope, there are just not enough.” Ms Thomas said qualified Australian volunteers should be given the opportunity to help. “While it’s important to train local people, the relief effort in West Africa must be supported by Australian and other healthcare workers from around the world; that’s the only way they are going to cope.” anmf.org.au/news/entry/health-workersdemand-clarity-over-number-of-australianvolunteers-at-sierr
THE LAMP DECEMBER 2014–JANUARY 2015 | 45
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46 | THE LAMP DECEMBER 2014–JANUARY 2015
BOOKS
BOOK ME Defend Yourself: Facing a Charge in Court Tim Anderson The Federation Press www.federationpress.com.au RRP $34.95 ISBN 9781862879614 For people facing a criminal charge the court process can be stressful, alienating, humiliating and frustrating. This is partly due to the penalty that may be looming but also because court procedures can appear to be a series of strange and irrelevant rituals. This slim, concise book, now in its third edition, explains the key principles of current New South Wales criminal law, case preparation and court procedure, in plain English. It sets out the basics from arrest and police questioning through making pleas and on to appeals, plus gives diagrams of typical court arrangements for a magistrates’ hearing or jury trial, and explains case law references, character references, warrants and more.
SPECIAL INTEREST Taking Control of Anxiety Bret Moore American Psychological Association via Footprint Books www.footprint.com.au RRP $32.95 ISBN 9781433817472 Taking Control of Anxiety is suitable for professionals and anyone who suffers from anxiety disorders. Written by a clinical psychologist it has a reassuring, conversational tone and is filled with practical, evidence-based techniques for reducing anxiety. A wide range of possible anxiety-provoking situations are addressed through insightful scenarios, useful facts and memorable quotes. Topics include examining thought patterns, adopting and dispensing with habits, exercising, managing social pressures, and dealing with fear and panic. To inspire concrete behavioural change it also includes worksheets, exercises and weekly experiments.
Child-Centred Nursing: Promoting Critical Thinking Bernie Carter, Lucy Bray, Annette Dickinson, Maria Edwards and Karen Ford Sage Publishing via Footprint Books www.footprint.com.au RRP $51.95 ISBN 978146248607 Child-Centred Nursing approaches the complex, multifaceted task of nursing children, young people and their families from the perspective of children as their own agents. Discussions include children’s position in society and how that frames the way they are involved in health care and decision making, children’s right to participate, be informed and make choices and how the places, spaces and technologies of care impact on their experience of illness. A case scenario illustrates each topic and several reflective prompts are provided to further develop active critical thinking skills. The final chapter explores the challenges of trying to implement change within a hospital.
What Every Mental Health Professional Needs to Know About Sex Stephanie Buehler Springer Publishing www.springer.com RRP $66.00 ISBN 9780826171214 Despite the significance of sexual health to overall mental health and physical wellbeing, few mental health professionals receive sufficient instruction about sex other than learning how to identify and report suspected abuse. This book aims to take the therapist through the entire process of assessment and treatment from the initial interview to final consultation. It covers the sexual complaints common to women, men and couples, as well as how to help parents with concerns about their children’s sexual development, answering their children’s questions about sex and understanding the needs of lesbian, gay, bi-sexual or transgender clients. Other chapters explore treating victims of sexual abuse, how sexuality can be affected by a range of medical conditions, what happens when people traverse conventional or expected boundaries and the ethical challenges of working with a clients’ sexual concerns.
NEW!
The NSWNMA Library Catalogue is now online! Visit www.nswnma.asn.au/library-services-online-library-catalogue/ for the link to open the catalogue, plus instructions on how to use it. Once you have searched by keyword or browsed the subject areas available you can send loan requests directly to the library via a quick online form. Many online resources can be accessed directly through web links included in the catalogue listing.
Mosby’s 2015 Nursing Drug Reference Linda Skidmore-Roth Elsevier Mosby www.elsevier.com RRP $45.45 ISBN 9780323278010 This latest edition alphabetically profiles more than 5000 generic and branded drugs. Each monograph details common and life-threatening side effects organised by body system, pharmacokinetics, nursing considerations for each step of the nursing process including treatment instructions for overdoses, plus contraindications, compatibilities and interactions between the drug and herbal products, food and lab test results.
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 DECEMBER 2014–JANUARY 2015 | 47
MOVIES
movies of the month
British director Mike Leigh can even make watching paint dry interesting, writes Sue Miles. Eighteenth century British artist Joseph Mallord William Turner is seen through the lens of director Mike Leigh and brought to life by actor Timothy Spall in Mr. Turner. The film begins in the 1820s and introduces us to Turner, a painter with a passion for landscapes whose career has taken off. He is a man of high ideals who nonetheless delights in basic pleasures, such as sharing a pig’s head with his ageing dad. At the Royal Academy of Art, Turner relishes his newly found celebrity, using it to wind his archrival John Constable (James Fleet) into a frenzy. Spall won best actor at the 2014 Cannes Film Festival for the role and cinematographer Dick Pope received a special jury prize. Spall recreates Turner as a rascal who, though “phlegm-filled”, produced epic artworks in a spiritualistic way that was revolutionary and radical. Mike Leigh’s direction allows for the inner tension of this very mortal, flawed individual to be examined. Throughout the film Turner travels, visits brothels, paints, stays with country aristocracy, is celebrated by royalty and the general public and at times reviled by the very same people. At one stage he straps himself to the mast of the ship so he can paint a snowstorm. My only criticism was the meandering length of the film, which at times bordered on excessive as it went into detail trying to reveal all the intricacies of Turner’s life. Despite this the film delivered its message and content due to an exemplary British support cast and the masterly efforts of Timothy Spall. Sue Miles is a CNC short stay at the Marie Bashir Mental Health Unit IN CINEMAS DECEMBER 26
METROMEMBERGIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to Mr Turner thanks to Transmission films. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!
