The Lamp February 2015

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 72 No.1 FEBRUARY 2015

Ratios save lives ED NURSE OF THE YEAR Print Post Approved: PP100007890

BIG BANKS AND YOUR SUPER

FIASCO: GP CO–PAYMENT

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 72 No.1 FEBRUARY 2015

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

COVER STORY

12 | Regions put spotlight on ratios Nurses in Goulburn have put health care at the top of the agenda for the state election on March 28.

Jane Cotter secretary Goulburn Base Hospital NSWNMA branch and Rosemary Durbidge RN PHOTOGRAPH: SHARON HICKEY

REGULARS

5 6 8 35 37 41 43 47 48 50

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

AGED CARE

22 | RNs needed for safe effective aged care

COVER STORY

16 | Ratios save lives

8 | Win an eco adventure

Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee • Brett Holmes, NSWNMA General Secretary • Judith Kiejda, NSWNMA Assistant General Secretary • Coral Levett, NSWNMA President • Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital • Michelle Cashman, Long Jetty Continuing Care • Richard Noort, Justice Health Advertising Patricia Purcell T 8595 2139 or 0416 259 845 or F 9662 1414 E ppurcell@nswnma.asn.au

An international study has shown that patients suffer when nurses are forced to work without safe staffing ratios.

NURSING EXCELLENCE

24| National recognition for Prince of Wales nurse Emergency Nurse of the Year Wayne says his proudest achievement is his involvement in the establishment of a new clinic that has motivated more of his colleagues.

COMPETITION

For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017

SUPERANNUATION

28 | Who’s looking after your super?

Information and Records Management Centre To find archived 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 2015 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $55.

Individuals $80, Institutions $135, Overseas $145.

ABC Radio National presenter Geraldine Doogue recently hosted a discussion about recommended changes to superannuation.

THE LAMP FEBRUARY 2015 | 3

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EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

Medicare and public health are sustainable and cost efficient Governments are quick to use economic arguments to justify cuts to healthcare spending – but there are compelling economic arguments for a well-resourced public health care system with sufficient nurses.

“The public debate in Australia about health spending is being skewed by the Abbott government’s ideological commitment to private enterprise.”

It has been amazing to watch the Abbott government hoist itself on its own petard since announcing a GP co-payment in last year’s budget.

Before the election Tony Abbott promised to lead “a problem-solving government based on values, not ideology”.

The health changes mooted in the budget – the GP co-payment, cuts to preventative health funding and cuts to state health budgets – defied logic and flew in the face of a wealth of empirical evidence. They were unabashedly ideological in nature.

Health economists and health practitioners alike will tell you that primary care and an emphasis on wellness will give health budgets significant value for money by reducing expensive hospitalisations.

A new report by medical researchers who have tracked GP activity for 16 years highlights the value for money and effectiveness of primary care.

Only 30 per cent of Medicare funds go to general practice, yet that part of our primary care system sees more than 80 per cent of patients.

The BEACH report (see page 21) found that the average cost of a GP visit was $47 from Medicare, plus a $5 patient contribution. For a private specialist the average visit cost Medicare $82 plus a $38 patient fee. A visit to an emergency department cost $599 on average (BEACH quoted WA emergency department figures).

A tax that deters people from visiting their GP is the worst price signal imaginable and hurts the health budget in the long run.Yet the federal government has locked itself into an absurd defence of this very poor health policy, driven by its unshakeable belief in specious ideological arguments about the “unsustainability” of Medicare.

The government’s mantra about the “unsustainability” of Medicare is bunkum. The OECD has consistently found that Australian

expenditure on public health is below average – and yet our system delivers world-class outcomes.

The government’s own agency, the Australian Institute of Health and Welfare, has found that health expenditure is growing at its lowest level in 30 years.

When population growth is taken into account, average annual health spending of $6430 per person is down in real terms on previous years and the Commonwealth’s share of health spending has fallen by 2.4 per cent in real terms.

NURSES ARE GOOD VALUE There are also strong economic and clinical arguments for employing more nurses. Last year we were privileged to have Professor Linda Aiken visit Australia from the United States.

Linda is a respected academic and author of world-renowned surveys on nursing.

She argues strongly that it is costing hospitals not to have more nurses (see page 16). She says the US health system is incurring higher costs from preventable re-admissions, more long-term institutional care for the frail elderly and expensive nurse turnover.

Research shows that in the United States “adverse occurrences” among hospital patients is associated with 251,000 deaths, 22.6 million additional hospital days and $41.8 billion in medical care costs. In the US, the annual saving per additional nurse added to improve staffing was $60,000, or 72 per cent of a nurse’s salary.

There were also additional savings through lower nurse turnover.

The public debate in Australia about health spending is being skewed by the Abbott government’s ideological commitment to private enterprise, even when the evidence unequivocally shows the efficiency of our public system.

The NSWNMA will continue to participate in this debate and to defend a public health system that we believe is a national treasure.

THE LAMP FEBRUARY 2015 | 5

COMPETITION

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To enter the competition, simply write your name, address and membership number on the back of an envelope and send to: Eaglereach Competition 50 O’Dea Avenue, Waterloo, NSW, 2017 *Conditions apply: based on twin share accommodation, valid until 1 September 2015 excluding peak periods, Monday-Thursday, subject to availability. Competition entries from NSWNMA members only.

Competition opens 1 February 2015 and closes 28 February 2015. The prize is drawn on 1st of the month following the competition. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. NSW permit no: LTPM/14/00042.

YOUR LETTERS

LE TTE R OF THE MONTH # 1

Profit over care in privatisation push 10 years ago I attended a placement as a trainee enrolled nurse at Stockton Hospital where I witnessed amazing staff assisting many needy residents in an idyllic beachside location. Some of these dependent members of our society were the same age as me (late 40s) at the time and had not known any other home. The professional yet intimate care given to these citizens in their cottages still inspires me today.

Credit is due to the managers of the facility for carefully selecting and training such a wonderful bunch of people.

It is sad to see our state government undoing the essential care warranted in a profit-driven privatisation push.

Mark Quealy, RN, Botany LE TTE R OF THE MONTH # 2

Informing against the fear mongers The Lamp is a very good union magazine, supplying well-selected articles on not only health issues, but also other topics of relevance to workers and our community. A good example was last issue’s “Index of ignorance” article, which highlighted the result of the fear mongering and misinformation that is relentlessly peddled by other media, i.e. that people think Muslims make up 18 per cent of the Australian population, when they only make up 2 per cent; that people think 23 per cent of the working age Australian population are unemployed, when only 6 per cent are; and that people think 15 per cent of Australian girls aged between 15 and 19 give birth each year, when it’s really only 2 per cent.

Such articles protect our interest because they inform us of the evidence-based truth and permit the opportunity to reflect on what is actually going on in popular media: that certain interests would like to have us fearing or resenting Muslims, the unemployed, and teenage mothers. Perhaps that way our community will be less likely to unite and organise for workers across the board, the way Victorian workers and their unions recently did so well in the lead up to the election that saw the right wing government thrown out after only one term.

To The Lamp team, well done. I’m proud to be a member.

Eddie Barry, mental health nurse,Wollongong

YOUR LETTERS

No diamonds, but satisfaction is a gem Every day in my work there is evidence of nurses working towards world peace. No, they are not contestants in a beauty contest, but people making life’s journey a little easier.

I work as a midwife in the antenatal clinic of a large public hospital in Sydney. About 450 women attend the clinic daily. Some have interpreters from many countries, which brings the world to me. In the midwives’ clinic I observe women being listened to, treated with respect, assisted in their pregnancy, no matter who they are or where they come from.

Women who are overseas visitors with no Medicare card are looked after by clerical staff, migrant officers and nurses. The early pregnancy clinic is run by midwives to assist women who have the threat of miscarriage. Women are counselled with kindness during a very hard time.

The clinic, I feel, runs an excellent service within an imperfect system, but everyone does the best they can. No diamond tiaras or prizes but the satisfaction that everyone is trying to make the world a better place.

Karen Childs, RN/RM, Carlingford Mandatory detention will affect us all I am privileged to work as a registered nurse as a member of the NSW Refugee Health Service. My working day is spent assisting “offshore” arrivals settle into our health system. My role is to undertake a comprehensive health check, address any urgent medical problems, refer clients on to appropriate area health clinics and give them an understanding of how our system operates. I follow complex cases and work closely with GPs and allied health services.

I encourage Australian nurses to take every opportunity to lobby government at all levels and get out on the streets whenever a peaceful opportunity arises to support human rights issues, especially when it concerns refugees and asylum seekers.

The voices of many can make a difference. If we are to be called a civilised society Australia’s immigration policy must change. History supports the fact that most of these asylum seekers will one day become Australian citizens and the lasting psychological damage caused from mandatory detention will eventually affect every Australian citizen or resident in one way or another.

M Ruth Sheahan, RN, Bowral

DVDs great for out of towners!

Thank you so much for the DVD of Heartbeat series 17 (rural member DVD giveaway The Lamp November 2014). When you live out of town, it is so good to have DVDs to watch when you do not wish to travel into town on your day off.

Thank you again.

Sharon Emerson, RN/CNS, Jindera

Lobby groups eyeing our common wealth America spends 18 to 20 per cent of its gross domestic product (GDP) on health and is one of the very few advanced nations not to provide universal health cover. We spend 8 to 10 per cent – like most OECD countries – but that means 8 to 10 per cent of our GDP is up for grabs by for-profit medicine.

There are some powerful lobby groups intent on transferring our common wealth to a greedy few – with no imperative to cover the full health spectrum.

Roslyn Prichard, CNS, Clovelly

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

letter of the

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

“Whatever your next purchase, remember Union Shopper.

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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.

THE LAMP FEBRUARY 2015 | 7

NEWS IN BRIEF

Australia

Britain

Health on voters’ agenda in NSW

Seven-day NHS: threat to patient safety

A quarter of voters in New South Wales have nominated health and hospitals as the most important issue in deciding how they will vote in the March 28 state election, according to a Fairfax/Ipsos poll.

Of those polled 26 per cent nominated health and hospitals as of primary importance to their voting decision, ahead of education (17%) and jobs and employment (13%).

Then followed managing the state’s finances (10%), coal seam gas and mining (8%) and law and order (7%).

Female voters were more likely than men to be concerned about health and hospitals (34% compared to 18%) and education (21% compared to 14%).

Male voters were more likely than women to be concerned about employment (16% compared with 10%) and coal seam gas and mining (10% compared with 6%).

19%

26%

7% 8% 17% 10% 13%

•HEALTH •EDUCATION •JOBS •STATE FINANCES •MINING •LAW AND ORDER •OTHER

Brreastfeeding:

Round One

Life and Science

HOBART February 26 SYDNEY February 27

A plan to offer a full range of NHS services at weekends – without an increase in resources – has been attacked by the British Medical Association.

The BMA says pushing ahead with an “unfunded, undefined” strategy is “wholly unrealistic” given the health service’s chronic staffing and financial problems, reported the Guardian.

NHS England wants to offer a wide range of services on all seven days of the week in order to improve the care that patients receive at weekends, tackle the high death rates that occur on Saturdays and Sundays, and better fit in with patients’ working lives.

“The BMA believes that without significant resource investment, a sevenday service will not be possible without compromising and/or re-evaluating existing service provision in the NHS. “There is a real risk that patient safety could be compromised in the week if the government attempts to implement seven-day services without additional resource investment.”

And online from: March 24, 2015 until May 31, 2015 SPEAKERS INCLUDE:

Round Tw wo MELBOURNE March 25 ADELAIDE March 26 PERTH March 28

20015 Seminars for Health Professionaals Hobbart | Sydney | Melbourne | Adelaide | Perrth Foor more information and registrations go to:

www.breastfeeding.asn.au b f di

www.breastfeeding.asn.au

Australian Breastfeeding Association in partnership with Breastfeeding Conferences

NEWS IN BRIEF

Australia

Hockey hands tax dodgers $600M gift There were 600 million reasons for champagne to be quaffed in the corporate boardrooms of Australia at Christmas, when Treasurer Joe Hockey reneged on his promise to impose tough new tax avoidance rules on multinational companies.

The ACTU described the backflip as another broken promise from the Abbott government and an act of “true hypocrisy”.

“The Abbott government has just given its big business mates a $600 million dollar Christmas present while continuing to pursue unfair budget cuts that will hurt hard working and vulnerable Australians,” ACTU secretary Dave Oliver said.

In November last year Joe Hockey ruled out introducing laws to stop global corporations minimising their tax, a move that had a projected $600 million dollar benefit to taxpayers. Instead Mr Hockey promised to introduce a targeted anti-avoidance provision.

Yet buried in December’s budget update was a single line saying the government was dropping its anti-avoidance provision.

“The Abbott government wants to saddle university students with mortgage-sized university debts and make people pay more to visit the doctor – yet it’s letting its big business mates avoid paying their fair share of tax,” Dave Oliver said.

Australia

Employer push to cut penalty rates Employer groups chose Christmas as the starting date for a campaign to cut penalty rates in a host of industries including hospitality and retail.

“If employer groups have their way this could be the last year millions of Australian workers will be paid existing penalty rates for working weekends, late nights and public holidays, including Christmas,” ACTU president Ged Kearney said.

The move came immediately after the Abbott government announced the terms of reference for a Productivity Commission review into the Fair Work Act, which covers all workplace laws.

Ged Kearney says wages, conditions and penalty rates are under attack on two fronts.

“The employers are going after them in the Fair Work Commission while the Abbott government is using the Productivity Commission to do the same.”

Ged Kearney said despite claims by employer groups there was no evidence linking productivity or employment levels to penalty rates, a finding confirmed by the Fair Work Commission.

“The business community justifies its push to get rid of penalty rates by saying they are making it unaffordable to hire workers.

The truth is that in recent years the share of business income going to wages has been falling in several key sectors.”

Total wages share in the food and accommodation sector was 78 per cent in 2013-14, down from a peak of 87 per cent in 199798. In retail, the wages share has fallen from a peak of 79 per cent in 1997-98 to just 73 per cent in 2013-14.

“THERE IS NO EVIDENCE LINKING PRODUCTIVITY OR EMPLOYMENT LEVELS TO PENALTY RATES, A FINDING CONFIRMED BY THE FAIR WORK COMMISSION.”

THE LAMP FEBRUARY 2015 | 9

NEWS IN BRIEF

Spain

Innovative transplant system victim of austerity The Spanish organ transplant model is world renowned, especially for its innovative use of highly trained hospital coordinators who approach families at the moment of deciding when to donate.

In 2014, even as the country’s health service staggered from cuts, Spain racked up a record-breaking year for organ donations and transplants, around 4400.

But austerity measures implemented by the Spanish government have hit the transplant system hard.

The training budget was reduced 20 per cent while, across the board, the country’s annual national health budget was cut by €7 billion in 2012.

“The reality is that we have fewer doctors, fewer nurses and less money than we had four or five years ago,” Rafael Matesanz, leader of Spain’s transplant organisation, told the Guardian.

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10 | THE LAMP FEBRUARY 2015

NEWS IN BRIEF

Britain

Babies screened for more genetic disorders All babies born in England will be offered screening for the four inherited metabolic diseases (IMDs) that can cause death or lifelong disability, reports the Guardian.

Australia

Unemployment hits high Australia’s unemployment rate has hit a 12year high of 6.3 per cent, with former Treasury secretary Martin Parkinson warning “we want to avoid the risk that cyclical unemployment develops into structural unemployment, which would create significant social and economic costs”.

ACTU assistant secretary Tim Lyons said “it is the highest unemployment rate in Australia since September 2002, when Tony Abbott was employment minister.

“The government needs to stop talking about jobs and start creating them. What we need is a plan for growth that is based on good jobs with decent wages and conditions and strong investment in skills and training,” he said.

Tim Lyons slammed the Abbott government’s policy response to higher unemployment.

“All this government has managed is an agenda of brutal cuts and attacks on workers’ rights, wages and conditions that will see the living standards of all Australians fall.”

He questioned how the Abbott government thinks people will get into work given the government has slashed $1 billion from skills and training in the budget and is making it easier for employers to bring in foreign workers on 457 visas.

“Figures show youth unemployment has climbed to 14.5 per cent, yet across the country we’re seeing employers cutting apprentice numbers and investment in training – then complaining they are unable to find skilled workers while youth unemployment soars.

“Sadly for Australian workers, the Abbott government’s agenda is based on cuts to wages and conditions and no support for Australian jobs.”

The NHS already uses blood tests to screen five-to-eight day old babies for five conditions including cystic fibrosis and sickle cell disease.

The same test will now be used to check if an infant has homocystinuria (HCU), maple syrup urine disease (MSUD), glutaric aciduria type 1 (GA1) or isovaleric acidaemia (IVA).

IMDs are genetic diseases that affect metabolism. Babies with these conditions cannot process certain substances in food and without treatment can suddenly become seriously ill.

They can be treated with a carefully managed diet, but untreated IMDs can lead to severe learning disabilities and developmental problems.

“UNTREATED IMDS CAN LEAD TO SEVERE LEARNING DISABILITIES AND DEVELOPMENTAL PROBLEMS.”

“THE GOVERNMENT NEEDS TO STOP TALKING ABOUT JOBS AND START CREATING THEM.” THE LAMP FEBRUARY 2015 | 11

COVER STORY

Regions put spotlight on ratios Nurses in Goulburn have put health care at the top of the agenda for the state election on March 28.

RESIDENTS OFTHE SOUTHERN NEW SOUTH Wales city of Goulburn queued for the microphone at a well-attended public forum that voiced strong support for improved nurse-to-patient ratios.

Ratios and the future of Goulburn Base Hospital were the main focus of the threehour meeting attended by more than 200 people.

The “Shine a Light on Health” forum was organised by the Goulburn branch of the NSWNMA, with support from Goulburn and District Unions.

Ninety nine per cent of respondents to an opinion survey distributed at the forum said they wanted their local Liberal MP, Pru Goward, to support improved staffing levels to bring Goulburn hospital into line with Sydney hospitals.

12 | THE LAMP FEBRUARY 2015

Medical and surgical wards in metropolitan hospitals are staffed according to six nursing hours per patient per day, but Peer Group C facilities such as Goulburn, 200km southwest of Sydney, get only five.

The NSWNMA branch invited election candidates to address the forum and asked them to sign a pledge committing to improved ratios for Peer Group C hospitals.

Labor candidate Ursula Stephens and Iain Fyfe of the Greens did so, but sitting Liberal member Pru Goward and the Christian Democrats’ Adrian Van Der Byl did not.

Jane Cotter, secretary of the NSWNMA Goulburn Base Hospital branch, says international research shows that increasing the amount of nursing

care results in better health outcomes for patients.

Reputable studies also show that for every patient added to a nurse’s workload there is a seven per cent greater chance of the patient dying.

“We want to make sure the Goulburn community receives the attention it deserves at the upcoming state election and we’ll continue to advocate in the best interests of our patients,” Jane said.

NSWNMA General Secretary Brett Holmes told the forum nurses deserve to be able to do their job “without going home feeling guilty that they’ve short changed their patients”.

“A patient with pneumonia in Goulburn deserves the same amount of care as a patient in Sydney who has access

“The forum was a good opportunity to put our case for the ratios we are fighting for.”

— Rosemary Durbidge RN

to Royal North Shore and RPA hospitals,” he said.

“The difference in Goulburn is that it doesn’t have the back-up resources and nurses carry the load.”

Registered nurse Mary Walker asked Ms Goward why patients in Goulburn were worth less than those in the big cities, especially given recent statistics showing car accident victims were less likely to survive in a regional hospital than a metropolitan one.

The Goulburn Post noted that Ms Goward “riled some sections of the crowd when she questioned whether people were there to talk about patients and health care or industrial issues.”

Jane said Ms Goward appeared “rattled”

by the size of the crowd and the level of criticism. “She was very much on the defensive.”

Ms Goward, who is Planning Minister and Minister for Women, told the forum: “I absolutely agree that as the clinical evidence becomes available that it’s better to do it this way than it is through the method that the hospital administration has adopted, if it is demonstrated that the ratio is a better way of providing the health care that people need and that it affects materially people’s recovery rates, the death rate and all the other things that go with being a better society and a healthier society, then I think it happens. But remember it depends on wealth.”

Goulburn branch president Rosemary

Durbidge said the forum was “a good opportunity to put our case for the ratios we are fighting for.”

Of the 123 people who completed the branch’s opinion survey, 80 per cent did not believe Ms Goward was making health a priority in Goulburn.

In other survey results, 91 per cent answered “yes” to the question: “Are you concerned about the privatisation of health? That is, allowing private corporations to take over the running of public hospitals?”

Eighty six per cent answered no to the question:“In your experience, do you think that the public hospital in your area is adequately staffed with nursing and midwifery professionals?”

A new or upgraded hospital was the other main issue at the forum.

The government has commissioned a study to help decide whether to build a new hospital or upgrade the existing one.

Labor candidate Ursula Stephens said everyone knew the hospital was “obsolete, not fit for purpose and inefficient.You have to wonder why we are the only regional community in New South Wales that has not yet had a significant health upgrade.”

Goulburn branch member Shirley Benbow said members of the public at the forum had “overwhelmingly” commented on how under resourced the local hospital was.

“I’m really encouraged that the community of Goulburn is getting behind the local unions and really critiquing the politicians and asking them to put their money on the table,” she said.

Brett Holmes told the forum Goulburn residents needed to know:“What will your new hospital look like? Who will own it and operate it? Will it be a privately operated, privately funded hospital delivering some public services or will it be a public hospital delivered by the public for the public?

“The people of Goulburn want to know what is being planned for them into the future and are rightly concerned about their access to vital public health services.”

Jane Cotter said the branch was concerned that the government favoured full or partial privatisation of hospitals, as with Sydney’s Northern Beaches hospital.

“Privatisation is aimed at making a profit and in general we worry that if you have two beds, a private patient will be given priority over a Medicare covered one.”

THE LAMP FEBRUARY 2015 | 13

COVER STORY

How to promote a healthy debate GOULBURN WAR MEMORIAL, A 20-METRE tower of stone and concrete on Rocky Hill, is topped with a powerful lighthouse beacon that casts a moving beam over the town at night.

The local branch of the NSWNMA chose the tower as the symbol of its “Shine a Light on Health” campaign.

The tower featured on leaflets advertising the Goulburn Local Health forum and served as a backdrop for a photo of local nurses in period uniforms dating back to World War II, published prominently in the Goulburn Post.

Branch members hit on the idea when thinking up new ways to promote the campaign for quality health care with improved ratios at Peer Group C hospitals.

“Some nurses have hung onto old uniforms so we got them out to get publicity for the campaign,” secretary of the NSWNMA’s Goulburn branch, Jane Cotter said.

Jane said the branch was always looking for photo opportunities to promote the campaign and elections were an ideal time to put pressure on politicians.

“We got good press coverage and radio coverage in the lead-up to the forum and after.”

The branch has been working with other local unions to gauge public attitudes to a range of issues including health, transport and education.

Jane said opinion surveys were a useful way of enlisting public support.

“We have been doing surveys at weekend markets over the past 18 months.

We find that members of the public like to be asked to sign something or fill out something.”

SOCIAL MEDIA AND SUPPORT She said support from other unions covering teachers, police, corrective services staff, transport workers and other industries was a big factor in the success of the health forum.

“Members of the other unions worked hard to help us get a big turnout on the night,” she said. “They used their contacts to distribute our flyers and put our material on their Facebook pages.We have a Goulburn Nurses Facebook page and so does the Goulburn District Unions group.

14 | THE LAMP FEBRUARY 2015

“The Goulburn community are very proud of their hospital and don’t like to see it run down.”

— Jane Cotter secretary Goulburn Base Hospital NSWNMA branch “Pushing the campaign out on social media really worked. A lot of people and organisations put it on their Facebook page and we also did a lot of letterbox dropping.”

The branch hired a flashing electronic sign to promote the forum and got advice from Goulburn Council on where to put it so it would not pose a distraction to drivers.

“We are very lucky that the council has always been on our side,” Jane said.The Liberal-controlled council earlier voted unanimously to support ratios for Goulburn Base Hospital.

“Saint Saviours Anglican cathedral allowed us to erect the sign on their grounds and the Catholic churches handed out our flyers at every mass.”

The branch wrote to principals and P&C groups at all local schools and preschools, asking them to put flyers on their

notice boards and invite parents to come.