DVD SPECIAL OFFER Now in its second series this wonderful television comedy is fast developing into an Aussie gem. Created by the writing team behind The Librarians, Robyn Butler and Wayne Hope, season two of Bogans sees the strong ensemble cast building each of its characters in wit and depth. Robyn Nevin is a delight to watch as the uptight adoptive mother, Margaret, and in series two her character comes up against all her own prejudices in the form of Wheeler daughter, Amber. Amber is whipsmart with a potty mouth. Not having had the advantages of wealth and education afforded her recently discovered, adopted-out elder sister, Bess, Amber wonders plaintively to Margaret: “Why couldn’t it have been me?”. Watching Nevin, Australian theatre royalty, and Banas, who has come up via the soap opera route, work opposite each other is gold. Like all great comedy Upper Middle Bogan walks the line between laughter and pain and goes straight to the bogan heart of Australia.
RURALMEMBERGIVEAWAY Email The Lamp by the 15th of this month to be in the draw to win a dvd of Upper Middle Bogan Season 2 thanks to Roadshow Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win! 48 | THE LAMP DECEMBER 2014–JANUARY 2015
DVD SPECIAL OFFER
Those who saw and loved the Irish indie musical film Once will be happy to line up for this second, bigger budget offering from writer and director John Carney. Those new to Carney’s work may get even more from his second film as some of the surprises it contains will be fresh. It is certainly a heartwarmer and Keira Knightly, as Gretta, returns to a character reminiscent of the low-key Bend It Like Beckham role that won many early fans. In Begin Again Gretta and her song writing partner/lover Dave (real life Grammy award-winning singer Adam Levine) move to New York when he lands a record deal. Sidelined as “the girlfriend” Gretta is left to find her own feet in the big city and even more dramatically so when Dave succumbs to the trappings of his newfound success. When Gretta meets drunken, disgraced record executive Dan (Mark Ruffalo) in an East Village bar she is sceptical of his claims he can get her a recording deal. But the pair bond over the purity of music and with New York providing gorgeous ambiance they begin work on Gretta’s first album. Knightly performs her own songs and singer and rapper CeeLo Green plays an amusing side character.
RURAL MEMBER GIVEAWAY Email The Lamp by the 15th of this month to be in the draw to win a dvd of begin again thanks to Roadshow Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!
DIARY DATES
conferences, seminars, reunions diary dates is a free service for members. Please send event details in the format used here: event name, date and location, contact details by the 5th of each month. Send your event details to lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space.
NSW Nurses Christian Fellowship Christmas BBQ 1 December Balls Head Reserve 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 Essentials of Nursing Conference 30 January 2015 Newcastle www.empowernurseeducation.com.au Men’s Mental Health Summer Forum Building a Healthier Future 19-20 February 2015 Crows Nest www.themhs.org Wounds Update Conference 28 February 2015 Newcastle www.empowernurseeducation.com.au Focus on Feeling Fabulous Retreat 28 February - 3 March 2015 Byron Bay www.nursesfornurses.com.au/events/91/Focus -on-Feeling-Fabulous-Retreat Australasian Cardiovascular Nursing College 9th Annual Conference 13-14 March 2015 Coogee www.acnc.net.au Dimensions of Cardiology Conference 27-28 March 2015 Newcastle www.empowernurseeducation.com.au Professional Development Workshop 1 May 2015 Newcastle www.empowernurseeducation.com.au Aspects of Aged Care Conference 22-23 May 2015 Newcastle www.empowernurseeducation.com.au Acute Care Nursing Conference 1 August 2015 Newcastle www.empowernurseeducation.com.au DANA Many Faces of Addiction Forum 13-14 August 2015 Sydney www.danaconference.com.au
Anaesthetics and PARU Conference 4-5 September 2015 Newcastle www.empowernurseeducation.com.au
ACT MHS Conference: Best Practice into Reality 25-28 August 2015 Canberra www.themhs.org
INTERSTATE Keeping Patients Safe 3 December Brisbane events@qnu.org.au World Indigenous Health Conference 2014 15-17 December Cairns www.indigenousconferences.com Australian Pain Society 35th Annual Scientific Meeting Managing Pain: From Mechanism to Policy 15-18 March 2015 Brisbane www.dcconferences.com.au/aps2015/ Australian and New Zealand Addiction Conference 2015 20-22 May 2015 Gold Coast www.addictionaustralia.org.au No 2 Bullying Conference 29-30 June 2015 Gold Coast www.no2bullying.org.au
4th World Congress of Clinical Safety 28-30 September 2015 Vienna, Austria www.iarmm.org/4WCCS/
REUNIONS Westmead Hospital 35 year reunion March 1980 Intake 7 March 2015 Contact Kerry Rouse (nee Everingham) 0414 971 441; Kerry.rouse@optusnet.com.au Paul Fisher 0412 417 489; vastech@fisher.id.au Facebook: 1980 West Metropolitan Group School of Nursing Reunion
INTERNATIONAL 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 Taipei, Taiwan www.2015aphc.org 9th European Congress on Violence in Clinical Psychiatry 22-24 October 2015 Copenhagen, Denmark www.oudconsultancy.nl/Copenhagen2015
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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.
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&DOO RU YLVLW ĆŠUVWVWDWHVXSHU FRP DX 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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