Branch members made contact with service groups such as Rotary, CWA and Soroptomist as well as support groups in fields such as palliative care, cancer, diabetes and Parkinson’s disease.

Jane also attended local political party meetings to promote the forum and hand out flyers.

The branch mailed flyers to local health professionals and non-government organisations such as Mission Australia, StVincent de Paul and Baptist Community Services.

“The Goulburn community are very proud of their hospital and don’t like to see it run down and not staffed properly,” she said. “Most people were happy to put our flyers in shop windows.

“If one of the branch members had her hair done she would get her hairdresser to put it up, for example.”

Penny pinching at Blacktown puts patients at risk A serious shortage of nurses in the Blacktown ED in January has highlighted the urgent need for mandated nurse-to-patient ratios of 1:3 in emergency departments.

Figures leaked to Fairfax Media showed that a dozen patients were left waiting for more than 48 hours one Monday afternoon in January in the Blacktown ED. Half were aged 80 or older. A further five had been waiting for 24 hours while another was left in a resuscitation bed for 14 hours.

Maureen Buckley CNC, Blacktown Hospital NSWNMA branch delegate, says this wasn’t a one-off.

“Our members working in ED say it is not unprecedented. The capacity of the ED is often stretched.

“It’s a very difficult environment at all times and it is extra tough with this added capacity.

“The nurses in our ED always aim to deliver safe patient care but it is hard to deliver quality care when the capacity of the ED is exceeded.”

NSWNMA concerns were confirmed by an anonymous health department source quoted by Fairfax Media.

“It is becoming routine to have a half dozen or more patients sitting in the emergency department waiting for a ward bed for more than 48 hours and, in occasional cases, 72 hours,”

the source said. “Every day of every week for the past year, at least a year, it has been routine. This is the norm. There is a chronic shortage of beds.”

A 2012 federal government report found that 10 per cent of patients at Blacktown waited longer than 27 hours for admission. The federal benchmark for patients to leave an emergency department is four hours.

Assistant General Secretary of the NSWNMA Judith Kiejda says it is unacceptable for the New South Wales government to leave patients and staff vulnerable when there is an avoidable shortage of nurses.

“This government has a track record of forcing the hand of Local Health Districts – prompting a high number of nursing staff on leave and bed closures to minimise budget pressures over the summer,” she said.

when compared to previous years, contrary to the NSW Health Minister’s claims,” Judith said. “The health minister is abdicating her responsibility of delivering safe patient care and a well-resourced public health system.

“Jillian Skinner promised the people of this state that patient safety would come first – clearly that’s not a commitment she’s kept.

“The health minister must make improved ratios in emergency departments a priority so that our members can deliver the safest possible care to their patients,” Judith said.

Maureen Buckley says shortages at Blacktown vindicate the NSWNMA’s claim for better ratios in our EDs. “We definitely support the 1:3 ratio in our EDs,” she said.

Judith rejected claims from health minister Jillian Skinner that there was an “unusual spike” in ED presentations at the time.

“We’ve been advised that there was no ‘unusual spike’ in presentations to Blacktown Hospital’s emergency department

Maureen Buckley CNC

THE LAMP FEBRUARY 2015 | 15

COVER STORY

“When you start telling the public there is a sevenfold difference in the likelihood they could die, you really get their attention on nurse numbers.’

— Dr Linda Aiken

16 | THE LAMP FEBRUARY 2015

Ratios save lives An international study has shown that patients suffer when nurses are forced to work without safe staffing ratios.

INCREASING THE WORKLOAD OF NURSES produces worse clinical outcomes for patients, including higher mortality following surgery.

This has been proved by the largestever international study of the relationship between nurse staffing levels and the quality of health care, which examined health outcomes in 30 countries on four continents.

The European component of the study, covering 617 hospitals, found that deaths following common surgical procedures were significantly lower in hospitals with fewer patients per nurse.

Every patient added to a nurse’s workload was associated with a 7 per cent increase in hospital deaths following common surgery.

These results add weight to the NSWNMA’s campaign to extend ratios to health services that were not included when the Association won mandatory ratios for many units of metropolitan and rural hospitals in 2011.

The results also validate the deep concern of nurses in New South Wales for their patients’ safety due to understaffing, and underline the importance of the Association’s decision to campaign for mandatory ratios.

The research, published in The Lancet*, was led by Dr Linda Aiken, professor of nursing and head of the Center for Health Outcomes and Policy Research at the University of Pennsylvania.

Dr Aiken, who is internationally renowned for her work on the relationship between the health care workforce and the quality of health care, spoke at a recent Queensland Nurses’ Union (QNU) symposium on Keeping Patients Safe, held in Brisbane.

Dr Aiken said the research also showed

the greater the number of bacheloreducated nurses, the lower the number of patient deaths.

Among the findings: • Every one patient added to a nurse’s workload is associated with a 7 per cent increase in deaths following common surgery.

• Every 10 per cent increase in university-educated nurses is associated with 7 per cent lower mortality.

• If all hospitals in nine European countries studied had at least 60 per cent university-educated nurses, with no more than six patients each, more than 3500 deaths a year might be prevented.

The study found that other adverse consequences of poor nurse-to-patient ratios included more complications following surgery and a reduced likelihood of elderly patients returning to community living.

The European research covered nations as diverse as England, Spain, Poland, Germany, Greece and Switzerland. Despite their organisational and financial differences, in-hospital general surgery mortality varied more within countries than between countries.

The same phenomenon is revealed in a related study of all 850 hospitals in four large states of the USA – Pennsylvania, California, New Jersey and Florida – which account for a quarter of all US hospital admissions.

Dr Aiken told the QNU symposium there was “huge variation” in mortality rates between hospitals within each country.

“There is a seven-fold difference in mortality following common surgical procedures across nine countries in Europe.

In the US it is a 12-fold difference.

“Even in England under the National Health Service – a ‘standardised product’ – you have a seven-fold difference in mortality after common surgical procedures.

“The question is not why is there a difference between mortality in different countries, but why do we have such a big difference in mortality within each country?

“The difference in nurse-to-patient ratios is a very big factor in explaining why.

Nurse staffing levels were dramatically different between these hospitals and more nurses means lower mortality.”

In English hospitals, for example, nurseto-patient average workloads ranged from 1:5.1 to 1:10.7.

“Even in countries that report they have ratios, we find that there is tremendous variation in the actual operation of those ratios, so this is why we find a relationship between difference in mortality and difference in nurse staffing.

“When you start telling the public there is a seven-fold difference in the likelihood they could die, you really get their attention on nurse numbers.’’

Dr Aiken said her team was getting similar results from surveys in Asian, African and South American hospitals.

She said while Australia was not included in her studies,“I’m willing to bet you will have the same variation in staffing and differences in mortality that we find in the 30 other countries.”

That was because in all countries studied, “... despite different systems, financing, resources in a country, every one patient increase in a nurse’s workload is associated with a 7 per cent increase in mortality.

“This is after we take into account all the other possible explanations for mortality, so this is the real direct impact of nurses on patient outcomes.”

*http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62631-8/abstract THE LAMP FEBRUARY 2015 | 17

COVER STORY

Nursing ‘foundational to safety’ Safety measures will be ineffective if the role of nurses is ignored, researcher warns.

“NURSING IS A SOFT TARGET FOR BUDGET REDUCTIONS.”

Campaign material from the National Nurses United.

18 | THE LAMP FEBRUARY 2015

FIFTEEN YEARS AGO THE UNITED STATES Institute of Medicine revealed that medical error was among the five leading causes of death in that country.

Since then the US has made no progress in making surgery safer “despite throwing lots of money” at the problem, Dr Linda Aiken told the Keeping Patients Safe symposium.

Dr Aiken said authorities had neglected the role of nurses, who have the most contact with patients and are best able to “conduct surveillance and to recognise problems.

“This has been problematic for improving patient safety because nursing is a soft target for budget reductions,” she said.

Authorities had “ignored a fundamental reality that nursing is foundational to quality and safety. If nursing is not as strong as it needs to be then this whole overlay of quality and safety we’re using is really not going to have its intended effect.”

Dr Aiken said most countries she had studied had increased the numbers of bedside nurses during the past two decades.

However staffing had not improved enough to keep up with the growing complexity of care as length of stay is shortened and more medical interventions are introduced.

“Policy makers assume if we reduce the number of in-patient days in hospitals we can also reduce the number of nurses.

“We can’t because all the patients left in the beds are sicker.”

Her research also revealed a direct link between nursing workloads and readmission rates for the elderly and children.

Inadequate nurse staffing resulted in a “very high human toll of unnecessary admissions. Every time a frail elderly person goes to a hospital it increases their odds of never being able to go home again.

“Each one-patient increase in [a nurse’s workload] in paediatric inpatient services is associated with an 11 per cent increase in readmissions among children.”

Dr Aiken said large-scale research was essential to demonstrate the case for improved nurse-to-patient ratios to policy makers. “It leads to very actionable changes in practice and policy.”

Her research helped Californian nurses in their successful campaign to have the state adopt mandatory ratios in 2004.

Californian mortality rates for hospital patients following surgery are now among the lowest in the US. “Importantly we found that public ‘safety net’ hospitals, which take poor people and are always lagging on nurse staffing, for the first time ever came up to the standard of the rest of the state and vastly improved their outcomes,” Dr Aiken said.

Before the introduction of ratios Californian hospitals could not attract and keep nurses because burnout rates were high. Today California no longer has a nurse shortage.

“On average, nurses in California have two fewer patients in their workload than nurses in my state of Pennsylvania, which does not have this legislation.

“We estimated that if Pennsylvania staffed at the same levels that Californian hospitals are required to staff at, we would prevent 2000 deaths a year in our state.

“Our study has led to federal pending legislation that will require all US hospitals to report their staffing levels on a public website.

“In the UK, their own quality organisation within the National Health Service, on the basis of our research, has recommended patient-to-nurse ratios.”

Challenging assumptions and myths PROFESSOR LINDA AIKEN IS ONE OF America’s most influential healthcare professionals.

“Her work blows away many of the assumptions and often challenges the myths that we know,” Queensland’s chief nurse Dr Frances Hughes said when introducing Dr Aiken to the Keeping Patients Safe symposium.

Dr Aiken recently won the US Institute of Medicine’s 2014 Gustav O. Lienhard Award – never before received in the field of nursing.The award has been likened to the medical research equivalent of the Nobel Prize.

The award recognises her research “documenting that nurses’ education, patient workloads, and work environment are associated with patient outcomes, as well as her work to translate those findings into practice and policy in the US and other nations.”

Dr Aiken is the director of the US Centre for Health Outcomes and Policy Research and professor of nursing at the University of Pennsylvania.

A clinical nurse specialist in cardiac surgery, she has received a total of 53 national and international awards and five honorary doctorates in the past 23 years.

She told a US magazine that, before she even had her first clinical job in nursing, she saw the “disconnect between what nurses wanted to do and what was possible in a hospital organisation.”

And so for her an ongoing question has been: “How is the care in hospitals facilitated or compromised” by institutional structures?

More nurses saves more money

Campaign brochure published by National Nurses United highlithing the importance of ratios.

Dr Linda Aiken and her co– researchers are starting to build a business case to show that hiring more nurses is good for a health service’s bottom line.

She said savings due to better care and reduced nurse turnover more than offset the costs of increased staffing.

“It is costing hospitals a lot not to have more nurses,” she told the Keeping Patients Safe symposium in Brisbane.

She said the US health system was incurring higher costs from preventable readmissions, treating complications like infections, more long-term institutional care for the frail elderly, and expensive nurse turnover.

Research showed that in the United States “adverse occurrences” among hospital patients were associated with: • 251,000 deaths • 22.6 million additional hospital days • $41.8 billion in medical care costs However, improved nurse staffing has been proven to reduce adverse occurrences and nurse turnover.

In the US, annual saving per additional nurse added to improve staffing was $60,000, or 72 per cent of the salary plus benefits of each additional nurse added – not counting savings through lower turnover.

“It is costing hospitals a lot not to have more nurses.”

THE LAMP FEBRUARY 2015 | 19

MEDICARE

GP co-payment fiasco As The Lamp went to press the Abbott government was on to its second health minister and the third version of its discredited GP co-payment plan.

THE ABBOTT GOVERNMENT’S FIRST HEALTH minister Peter Dutton – widely regarded by health professionals as the worst ever (see right) – has been replaced by Sussan Ley. But the government is doggedly sticking with its reviled GP co-payment plan, albeit with a new veneer.

The co-payment has now had three incarnations but with the same objective of making people pay more to visit their GP: VERSION 1 Last year’s budget flagged an across-the-board $7 GP co-payment as a price signal to deter visits to GPs. VERSION 2 In December health minister Peter Dutton and Prime Minister Tony Abbott announced a new plan to reduce or freeze Medicare payments to GPs, leaving it to the doctors to decide how much and to which patients to pass on the costs.

Effectively making doctors tax collectors for the government.

VERSION 3 New health minister Sussan Ley scrapped the $20 cut to Medicare rebates for short GP visits, three days before they were to be implemented and just weeks after they were announced. A $5 co-payment remains as government policy, with the revenue still going to the government’s medical research fund.

New broom Sussan Ley, however, has maintained the same rationale trotted out since last year’s budget that Medicare is “not sustainable”.

“The Medicare levy raises $10billion approximately at the moment and the cost of Medicare is $20billion, so the Medicare levy is hopelessly inadequate in funding Medicare,” she said.

Labor’s health spokesperson Catherine King said the government’s argument about Medicare sustainability was “a sham” when “not a single dollar” from the copayment would be reinvested in Medicare.

King said only 30 per cent of Medicare Benefits Schedule funds went to general practice, yet that part of the system saw more than 80 per cent of patients.

A report by a group of medical researchers at Sydney University, who have 20 | THE LAMP FEBRUARY 2015

Doctors name Dutton “worst health minister ever” Doctors have voted Peter Dutton as the worst health minister for the past 35 years in a poll conducted by Australian Doctor magazine.

The magazine, which has a readership of 20,000, mainly general practitioners and specialists, received 1100 doctor responses to the survey.

A Tasmanian GP, Dr Donald Rose, told Australian Doctor: “Dutton will be remembered as the dullest, least innovative and most gullible for swallowing the reforms from his think tank ...

Although I am glad he has been demoted, it would have been good if he was still around to take responsibility for the current chaos he has caused.”

been studying general practice activity for more than 16 years through the Bettering the Evaluation and Care of Health (BEACH) program, also argued that GPs are providing good value to the health system.Their report found: • In 2013-14 there were 35 million more GP services than 10 years earlier, a 36 per cent increase. This included 17 million more attendances by patients aged 65 years and over (a 67 per cent increase).

• Length of GP consultations recorded through BEACH suggest that the average consultation now takes almost one minute more than a decade ago.

The result is that GPs spend an extra ten million clinical hours with their patients, a 43 per cent increase.

• The number of problems managed at these consultations has also significantly increased. GPs managed an additional 68 million health problems at these encounters (an increase of 48%), including 24 million more chronic problems.

• Management of these problems involved an additional 10 million procedures (a 66 per cent increase) and 12 million clinical treatments (such as counselling, advice and education) compared to a decade ago.

“Clearly, increases in the amount and complexity of GP clinical work are reflected in additional Medicare expenditure.

If other medical specialists and/or emergency departments had provided these extra services, they would have cost far more,” the researchers said.“The average cost of a GP visit was $47 from Medicare, plus a $5 patient contribution. For a private specialist, the average visit costs Medicare $82 plus a $38 patient fee.

“A visit to the emergency department, which is paid by state and territory governments, costs far more. In Western Australia for example an emergency department visit cost $599 on average in 2011-12.”

“PETER WHO?” — Professor Mary Chiarella

Experts give Dutton a “D” When online health blog Croakey asked health professionals for their opinion about Peter Dutton’s tenure as federal health minister they received a range of damning assessments.

“Someone with little interest in the portfolio and little energy to challenge when policy changes are handed to him which run contrary to public wishes and all the local and international evidence.”

— Professor Jill White, Dean, Sydney Nursing School, University of Sydney GP activity 2013-14 report: http://tinyurl.com/luhf7t3 Decade Report: http://tinyurl.com/nxejupb Sources used in this infographic: http://tinyurl.com/nd69jmu

Experts debunk GP tax rationale The Abbott government has relentlessly claimed through all three versions of its GP co-payment that Medicare costs more now than it did three years ago – proof that growth in health funding was unsustainable. However three reports authored by health experts have debunked this claim: IN SEPTEMBER, the Australian Institute of Health and Welfare found that health expenditure was growing at the lowest level in 30 years, when it began keeping records.

The report found total spending on health was just 1.5 per cent higher for the year. When population growth is taken into account, average annual health spending of $6430 per person was actually down in real terms compared to previous years and the Commonwealth’s share of health spending had fallen 2.4 per cent in real terms.

IN OCTOBER, the OECD found that Australia’s health outcomes were significantly better than the OECD average and Australia’s health spending (as a percentage of GDP) was lower than the OECD average.

IN NOVEMBER, the BEACH (Bettering the Evaluation and Care of Health) report into general practice found that spending on GP services was a sound investment that was reducing pressure on the health budget. “As GP services are far cheaper than other types of medical services, discouraging GP visits by introducing a standard co-payment for most patients would increase costs to governments, now and later,” it found.

“Chaotic and humiliating.

Completely out of his depth.”

— Stephen Leeder, Emeritus Professor of Public Health and Community Medicine, Menzies Centre for Health Policy and School of Public Health, University of Sydney “Peter Dutton totally disregarded preventative measures and got rid of the important Australian National Preventative Health Agency, whose research and subsequent recommendations could have saved the health care budget a great deal of money.”

— Dr Rosemary Stanton, nutritionist “He squandered his time in opposition and so in government came unprepared to his portfolio where he ignored expert advice, evidence and public opinion to place ideology over good policy.

— Prof Lesley Russell, Menzies Centre for Health Policy “Peter who?”

— Professor Mary Chiarella, Sydney Nursing School, University of Sydney

THE LAMP FEBRUARY 2015 | 21

AGED CARE

RNs needed for safe effective aged care “It’s dangerous to put profits ahead of resident care.”

— Gerard Ryan RN

AS MOVES ARE AFOOT TO REMOVE THE LEGAL REQUIREMENT TO employ RNs in aged care, a survey conducted by the NSWNMA of more than 800 aged care nurses has revealed their serious concerns about the consequences of such an action.

Almost all (98 per cent) survey respondents said it was important to protect the legal requirement for an RN in aged care. Most were aware of the legal requirement but only 61 per cent were aware that it was under threat.

Most (92 per cent) said that removing the legal requirement would have a negative impact on their workplace.

When asked about the importance of having an RN for palliative care and end of life care, pain management, oversight of the nursing team, assessing and managing deterioration and changes in condition, management of medications and deciding when to seek medical advice or transfer to hospitals, in each category more than 90 per cent found it “extremely important” to have an RN. There was widespread concern about the consequences if the mandatory requirement for an RN was removed: • 95% said there would be more hospital admissions

22 | THE LAMP FEBRUARY 2015

• 80% said GPs would be reticent to visit aged care homes • 86% said families would consider moving elsewhere • 98% said there would be a delay in identification and

treatment of illness and complications • 96% said there would be lower quality of care PROFITS AHEAD OF PATIENT CARE Gerard Ryan, an RN in aged care based in Tamworth said “the very thought of eliminating RNs from aged care is ridiculous and outrageous.

“It is the worst thing in the world that they could do. In New South Wales the Poisons Act requires an RN to handle narcotics. If the state government changes that it will be a horrible mistake,” he said.

“Most facilities would take the cheapest option of [employing] AiNs over RNs. It would be a short-term gain at the expense of resident care.

“It’s dangerous to put profits ahead of resident care.”

Aged care profits jump 159% in one year An annual survey by Bentleys Chartered Accountants has revealed that aged care homes more than doubled their profitability on average last year; in large part by cutting the hours of care delivered by RNs. Bentleys National Aged Care survey, which benchmarks the profitability of the aged care sector, has been conducted for 20 years. The survey covers 179 homes around Australia.

The 2013-14 survey found that net profits had jumped 159 per cent, from $4.14 to $10.71 per resident per day. The results were outlined in a presentation given in Brisbane last October and obtained by Crikey.

The survey found that the average nursing home spent $99 per resident per day on nursing and care, mostly wages. The most profitable operators, however, spent six per cent less – just $92 per resident or 40 per cent of revenues.

The presentation noted that providers had found “efficiencies” mainly through a steady trend away from reliance on nurses towards personal care assistants.

A chart showed the long-term decline in the time spent on care by registered nurses, which fell from 5.9 hours per patient per fortnight in 2004, comprising 17 per cent of total care staff hours, to 5.2 hours or 13 per cent of total hours in 2014.

The amount of time spent by personal care assistants jumped from 11.4 hours in 2004 comprising 31 per cent of total care staff hours, to 16.8 hours or 39 per cent of total hours in 2014.

Bentleys describe aged care as “a growth industry underpinned by government subsidies and an ageing population”.

PRIVATE HOSPITALS

Update on Ramsay negotiations

What Aged care workers say in our survey “The federal government has rolled out tools for the best practice for palliative care in aged care facilities and this would be impossible to act on effectively if there were not RNs on duty.”

“I am already the only RN in charge of 70 plus residents and my facility has a dedicated 20 bed dementia unit included in these numbers. There is only one RN on all three shifts. At weekends and public holidays there is no management present in the facility.”

“The elderly do not go to aged care to die, but to improve their quality of life and have care whenever they need it. This move by the government is, as usual, a monetary decision that has no basis in any understanding of the real world. A cheap decision and a negligent decision that will result in deaths.”

“If an RN is not on the premises 24/7 the amount of unnecessary hospitalisations will dramatically increase putting further strain on the health system.”

Negotiations between private hospital operator Ramsay Healthcare and the NSWNMA continue.

As The Lamp went to press Ramsay had yet to respond to the Association’s five per cent pay claim. Following our request for an interim increase, Ramsay agreed to a 2% downpayment while talks continue.

Ramsay rejected a claim to adopt ACORN staffing standards in the peri operative environment, saying they were not relevant to private hospitals, despite several Ramsay employees contributing to writing the standards.

Ramsay rejected our claim for guaranteed adequate work time to complete mandatory training, saying there is already sufficient time for nurses and midwives to complete mandatory training. It is their view that the inability of nurses to complete mandatory e learning reflects a time management issue, not a workload issue.

Ramsay has put forward changes it would like in an agreement including: • Payment of wages to be postponed to the next business day when the ordinary pay day occurs on a public holiday.

• Payroll to have up to seven days to complete the last pay when an employee leaves Ramsay.

• When a permanent employee is recalled, all time worked is to be paid and can’t accrue as Time Off In Lieu.

• Casuals to be paid on-call allowance when on call, with payment for recalls at the appropriate casual rate without overtime.

The Association has not agreed to any of these changes and talks continue.

THE LAMP FEBRUARY 2015 | 23

NURSING EXCELLENCE

National recognition for Prince of Wales nurse Emergency Nurse of the Year Wayne Varndell says his proudest achievement is his involvement in the establishment of a new clinic that has motivated more of his colleagues to pursue nurse practitioner careers.

PRINCE OF WALES HOSPITAL HAS WON TWO prestigious College of Emergency Nursing Australia (CENA) annual awards for its pioneering work in redesigning and advancing the delivery of timely emergency care.

Along with naming the hospital’s ED clinical nurse consultant WayneVarndell its Australasian ED Nurse of the Year, CENA also named Prince of Wales as the Australasian Emergency Department of the Year.

The Prince of Wales emergency department cares for more than 54,000 adult patients a year and is one of the busiest departments in the 500-bed hospital. Its 35 beds are divided between the resuscitation area, acute, sub-acute and short stay unit and staffed by 89 registered nurses, including nurse practitioners, and 69 medical officers.

“Both awards have acknowledged the hard work of the entire team in innovating emergency healthcare,”Wayne said.

For the past two years Wayne, who is an active member of the Nursing Research Council at Prince of Wales, has been a vital member of a team that has collaborated with the local community, hospital service providers and administrators to address the key issues that confront emergency departments throughout Australia.

“This has meant that we’ve been able to meet the needs of the community on a very broad scale through a number of projects,” he said. “I think our most significant achievement – and the one I am certainly most proud of – has been the implementation of an ED Review Clinic “It is an extended practice nurse-led service to provide short-term management of patients with low risk differentiated conditions suitable for rapid discharge.”

Prince of Wales Hospital ED treats many patients who have travelled from 24 | THE LAMP FEBRUARY 2015

overseas or interstate and who might require review within 48 hours, but can’t readily access primary care for follow-up.

“Being able to ensure their care and recovery is on track, while ED continues to see new patient presentations, has reduced our unplanned representation rate and ED length of stay for Fast Track and enabled advanced nursing practice to develop,”Wayne said.

“As a consequence of implementing the Review Clinic we now have two endorsed nurse practitioners as part of the ED team and we have motivated others to pursue a nurse practitioner career.”

The clinic, staffed by three senior emergency nurses supported by a sub-acute senior medical officer, bridges the gap between primary and secondary care.This has led to an overall reduction in patients leaving before beginning or completing treatment and decreased sub-acute waiting times from 2.2 hours to 1.4 hours.

The success of the ED Review Clinic has led Prince of Wales to implement an extended practice area for transitional nurse practitioners, extending the professional profile of nurses in its ED and across the hospital.

Wayne has also been involved in the establishment of a nurse-led Aged Care Emergency Service (ACE). By working with community care services such as GPs, podiatrists, dietitians and outpatient services it has been able to reduce lengths of stay and diverted patients for management. It also directly admits patients to inpatient teams following domicile visits and discussions with primary care practitioners.

This model of care has been integrated into the Age Specialist Emergency Service that provides 16 hours a day, seven days a week service for patients over 70.

Wayne also leads an in-house program

that supports staff undertaking tertiary qualifications. So far he has mentored 25 nurses to achieve graduate certificates in emergency nursing and six of these have completed a masters.

He has also published a number of research articles and contributed chapters to international books*, is president of the NSW branch of CENA and has received more than $900,000 in research and project funding.

Wayne told The Lamp that when he graduated in the UK in 2001 he had no idea his career would take him so deeply into research. But he would never be involved to the exclusion of clinical practice.

“I always wanted to do both.Translating best evidence into practice is key, if patient care, better ways of working and safer standards of practice are to be realised and experienced by the patients in our care.

“Balancing clinical practice and research can be challenging, however the achievements that have been made are a direct result of the high degree of teamwork, collaboration and dedication of the ED staff and hospital management; patient focused, patient driven.”

Prince of Wales ED nurse manager Elizabeth Ryan said: “Wayne has been pivotal in developing the scope of clinical practice and mobilising multi-disciplinary support for initiatives across the hospital.

“He is the most inspirational emergency nurse I have worked with during my 26 years of emergency nursing,” she said. “I’m continually amazed how he fits so much into 24 hours. His clinical skills are of the highest standard and his intelligence and analytical ability are outstanding.

“He contributes to the department not only on a practical level but is able to impart his knowledge and experience to nursing and medical staff.”

“He is the most inspirational emergency nurse I have worked with during my 26 years of emergency nursing.”

— Prince of Wales ED nurse manager Elizabeth Ryan

*Wayne Varndell’s research interests include exploring the role of ED in supporting palliative care patients (Varndell, Mackenzie and Sands, 2013), management of post-intubation sedation of critically ill patients in ED (Varndell, Fry and Elliott, 2011,Varndell, Doug and Fry, 2014), the dependency of patients on emergency nursing workloads (Varndell, Fry, Gallagher and MacGregor, 2013) and the impact of noise on staff and patient wellbeing (Ortiga, Kanapathipillai, Daly, Hilbers,Varndell and Short, 2013).

THE LAMP FEBRUARY 2015 | 25

SUPERANNUATION

Big banks want a share of your super The federal government’s Financial System Inquiry, led by ex-Commonwealth Bank head David Murray, has recommended changes that could undermine Australia’s successful and widely admired superannuation system.

ONE OF THE KEY RECOMMENDATIONS IN the Financial System Inquiry’s (FSI) final report, published in December, was that all APRA-regulated super funds should have a majority of “independent directors” on their trustee boards. It also recommended an independent chair.

The FSI’s recommendations relating to super funds have widely been interpreted as an attempt to reduce or eliminate union influence on industry super funds, opening the way for banks to gain a greater market share of the superannuation sector.

But Industry Super Australia CEO David Whiteley says the logic behind the recommended changes is deeply flawed.

He says the superior performance of industry super funds (which are run on a not-for-profit basis), compared to the bank-owned super funds (which are run to profit shareholders) is proof that the current governance structure of industry funds is working.

The industry funds have a representative trustee system with a “sole purpose test” that legally obliges their boards to act in the interests of their members.

Bank-owned super funds generally have a contract-based system in which board members are effectively employed and act in the interest of shareholders.

“Industry super is not broken so why try to fix it?” asks David Whiteley.“Industry super trustees come from diverse backgrounds including unions, business, academia, law, politics and economics.

“They come from many sectors – construction, hospitality, health, manufacturing, education, law and retail.They could never be accused of being captured by the finance sector.”

26 | THE LAMP FEBRUARY 2015

He argues that it should be the governance of banks under scrutiny in light of their poor performance relative to the industry super funds.

Industry super funds have consistently outperformed bank-owned super funds in the past 17 years, according to data published by APRA*.

“The FSI report notes good governance is worth an extra 1 per cent in returns but does not reach the logical conclusion that this is already evident in the outperformance of industry super funds.

“Instead, its curious conclusion is that the better-performing sector could further lift its outperformance by adopting the governance model of the underperforming bank-owned super funds.

“If better governance will deliver better returns, why not focus on the underperforming bank-owned funds?” he said.

David Whiteley says it is the banks that are pushing to fundamentally change the industry super fund structure.

“Increasingly, their calls have become ideological and shrill.The enduring success of industry super funds has been deeply confronting for the major banks, which see themselves as natural custodians of people’s savings.

“This is in stark contrast to community sentiment. Following a stream of scandals, trust in the banks and the finance sector is at an all-time low. Industry super funds, returning all profits to members, typically delivering better returns than bank-owned super funds, should be a source of pride for policy makers rather than a target for commercial and political attack.”

“If better governance will deliver better returns, why not focus on the underperforming bank-owned funds?”

— David Whiteley CEO Industry Super Australia

*APRA, the Australian Prudential Regulation Authority, oversees banks, credit unions, building societies, general insurance and reinsurance companies, life insurance, friendly societies and most members of the superannuation industry.

Super’s safety net under threat “Not content with whopping market domination in banking, the banks are determined to find ways to obtain similar dominance in superannuation.”

— Greg Combet former ACTU Secretary and adviser to Industry Super Australia CHANGES TO SUPER FUND GOVERNANCE are not the only thing major banks have been gunning for, in order to tilt the super field in their favour.

They have also been advocating for the abolition of the default super safety net, set up by the Gillard government to safeguard the retirement incomes of Australian employees.

David Whitely argues that the evidence overwhelmingly endorses the success of the current super structures.

“The performance of industry super funds further solidifies the case for the default super safety net not only being retained, but being strengthened and expanded,” he said. “The heart of Australia’s superannuation system is the default super safety net. This system provides a default superannuation fund for the eight out of 10 workers that do not choose their own fund.”

The default super safety net is overseen by the Fair Work Commission and is part of workplace awards. It provides important

protection for the 80 per cent of Australians who don’t actively choose a super fund.

To become a default super fund a fund must first be approved by an expert panel at the Fair Work Commission. There are criteria, based around performance, that mean only the best super funds make the grade.

super savings,” he said. “Not content with whopping market domination in banking, the banks are determined to find ways to obtain similar dominance in superannuation.

“Many would question whether such an outcome is in the interests of consumers, the economy and future taxpayers.”

Bank-owned super funds have, on average, been poor performers. Analysis of APRA data from 1996 to 2013 shows they delivered, on average, between 1.7 and 2.5 per cent less per year than other types of super funds. Long-term underperformance in investment returns can add up to tens of thousands of dollars less at retirement.

“Despite their history of poor average super returns during the past 17 years, the banks have more than a quarter of the entire superannuation market. With such poor average returns, how have they been able to do it? Mainly it’s because they have paid financial advisers to recommend their products,” Greg Combet said.

BANKS WANT SYSTEM TAILORED TO THEM The major banks have been lobbying to remove the superannuation safety net in favour of a system designed to suit their own business models.

Former ACTU secretary Greg Combet, now a principal adviser to Industry Super Australia, says banks will use their bargaining power with their business customers to pressure them to use the bank-owned super fund and transfer unsuspecting employees into it.

“On past performance, and without a quality filter, this could leave those employees significantly worse off with their

Industry super outperforms bank-owned super Commission-free industry super funds have consistently outperformed bank-owned super funds and other retail super funds, whether measured over one, three, five, seven or 10 year time periods, according to monthly data from SuperRatings.

Median rolling returns – SuperRatings’ Fund Crediting Rate, SR50 Balanced Index to November 30, 2014

%

Rolling 1 Year

Rolling 3 Year

Rolling 5 Year

Rolling 7 Year

Rolling 10 Year

Industry funds

8.82

11.75

8.29

4.20

6.86

Retail funds

7.63

11.24

7.28

2.83

5.24

Bank-Owned funds

7.25

10.42

6.68

2.59

4.93

Industry funds outperformance of retail funds

1.19

0.51

1.01

1.38

1.63

Industry funds outperformance of bank-owned funds

1.57

1.34

1.62

1.62

1.93

THE LAMP FEBRUARY 2015 | 27

SUPERANNUATION

Who’s looking after your super?

THE ROLE OF UNIONS IN INDUSTRY SUPER. ABC Radio National presenter Geraldine Doogue recently hosted a discussion between Brett Holmes (HESTA, NSWNMA) and Gerard Noonan (MediaSuper) about recommended changes to super from the federal government’s Financial Systems Inquiry.

Following is a transcript of their discussion.

Geraldine Doogue The recent Financial Systems Inquiry recommended a series of changes to superannuation including the seemingly straightforward suggestion that a majority of directors on all super fund boards be independent.

Is it as straight forward as it sounds or is it a device – part of a campaign by parts of the financial establishment to dilute union influence in the superannuation sector, despite industry funds consistently outperforming the retail funds? What are the current obligations of superannuation trustees?

Gerard Noonan There is a simple obligation and that is we do everything to benefit members. It’s called the sole purpose test. On my board, and I’m sure on Brett’s as well, there are representatives who are nominated by unions and also by employer organisations within both of our industries but on all of them – and in my experience over the past two decades being involved in industry superannuation – all those [board] members, all of the time, act in the interests of their members. That is 28 | THE LAMP FEBRUARY 2015

what they are obliged to do by law but in reality they do that.

Geraldine Doogue Are you paid?

Gerard NoonanYes. Previously that was not the case and now there is a payment made. It’s relatively modest compared with the amounts paid to directors of corporate companies in Australia. But there is a payment made.

Geraldine Doogue Would it be about $50,000 a year?

Gerard Noonan It’s in the order of $30,000 in our case.

Geraldine Doogue Is there any difference, in your experience, between the employer and the employee representatives on these boards? Can you feel it?

Gerard Noonan No you can’t. One of the interesting things that I have discovered, being involved in it, they are very skilled, surprisingly skilled. On our board we’ve got – I’ve just done a quick survey – we have three with bachelors of business or economics, we have a lawyer, we have a corporate treasurer who specialises in cur-

rency and bonds of course. We have got two business people who have quite a lot of experience. We have an MBA, we have an ex-editor of the Australian Financial Review, who happens to be me who actually is a historian by background. And we have the head of a major union. Now that brings a lot of skills to the table but those people act as fiduciaries [trustees].They understand what it is all about. There is no division whatsoever.

Geraldine Doogue And how often do you meet?

Gerard Noonan We meet six times a year as a board. In fact, typically with committees we are meeting 14-16 times a year.

Geraldine Doogue So you earn your money! Brett Holmes, how have you managed the transition from being a union rep to suddenly being the custodian of billions of dollars. Is it billions of dollars by the way? How much is invested with HESTA? Brett Holmes $30 billion.

Geraldine Doogue $30 billion. Wowee!

And how many members?

Brett Holmes Nearly 700,000 members.

More than 580,000 active members of the fund.

Geraldine Doogue How would you answer that? One would think looking on that that is a phenomenal transition to make.

Brett Holmes Yes. When I first went on the board 14 years ago I had to get up to speed fairly quickly around investment issues and obtain information on a regular basis. We were required to undertake at least 35 hours of professional development every year after we had done the initial training. That includes one, two or three superannuation conferences where you are subjected to the experts and the people who are guiding the whole investment industry. So you get that face-to-face experience, learning from those people that are actually doing the investments for you.

Geraldine Doogue Do you mind if I ask you this basic question? Could you read a balance sheet? It’s not a straightforward question. I know that myself.

Brett Holmes Yes. I had learnt to read a balance sheet. I had become a member of the management of the union. When I started I was the assistant secretary of our

union and required to undertake responsibility for management of funds of the union and I’ve certainly learnt a whole lot more in those 14 years of serving on the HESTA board. But let’s put this back – it is employers and unions who actually negotiate around the original wages from which superannuation is taken. So we have an ongoing obligation to our members every single day to make sure they’re able to take home their wages and superannuation is a component of that. It is then held in trust. So it is core to everything we do on a daily basis to look after the interests of our members so there is never any question in your mind to as to why do you exist – you exist in your union role and you exist in your role on the board looking after their retirement savings. It is about them.

Geraldine Doogue So why does someone like David Murray, who used to run the Commonwealth Bank and who has done what is generally agreed an interesting, national interest-based report, why does he nominate reducing union influence as important? He thinks there is too much interest in maintaining union influence rather in maintaining the value of the members’ investments.

Brett Holmes Well when you look at the research that has been undertaken about the value of independent directors then a lot of that is equivocal. Some are positive and some are negative about the value of independents.That means you can only conclude that there is an ideological problem about having workers involved in investing in capital and I think that is driving much of the discussion about industry super funds and why you should get rid of unions off them. It’s always interesting to hear that industry super funds are described as union funds when in fact there is equal representation [with employers] and no one who has ever sat around a negotiating table would think that employers and unions are going to be getting together and contriving to do bad things for their employees or their members.

Gerard Noonan Look, David Murray is obviously a pretty good banker but why he would be a specialist in governance of organisations is a puzzle to me.

I know a lot of directors of publicly listed companies in Australia and I know a lot of directors of superannuation funds in Australia and I can tell there is no difference in the skill sets between the two. They are drawn from different quarters but the skill sets are actually the same and it seems to me there is more passion involved from the people in superannuation. Remember, we don’t make decisions about billions of dollars without being advised. We have asset consultants and other layers of advice about this. But as a board, a group of wise people – that’s the intention - you make judgments on the basis of the good advice given to you by specialists.

There are about 600 trustees in the system across the industry funds.About 60 of them have actually been chosen for specific skills so in some ways they are independent but the remainder of them give advice, make wise decisions and as you said in the introduction, the end result has been a spectacularly good system.

THE LAMP FEBRUARY 2015 | 29

WORKCOVER

Older workers hardest hit

OLDER WORKERS HAVE BEEN AMONG THE HARDEST-HIT BY THE Liberal/National government’s cuts to WorkCover.

The 2012 changes included termination of weekly payments on reaching retirement age (the age a person is eligible to receive the age pension), with medical benefits ceasing one year later.

That meant a worker could be injured one day before their 65th birthday and receive only one day of weekly payments and 12 months plus one day of medical entitlements, which would cease on their 66th birthday.

If that same worker was injured one day later, on their 65th birthday, they were entitled to weekly payments for 12 months plus a total of two years of medical entitlements, which would cease on their 67th birthday.

The Manly Daily newspaper reported the case of John Clarke, a grandfather from Narrabeen in Sydney who injured his right knee when a set of stairs collapsed underneath him while he was working full-time on March 3, 2013.

Mr Clarke claimed workers compensation for physiotherapy and surgery he received in the months following the injury.

However, Mr Clarke turned 65 on April 21, 2013, so was ineligible to receive workers compensation for wages for the 10 days needed for knee surgery in June 2013 and was forced to use his sick leave.

Mr Clarke continues to work but will require knee replacement surgery in three to five years time: he will be unable to claim compensation for this because it will occur more than 12 months after the date of injury.

Public complaints about this age-related discrimination recently shamed the government into a minor back down.

Workers injured before retiring age may now get weekly payments for up to 12 months after reaching retiring age.

However the changes only apply to workers who made a claim for compensation before 1 October 2012.

30 | THE LAMP FEBRUARY 2015

Voters have compo on their minds The Liberal/National government’s cuts to workers compensation will be on the minds of a big majority of injured workers at the state election on March 28, a survey suggests.

Unions NSW surveyed 1692 people who suffered an injury or illness at work, or while travelling to or from work. 81 per cent (1369) had made a workers compensation claim.

The survey conducted in May and June last year covered workers who were injured both before and after the 2012 changes. The changes were retrospective, meaning that all injured workers, regardless of their injury date, were impacted.

About 85 per cent of those surveyed disagreed with the changes and 83 per cent indicated it would affect the way they vote in the 2015 state election. When survey respondents were asked what they thought of the government’s changes to workers compensation, “unfair” and “wrong” were the most common descriptions given.

As a result of the 2012 changes to WorkCover, 43 per cent of injured workers who responded to the survey had had their medical payments cut off or had been told that they would be cut off soon.

About 46 per cent of injured workers said their financial situation had worsened since they were injured. For workers who had been told their medical payments would be cut off, 63 per cent said their financial situation had worsened.

A helping hand for injured workers The NSW Injured Workers Support Network extends a helping hand to the people most affected by the state government’s savage cuts to workers compensation.

The network is sponsored by Unions NSW and the Workers’ Health Centre.

The network has set up a dedicated phone line — (02) 9749 7566 — for anyone with questions or concerns about workers compensation.

Labor will scrap harsh cuts

“None of the anguish they have caused was necessary.”

— Shadow Minister for Finance and Services Peter Primrose

NSW Labor has promised to scrap the 2012 changes to workers compensation if it wins the next state election in March.

The changes were “a major cost shifting exercise” from the workers compensation scheme and employers, on to injured workers, their families and Medicare, said the Shadow Minister for Finance and Services, Peter Primrose.

“There was no economic justification for the 2012 amendments, which solely targeted injured workers. None of the anguish they have caused was necessary,” he said.

Peter Primrose said Labor would conduct its own review focusing on the performance of claims and injury management by WorkCover, scheme agents, and employers.

He also promised to: Restore “journey claims” to cover workers for injuries occurring on their way to and from work.

Give injured workers the financial assistance they need to pay their medical bills.

Reinstate protections for workers with total and permanent disabilities.

• • •

If you can’t get through on that number send an email with your name and contact details to help@injuredworkerssupport.org.au The network is working closely with unions to reverse the compo cuts. Regional support groups meet monthly and all are welcome to attend.

Four regional groups have been set up in Bathurst, Gosford, Parramatta and Newcastle, with more planned.

Meeting dates BATHURST 11am-1pm every fourth Friday of the month Bathurst Community Centre William Street, Bathurst GOSFORD 11am-1pm every fourth Monday of the month Level 1, Coast Shelter 346 Mann Street, North Gosford PARRAMATTA 11am-1pm every 1st Thursday of the month Level 2, Unions NSW 20 Wentworth Street, Parramatta NEWCASTLE 11am-1pm every 1st Friday of the month Level 2, Trades Hall, Devonshire House 408 King Street, Newcastle

THE LAMP FEBRUARY 2015 | 31

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ASK JUDITH Testamur to AHPRA Over the course of the past 12 months I have submitted to AHPRA (the Australian Health Practitioner Regulation Agency) all documents requested with my application for nursing registration, except my testamur. However, as I have not had my graduation ceremony for my undergraduate studies, my university has advised that they cannot provide me with the testamur. I’ve submitted my transcript from the Nepalese university I attended and also a letter from my course provider stating that I have passed all the subjects. APHRA have told me that if I cannot provide the testamur they will cancel my application. Can they do this?

Yes. AHPRA has a process in place for the registration of overseas nurses. They must receive all documents they ask for, including the testamur (certificate) from your Nepalese university, which is proof of your degree. This testamur enables you to achieve the Australian Qualifications Framework criteria that the Nursing and Midwifery Board of Australia considers necessary for registration. Without this testamur you cannot be registered as a nurse through AHPRA.You need to wait for the graduation ceremony to occur and to receive your testamur before filling out your application for registration.

Poor practice in pharmacy I am an RN working in a private nursing home where the facility has recently changed its pharmacy provider. We are now being presented with multi-dose medication packs through which nursing staff cannot always visually identify the individual tablets contained within the pack. If there is a medication change for a resident, management has directed nursing staff to cut the pack, take out the ceased medication and re-seal it. Is this legal?

While the process you describe in respect to removing ceased medications is not illegal, it is certainly not best practice and increases the risk of medication errors occurring. There should be a procedure in place to ensure this process is only a short-term solution. Best practice would be for the medication to be repackaged by the pharmacist to ensure safety for both residents and staff. RNs and ENs are required to know and be able to identify medications they are administering to residents. In relation to assistants in nursing and care service employees, they are considered to be assisting a resident and not applying clinical judgement about the actual medication being taken. The process you describe places these latter staff at risk, while responsibility remains with the RN and EN to delegate and supervise

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

AiNs and CSEs to ensure the correct medications are being given; using a tampered pack is not a safe practice to be delegating. The NSWNMA only endorses best practice in any area of nursing to ensure you are not putting your residents at risk and are less likely to find yourself and/or your colleagues facing disciplinary actions. The facility must have proper policies and guidelines in place that cover all areas of their daily care provision. The Association recommends the ANF Management of Medicines in Aged Care Nursing Guidelines booklet, which is available online for members, using the following link: http://anmf.org.au/documents/reports/Management_of_Medicines_ Guidelines_2013.pdf

Learning leave declined I am an RN in the public sector and would like to apply for study leave. However, I understand that other staff members have applied and were advised, verbally, by management not to bother applying for learning and development leave as it would not be granted for an indefinite period. Can they do this?

If learning and development leave is declined to staff in your workplace I advise you to raise the issue through your NSWNMA branch, referring your employer to clause 55, ‘Learning and Development Leave’ of the Public Health System Nurses’ and Midwives’ (State) Award 2011 which states: (iii) Eligibility Access to Learning and Development Leave is at the discretion of the Health Service. It should be made available to all eligible employees within the Health Service to promote the development of a highly trained, skilled and versatile workforce which is responsive to the requirements of government and Health Service delivery.”

The award also states: (ii) General Learning and development is a shared responsibility between the organisation and the individual…”

The responsibility falls upon the employee to demonstrate to the employer that the course is relevant to their work.You may request in writing that management reconsider granting leave on the basis that you have already undertaken education and training in your own time and that the course is relevant to your work and would be beneficial to the employer.

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THE LAMP FEBRUARY 2015 | 35

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

Midwife – what’s in a name? www.nurseuncut.com.au/midwife-whats-in-a-name/

Registered nurse and student midwife Olivia Powell considers a major issue for the profession of midwifery – differentiating itself from nursing.

Stevie’s EN diary: it’s that time of the year www.nurseuncut.com.au/stevies-en-diary-its-that-time-of-the-year

Christmas is not a joyful season for everyone – Stevie notices there are more admissions for mental health issues near to the traditionally festive time.

When the Lamp met another lamp in Fiji www.nurseuncut.com.au/when-the-nswnma-lamp-met-another-lamp-in-fiji/

Georgina Hoddle travelled to a Christian nurses conference in Fiji and found it an exhilarating experience.

#FOANed – free, open access, nursing education www.nurseuncut.com.au/foaned-free-open-access-nursing-education-not-just-anotherhashtag/

It’s not just another hash tag – nurse educator Jesse Spurr explains the use of Twitter for interactive nursing education.

More than bombs and bandages – Australian nurses in WW1 www.nurseuncut.com.au/more-than-bombs-and-bandages-australian-nurses-in-ww1

“What did Gran do in the war?” Historian Kirsty Harris ended up writing a book to answer that question.

How Australians can get nursing jobs in the UK www.nurseuncut.com.au/how-australians-can-get-nursing-jobs-in-the-uk/

There are several new steps to finding a nursing job in Britain’s National Health Service – one of the best health services in the world.

New on SupportNurses YouTube channel Joanne: aged care needs RNs 24/7 A nurse practitioner in residential care speaks about the crucial role of the RN. >youtu.be/HTU74LGa_LE Rally against privatisation of disability services Deborah Langridge RN delivered a passionate speech. >youtu.be/62z-8Nn_CO0

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 FEBRUARY 2015 | 37

SOCIAL MEDIA

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NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Should midwives screen for domestic violence?

Midwives could be trained to screen for domestic violence (DV) – but should they be?

Westmead midwives

Catering for prejudice An aged care facility in New South Wales appears to have acquiesced to a patient’s request to only be cared for by nurses of Anglo-Celtic background. It is against the law to separate nurses based on ethnicity. If a patient has dementia this can be a delicate area. Should prejudices be catered to?

We screen for DV – research does show that the incidence of DV increases in pregnancy.

However, it can be difficult as the language used in screening is a bit wishy-washy: do you feel safe in your home? You may you may not feel safe at home if you have violent neighbours or you’ve been broken into. In some cases the partner is always present at visits and it is difficult to ask screening questions. However, not all partners who come to all appointments are seeking to control, most are genuinely interested in the pregnancy, the baby and caring for their partner. Some women will not disclose until later in pregnancy – maybe not at all where care is fragmented, as it is with the “standard” care in Australia – a good case for all women to have continuity of care by the same midwife or team of midwives.

Let nurses be nurses, not added workloads and playing on feminine emotional humanity please.

Enough is enough.

I just hope there are adequate support services available for these mothers once DV has been identified. Don’t expect the midwife to solve the situation. Domestic violence is a very complicated issue.

Being an ex-nurse, I also endured DV during pregnancy. Such a shame nobody had thought of this brilliant idea many years ago!

I guess if it increases the patient’s behaviour, causes them emotional distress and obvious discomfort, then we need to recognise this and do what we can to alleviate the problems. I understand this could upset some staff. But don’t patients have rights as well? I work in a female-only, dementia-specific ward. We have ladies who refuse to let a male nurse attend their personal care. This is no different.

So if the resident wants only Caucasian carers, does the aged care facility discriminate by only employing Caucasians? What about gender? Do they then stop employing males? It makes it very hard to roster if every resident makes these types of requests. Where do they draw the line?

It’s healthcare, not dry cleaning. If he’s fallen and broken his hip, are any staff who can help banned from entering his room until an Anglo staff member can be called? What if it’s a matter of resuscitation or other lifesaving, time-critical, procedure?

In my experience this is a very small percentage of aged care residents. They have the right to ask for a carer of choice if it is gender issue or a personality issue and it is their home, for which they are paying. Sometimes this can be racist, but more often it is due to upbringing and experience during their life, which should be respected. This trend will die out over coming years with generational changes of attitude ... Thank goodness for our carers from all cultures and backgrounds for their hard work and dedication. What would the industry do without them?

I think they have the right, I have seen the distress it causes some residents. If we were serious we would look at these issues when a person was admitted, find out their background and cater to it.

That’s exactly person-centred care. We need to have some compassion for where people have come from and what they have been through. Not everything is about racism, BUT if that is what is happening it can usually be managed for the benefit of staff and residents

PHOTO GALLERY

Goulburn nurses shone a light on local health issues with a community forum for 2015 state election candidates.

Gosford nurses took a stand for better ratios in the emergency department.

This nurse went door knocking in western Sydney in support of jobs, rights and services.

Cobar nurses don’t want Medicare co-pay version A, B or C. THE LAMP FEBRUARY 2015 | 39

test your knowledge

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Across 4. Pneumoconiosis due to inhalation of iron particles (9) 9. Referring to a type of exocrine secretion (8) 10. Sacs or vesicles in the body (5) 11. Stroke (1.1.1) 12. An inflammatory disease of the skin mainly in children (8) 14. Chromium (2) 15. Symbol for actinium (2) 16. Silent (9) 17. Malformed physical development; grossly misshapen parts (8) 18. Old tuberculin (1.1) 19. Symbol for indium (2) 20. Abandoning, withdrawing from (9) 23. Symbol for tantalum (2)

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24. Complete antibody (6.10) 28. Symbol for aluminum (2) 29. Rhodium (2) 30. The 12 pairs of bone arches forming most of thoracic skeleton (4) 32. One of the world’s most feared diseases (5) 35. Frothy saliva (4) 36. The eyelids or eyelashes (5) 37. Constructed (5) 38. A 2009 pandemic involving H1N1 virus (5.3) 39. A method of body weight estimation (1.1.1) 40. One of our current campaign (6) 42. Pancreatic expase (8) 43. Fibers that carry sensory information (5)

Down 1. To spread out in all directions from a center (7) 2. Pertaining to the body (9) 3. A narrowing, contraction, or stricture of a canal or opening (9) 4. Partial thickness burn (6.6.4) 5. The act of discharge or dispose (9) 6. A functional system in the brain essential for wakefulness, attention, concentration, and introspection (1.1.1) 7. A substance, such as saliva or mucus, that is produced and given off by a cell or a gland (9) 8. Marks created during the healing of damage to the skin or tissues (5) 13. Any visual image used as a marker

14. A soft, semi-solid mass that forms when blood gels (4) 21. The act of drawing back or in; shrinking (10) 22. Relating to the production of offspring (10) 23. Ankle bones (4) 24. Abnormal increase of flesh (8) 25. Chronic inability to sleep (8) 26. Ear coverings used in cold weather (8) 27. A blood test used to monitor diabetes treatment (1.1.1) 31. Biceps femoralis (1.1) 33. Any drug derived from opium (6) 34. A large flaccid vesicle (4) 41. Selenium (2)

THE LAMP FEBRUARY 2015 | 41

nursing research online

The Abbott government began 2015 with a new Cabinet lineup including a new Minister for Health, Sussan Ley. Time will tell whether this change will benefit the health sector but it would be hard to compete with the former minister, Peter Dutton, who was voted by readers of Australian Doctor as the worst federal health minister for the past 35 years.

Dutton’s legacy: the anti-health minister Paul Smith, 12 January 2015 Mr Dutton leaves behind many questions, among them whether he was Australia’s worst federal health minister.

There may be candidates whose efforts in pursuit of the dishonour go too far back in time, or whose tenure was too short. But Mr Dutton was around long enough — just over a year — to at least make a claim.

For many, he will stand as an anti-health minister, someone intent on loyally serving nothing but the narrowest of party interests, rather than taking on the laborious task of fixing the dysfunctions of the health system.

The clues were there during his time as Opposition health spokesperson. He rarely troubled the democratic process by putting parliamentary questions to the health minister of the day — whether that was Nicola Roxon or Tanya Plibersek.

This was meant to be the period of great reform.

Such dormancy on the floor of the house eventually became a running joke around the corridors of Canberra.

How was he filling his days? www.australiandoctor.com.au/opinions/paulsmith/dutton-s-legacy-the-anti-health-minister

Co-pay road to nowhere Joanna Heath, AFR, November 2014 When rumours first surfaced that the government was considering a co-payment for visiting a doctor, then Australian Medical Association president Steve Hambleton didn’t think the government would be brave enough or crazy enough to upset millions of Australians who don’t pay for medical advice.

“It would be political suicide,” he told The Australian Financial Review. “I just can’t imagine they’d do it.”

Turns out he was wrong – but he was on the money about the fallout.

Nearly 12 months on the government has completed the full political life cycle: denying it had plans to introduce the co-payment, announcing it on budget night, defending it for seven months, and then wanting to dump it.

In the process it has saddled itself with a disgruntled backbench, a furious medical community, an electorate that mistrusts the government’s principles of fairness, and a health minister who looks ineffectual.

And it has made future efforts to reform the health system, which the government is still committed to, that much harder. www.afr.com/p/national/co_pay_road_to_nowhere_k9eMacVv2c8NsiXJSas9dO

Some pithy advice for Minister Ley and sharp assessments of Minister Dutton Melissa Sweet, December 2014, Croaky Perhaps Minister Ley – who has promised to focus on improving the health of Aboriginal and Torres Strait Islander peoples – could consider basing policy upon evidence and a concern for health outcomes.

And it should not be too difficult for her to make a mark in the portfolio, given the record of her predecessor – “Peter who?” was a common response when Croakey contributors were asked about Dutton’s legacy. Continue reading for some wide-ranging Ministerial advice and assessments from Croakey contributors. http://blogs.crikey.com.au/croakey/2014/12/23/somepithy-advice-for-minister-ley-and-sharp-assessments-ofminister-dutton

THE LAMP FEBRUARY 2015 | 43

vale

Janice (Jan) Elizabeth Stow [e\

44 | THE LAMP FEBRUARY 2015

an incredible legacy The nursing profession lost a great nurse on 26 December 2014 – one who left an incredible legacy in nursing and nursing care; a special person with many qualities, much in evidence during the last two-and-a-half years of her life.

It was at Westmead Hospital that all of Jan’s management skills, clinical knowledge and personal attributes were given their fullest expression: Westmead Hospital and her nursing staff were the most fortunate beneficiaries.

Jan had a successful and productive nursing career that began in 1964 as a student enrolled nurse at Burwood Hospital in Christchurch, New Zealand. She then moved to Timaru to undertake her general nursing and worked there as a registered nurse. Following some overseas nursing and travel Jan returned to Timaru as charge nurse in the intensive care ward. In 1973 she moved to Australia to undertake the post-graduate intensive care nursing course at St Vincent’s Hospital in Darlinghurst, ultimately becoming the unit’s clinical nurse educator and course co-ordinator.

In any hospital, one of the major challenges for a director of nursing is to manage a workforce engaged in a shift system, 24-hours-a-day, without exception. In the dynamic environment of a major teaching hospital the ability to effectively manage staff is critical to the ability of the organisation to consistently deliver. It takes great skill to do that effectively and consistently. It was a skill that Jan possessed in abundance.

Jan’s interest in, and commitment to, clinical services was a continuing hallmark of her professional life.

In 1982 Jan moved from St Vincent’s to Royal North Shore Hospital as nursing supervisor in charge of that hospital’s high dependency units. In 1984 Jan returned to St Vincent’s as assistant director of nursing. In 1986 she was appointed deputy director of nursing at Prince of Wales and remained there until 1989 when she was appointed director of nursing and clinical services at Westmead Hospital – a position she held at the time of her retirement from the New South Wales public hospital system in 2002.

In whatever situation that arose Jan invariably met each one with the same outward composure that belied strength of character that you ignored at your peril. That strength of character was accompanied by a sharp intellect and a quiet graciousness and kindness that was a hallmark of Jan’s personality and which saw her so widely admired.

We have never encountered anybody with an unkind word to say about Jan – even those who were on the receiving end of a decision they did not agree with. Given the diverse and challenging nature of the nursing workforce in any large hospital that is an astonishing achievement. Her nursing staff admired her and recognised the great support she always gave them.

While pursuing her nursing career Jan completed a diploma in nursing education through Armidale College of Advanced Education, followed by a degree in health administration at the University of New England.

Jan’s patient advocacy, staff advocacy and her successful collaboration with medical and allied health professionals and other health service staff were legendary. She was a very talented lady.

Jan achieved a great deal as an intensive care nurse and nurse educator, as well as in the delivery and management of clinical services. She also published and presented papers on a wide variety of subjects.

After several years “retired” to the mountains Jan moved to Tasmania. She worked for a time as night duty supervisor at Rosary Gardens Nursing Home until her illness meant that she had to retire completely. Jan’s characteristics did not desert her during her last two-and-a-half years. She dealt with her illness with dignity and resilience as well as a touch of humour that was truly amazing.

Jan was a long time member of the NSWNMA and was active in the then NSW College of Nursing and Institute of Nursing Executives. She was a member of Sigma Theta Tau International and the Honor Society of Nursing, University of Western Sydney.

She spent some time as board member of the Premier Credit Union, was a member of Australian Institute of Management and a surveyor for the Australian Council on Healthcare Standards.

Jan was also involved in the development of the first paramedic course for the Ambulance Service of NSW.

Jan was a good friend and a person we both (like so many others) admired personally and professionally. As we both had said to her in different ways “when you go, do so knowing yours has been a life well lived and one that has evoked love, respect and admiration from so many people”.

Our lives were the better for knowing Jan Stow. Rest in peace.

— Patricia J Staunton AM and Judith L Meppem PSM

THE LAMP FEBRUARY 2015 | 45

book me

Managing Workplace Conflict: Alternative Dispute Resolution in Australia Bernadine Van Gramberg

The Federation Press www.federationpress.com.au RRP $60.00 ISBN 9781862875777 Useful for alternative dispute resolution (ADR) and management consultants, legal practitioners, human resource managers and students of ADR, this book includes coverage of various ADR techniques and the roles played by ADR practitioners in workplace conflict. It discusses the need for workplace grievance policies and the forms these can take and the suitability of ADR for various types of disputes. Written against the background of a rapidly changing Australian labor market, Managing Workplace Conflict argues that ADR in the Australian workplace needs to be conducted with an understanding of the changed industrial relations environment and the power differences between key workplace stakeholders, as well as a commitment to ethical practice and workplace justice. It presents the key concepts central to the practice of ADR in Australia and provides a practical, useable reference book for both the professional and the student.

Finding Meaning in the Experience of Dementia: The Place of Spiritual Reminiscence Work

Elizabeth Mackinlay and Corrine Trevitt Jessica Kingsley Publishers via Footprint Books www.footprint.com.au RRP $49.95 ISBN 9781849052481 This book, based on the first major study into spiritual reminiscence, shares what has been discovered in the process of working and researching with people who have had dementia for more than eight years. The book provides practitioners with a thorough understanding of the theory and practice and provides many case studies to demonstrate the value of spiritual reminiscence in helping people to find meaning in the experience of dementia.

Consideration is given to the benefits of humour as well as to working in multicultural and multi-faith settings and with people who do not have a religious faith.

This accessible guide to spiritual reminiscence work is recommended for dementia care practitioners, pastoral carers, aged care chaplains, activity coordinators and anyone else concerned with the wellbeing of people with dementia.

SPECIAL INTEREST One Piece of Advice: Words to Guide You Through Early Breast Cancer (1st ed.)

Yvonne Hughes www.onepieceofadvice.com.au

RRP $24.95 (hard copy + p&h) or $14.95 (eBook) ISBN 9780987469007 The advice in this book is general enough to benefit anyone who has just been diagnosed with breast cancer or has been told they have a different type of cancer. It is full of practical, positive and empowering information gathered from the author’s personal experience and conversations with other women and their families. The information is succinct and provides insight into what to expect from the moment of diagnosis, surgery, treatment and the recovery process. There are also sections set aside for partners, families, carers and friends so they can see how to provide support throughout the experience.

news for members Access to CINAHL Plus with Full Text Members can now access the CINAHL Plus with Full Text research database simply by logging in to the Association’s member-only page and clicking on the CINAHL link. CINAHL Plus with Full Text is a reliable online source for full text nursing and allied health information, providing full text for more than 750 indexed journals.

This database contains thousands of full-text articles dating as far back as 1937, as well as searchable cited references, legal cases, clinical innovations, critical paths, drug records, research instruments and clinical trials. It is the definitive research tool for all areas of nursing and allied health literature. For further information or assistance in using CINAHL contact the NSWNMA Library

Fundamentals of Nursing Case Studies Natashia Scully and Damian Wilson

Mosby Australia via Elsevier Australia www.elsevierhealth.com.au RRP $36.32 ISBN 9780729542098 Fundamentals of Nursing Case Studies presents 24 quality progressive case studies based on real life scenarios involving the knowledge, skills and practice students require, including vital signs, skin integrity, medication therapy and pain management. Multiple choice questions are integrated throughout. Nursing students are provided with an opportunity to explore the scenarios they are likely to encounter in a variety of practice settings. This text can be used in conjunction with Potter and Perry’s Fundamentals of Nursing 4th edition as part of a suite of resources for undergraduate and diploma of nursing students.

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 FEBRUARY 2015 | 47

movies of the month

This film is a lesson in family dynamics and dysfunction, writes Meg Collins.

What We Did on Our Holiday centres on a young family with a secret: Mum and Dad are not living together any more.

They are heading towards their grandfather’s home to celebrate his last birthday – he is riddled with cancer. The happy family charade, however, does not go on for long.

The grandfather (Billy Connelly) whisks his three young grandchildren away from the party planners and takes them to a beach. He sees the three children for what they really are and tries, in his own way, to counsel them.

Separation and divorce are, sadly, common features of contemporary society. This film uses a comedic style to examine the impact on children and the types of behaviours that it induces. The eldest daughter has resorted to documenting lies in her notebook and her younger brother retreats into a fantasy world.

The most outstanding feature of this film are the performances of the three children, particularly the youngest child Jess (Harriet Turnbull), and the comedic dialogue. The writers/directors Andy Hamilton and Guy Jenkin have excelled themselves in that regard.

This is a nice little British comedy with a good ensemble cast, including Rosamund Pike and David Tennant. You will laugh a lot.

Meg Collins is Patient Safety and Quality Manager at the Royal Prince Alfred Hospital.

IN CINEMAS FEBRUARY 12

METROMEMBERGIVEAWAY Email The Lamp by the 7th of the month to be in the draw to win a double pass to What We Did On Our Holiday 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 A big city lawyer with dubious ethics, Hank Palmer (Robert Downey Jr), is called back to his childhood home to attend his mother’s funeral. While he is home he discovers that his father, the small town’s long serving judge, is suspected of murder. Hank sets out to discover the truth but must first overcome the anger and resentment he feels towards his father who is a harsh and emotionally cold man. But is he a murderer?

RURALMEMBERGIVEAWAY Email The Lamp by the 10th of this month to be in the draw to win a dvd of The Judge 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 FEBRUARY 2015

movies of the month

An emotionally wrenching film based on the memoir Then They Came for Me, writes Cathie Montgomery and Greg Kennedy.

In June 2009, BBC journalist, Maziar Bahari (Gael Garcia Bernal) an Iranian born Canadian, returned to his native home for one week to cover elections for the magazine Newsweek.

Following filming the death of a protestor, killed during the riots that followed President Ahmadinejad’s declaration of victory, Bahari is woken from his childhood bed by his elderly mother: “Wake up. These men want to talk with you.”

There ensues a search of his bedroom, looking for evidence to convict him of wrongdoing or being a spy.

Humour is used to break the tension in a restrained way, the interrogator holds up DVDs asking if they are porn, The Sopranos being one, and a magazine featuring Megan Fox, which Bahari agrees could be counted as porn.

He is arrested, imprisoned and interrogated for 118 days. Accused of spying for everyone from the CIA to MI6 to Newsweek, Bahari is psychologically and physically tortured.

Kept in solitary confinement, blindfolded for interviews, beaten and housed in a room with walls scratched in words of hopelessness, Bahari finds strength in apparitions of his dead father and sister.

The film’s title comes from the name Bahari gives to his “specialist” – a euphemism for torturer – the distinctive scent being the only distinguishing feature Bahari can gain as he is blindfolded throughout the interrogations. The smell also serves to remind Bahari of childhood visits to a shrine.

The main tension in the film is psychological with little physical violence shown.

The film focuses almost exclusively on Bahari’s experience inside Evin prison, echoing how little he himself knew of the global campaign underway for his release.

This is a film of a family’s love, captivity and survival.

It is the first film to be directed by American satirist and comedian Jon Stewart, television host of the satirical news program, The Daily Show, who also wrote the screenplay.

Cathie Montgomery is a CNS at Concord Hospital in Operating Theatre and Greg Kennedy is an RN at Sydney Dental Hospital.

IN CINEMAS FEBRUARY 19

METRO MEMBER GIVEAWAY Email The Lamp by the 10th of the month to be in the draw to win a double pass to Rosewater 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 Australian actor and filmmaker Damon Gameau embarked on a unique experiment to document the effects of a high sugar diet on a healthy body, by only eating foods commonly perceived as “healthy”. In THAT Sugar FILM Damon highlights some of the issues that plague the sugar industry and discovers where sugar lurks on our supermarket shelves. A topical tale for Australian health professionals, this film could change the way you think about “healthy” food. THAT Sugar FILM will tour cinemas around the country – for details of screenings visit www.thatsugarfilm.com.

To celebrate its release we have some healthy DVD packs to give away.

RURALMEMBERGIVEAWAY Email The Lamp by the 10th of this month to be in the draw to win a dvd pack of healthy titles including Our Food and Radiance Yoga thanks to Madman Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

THE LAMP FEBRUARY 2015 | 49

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

Send 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 ASPAAN Seminar (Hunter) 7 February Maitland www.aspaan.org.au National Disability Service NSW Conference 16-17 February Sydney www.ndp.org.au/events MHS Confrence Men’s Mental Health Summer Forum Building a Healthier Future 19-20 February Crows Nest www.themhs.org ABA 2015 Seminar Series Breastfeeding: Life and Science Program 1 26-27 February Sydney www.breastfeedingconferences.com.au Wounds Update Conference Empower Nurse Education 28 February Newcastle www.empowernurseeducation.com.au Focus on Feeling Fabulous Retreat Continuing Professional Development - 14 hours 28 February - 3 March Byron Bay www.nursesfornurses.com.au/events/91/Focus -on-Feeling-Fabulous-Retreat Australasian Cardiovascular Nursing College 9th Annual Conference 13-14 March Coogee www.acnc.net.au The person centred approach to healthy weight management.

If not dieting, then what?® 2015 20-21 March Darling Harbour www.apna.asn.au/ifnotdieting Dimensions of Cardiology Conference Empower Nurse Education 27-28 March Newcastle www.empowernurseeducation.com.au Professional Development Workshop Empower Nurse Education 1 May Newcastle www.empowernurseeducation.com.au Aspects of Aged Care Conference Empower Nurse Education 22-23 May Newcastle www.empowernurseeducation.com.au Medical Imaging Nurses Association National Conference 19-21 June Sydney

50 | THE LAMP FEBRUARY 2015

www.trybooking.com/Booking/BookingEvent Summary.aspx?eid=110777 Acute Care Nursing Conference Empower Nurse Education 1 August Newcastle www.empowernurseeducation.com.au DANA Many Faces of Addiction Forum 13-14 August Sydney www.danaconference.com.au Anaesthetics and PARU Conference Empower Nurse Education 4-5 September Newcastle www.empowernurseeducation.com.au 2015 Australian Nursing and Midwifery Conference 15-16 October Newcastle www.nursingmidwiferyconference.com.au/

ACT MHS Conference – Best Practice into Reality 25 - 28 August Canberra www.themhs.org

APNA Continuing Education Workshops for Nurses in Primary Care 2015 1-2 May Perth 29-30 May Adelaide www.apna.asn.au/educationworkshops Australian and New Zealand Addiction Conference 20-22 May Surfers Paradise www.addictionaustralia.org.au No 2 Bullying Conference 29-30 June Gold Coast www.no2bullying.org.au 16th International Mental Health Conference 12-14 August Gold Coast www.anzmh.asn.au/conference/ 2015 CRANAplus Conference 15-17 October Alice Springs www. crana.org.au

INTERNATIONAL Asia Pacific Hospice Conference Transforming Palliative Care 30 April - 3 May www.2015aphc.org/ 9th European Congress on Violence in Clinical Psychiatry 22-24 October Copenhagen, Denmark www.oudconsultancy.nl/Copenhagen2015 4th World Congress of Clinical Safety 28-30 September Vienna, Austria www.iarmm.org/4WCCS/

REUNIONS Westmead Hospital 35-year reunion March 1980 Intake 7 March Kerry Rouse (nee Everingham) 0414 971 441 kerry.rouse@optusnet.com.au Paul Fisher 0412 417 489 vastech@fisher.id.au

INTERSTATE Eating Disorders and Obesity Conference 18-19 May Surfers Paradise www.eatingdisordersaustralia.org.au/ The person centred approach to healthy weight management.

If not dieting, then what?® 2015 27-28 February Melbourne 13-14 March Brisbane 22-23 May Hobart 29-30 May Adelaide 5-6 June 2015 Perth 19-20 June Adelaide www.apna.asn.au/ifnotdieting Australian and New Zealand Addiction Conference 4-6 March Surfers Paradise www.addictionaustralia.org.au Australian Pain Society 35th Annual Scientific Meeting Managing Pain: From Mechanism to Policy 15-18 March Brisbane www.dcconferences.com.au/aps2015/ APNA Continuing Education Workshops for Nurses in Primary Care 2015 27-28 March Melbourne www.apna.asn.au/educationworkshops

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