The Lamp October 2015

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 72 No.9 OCTOBER 2015

RN 24/7 forces parliamentary debate RAMSAY ACTION SAVES ALLOWANCES CALL TO REJECT PPL CHANGES FAN OF THE FAT TAX Print Post Approved: PP100007890

2014 winners, left to right: Outstanding Graduate: Zoe Sabri, Nurse of the Year: Stephen Brown, and Team Innovation: Prof Jeanine Young representing the Pepi-pod速 Program.

Join your colleagues and celebrate at the HESTA Australian Nursing Awards Thursday 15 October 2015 at 6.30pm Brisbane Convention and Exhibition Centre

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CONTENTS

CONTACTS NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office.

Sydney Office 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au W www.nswnma.asn.au

VOLUME 72 No.9 OCTOBER 2015

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

COVER STORY

12 | RN 24/7 campaign forces parliamentary debate

Barbara Anson RN and Jennifer McGrath RN PHOTOGRAPH: SHARON HICKEY

REGULARS

5 7 8 31 35 39 41 43 44 45 46

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

SAFE STAFFING

18 | LHD defies Industrial Relations Commission

A NSWNMA petition has triggered a debate in the New South Wales Legislative Assembly over the need for RNs on duty at all times in the state’s nursing homes.

COVER STORY

14 | Speaking up for the aged

6 | Win a trip to Canberra

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

In the debate over aged care, many elderly cannot speak for themselves while their families are often ignored.

PAID PARENTAL LEAVE

22 | Calling on PM Turnbull to reject parental leave changes

As all eyes turned to the Liberal Party leadership struggle, a Senate Committee report was tabled in parliament.

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

PROFESSIONAL

26 | Richer lives bring new health risks

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.

Nurses and midwives will be crucial in dealing with the crisis of non-communicable diseases.

THE LAMP OCTOBER 2015 | 3

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Rosie Batty’s Never Alone campaign is building a groundswell of support for victims of family violence and raising awareness to help end this epidemic.

The ANMF and NSW Nurses and Midwives’ Association are proud to be partners of Never Alone. Join nurses and midwives across the country for one important movie night to raise funds for this campaign as a powerful, united voice for victims of family violence.

Have fun, raise the roof and raise funds for Rosie’s Never Alone campaign.

MOVIE FUNDRAISER Tuesday 27 October 7pm Event Cinema Burwood Westfield Burwood, 100 Burwood Rd

Cost: $35, includes a popcorn and a glass of sparkling wine or beer.

To book tickets online:

www.trybooking.com/JDKM Proceeds go to the Never Alone campaign For more information please email gginty@nswnma.asn.au

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EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

The health minister should do the right thing by the aged Thanks to the sterling work of aged care activists, our arguments in favour of RNs 24/7 in aged care received an airing in parliament.

It is now up to the health minister to resist the siren call of moneyed, vested interests and do the right thing by older Australians.

The Association calls on the health minister to show leadership and ensure there is a commitment to a minimum number of registered nurses.

The voices of the aged deserve to be heard in any policy discussion which impacts on their future and thanks to a committed band of aged care nurses, community supporters, family members and NSWNMA staff that has just happened (see pages 12-15).

These tireless advocates for older Australians collected 24,000 signatures on a petition in order to trigger a debate in the NSW Legislative Assembly on the crucial role played by RNs in aged care facilities.

(I would urge members to read the debate for themselves available online.)* The petition called on the New South Wales government to retain the legal requirement to have an RN on duty 24/7 in all aged care facilities with high care residents. This requirement is at risk following changes to Commonwealth aged care laws.

The petition and the parliamentary debate were the latest steps in a sustained campaign the Association and its supporters have prosecuted in order to protect some of the most vulnerable members of our community.

An Upper House inquiry into this matter that began in June this year received 165 submissions. 80 per cent called for the legal requirement to stay. The report from this inquiry is due by the end of October. The health minister Jillian Skinner is expected to hand down her decision soon after.

It is a decision laden with responsibility towards dependent and frail people who have paid their dues to society.

DEMOGRAPHIC CHANGES WILL LEAD TO HIGHER ACUITY Thanks to scientific and technological advances many people now live a good quality of life beyond retirement age. Over the next 40 years the number of people over 65 years of age is expected to double.

In NSW these demographic changes will inevitably lead to rising acuity levels in residential aged care facilities. People entering these establishments will have multiple co-morbidities, which can only be met by round-the-clock care and qualified expert supervision.

We have a moral obligation to ensure decisions to place our older people within residential aged care facilities are supported by legislation that ensures ongoing access to sufficient numbers of registered nurses and appropriately trained and regulated care workers to meet their assessed needs. This legislation only sets what any reasonable person would regard as the minimum requirement which is far from the ideal.

The requirement to retain RNs around the clock in aged care facilities is critical to the welfare of these residents.

Abandoning this requirement would mean we would have to rely on the goodwill of aged care providers whose financial decisions may override clinical need.

Until now the Public Health Act has set a bare minimum requirement for quality of care and that protection for the aged needs to be maintained.

The Association calls on the health minister to show leadership and ensure there is a commitment to a minimum number of registered nurses at all times in order to provide the best standard of care for older people in aged care homes in New South Wales.

* www.parliament.nsw.gov.au/prod/parlment/hansart.nsf/0/E80F40C01607C021CA257EBC007D683F Our petition is discussed on pages 58-62.

THE LAMP OCTOBER 2015 | 5

COMPETITION

Win a trip to Canberra

LE TTE R OF THE MONTH

Speak up for working conditions

The Lamp is offering members a chance to win a two-nights Bed and Breakfast for two at the Forrest Hotel and Apartments with a bottle of wine and two tickets to the Tom Roberts exhibition.

Quiet, convenient and tranquil, Forrest Hotel and Apartments is situated in the leafy suburb of Forrest, with views to parkland and Parliament House, just minutes from the NGA. You will enjoy all the comforts of home complemented by outstanding service.

Shearing the rams 1888-90 (detail) National Gallery of Victoria, Melbourne, Felton Bequest Fund, 1932

.ATIONAL 'ALLERY OF !USTRALIA s /PEN $ECEMBER Experience the work of legendary Australian artist Tom Roberts this summer at the NGA in Canberra. This extraordinary exhibition brings together Tom Roberts’ most famous paintings loved by all Australians. Paintings such as Shearing the rams (1888-90) and A break away! (1891) are among the nation’s best known works of art. An exhibition for all Australians, it is not to be missed.

The Tom Roberts exhibition takes place during an exciting period of change at the NGA, including a large-scale rehang of almost every work of art, with Australian art taking pride of place in a new location. Rediscover your NGA! RECEIVE 5% OFF ANY ADVERTISED ACCOMMODATION PRICE ONLINE WHEN YOU BOOK DIRECTLY ON OUR WEBSITE! www.forresthotel.com To enter the competition, simply write your name, address and membership number on the back of an envelope and send to: Canberra Trip Competition 50 O’Dea Avenue, Waterloo, NSW, 2017

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tickets are valid for use during the exhibition period: 4 December 2015 – 28 March 2016. Please note: only one entry per member will be accepted. Competition entries from NSWNMA members only.

Competition opens 1 October 2015 and closes 31 October 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/15/00192.

Many of the nurses we work with, both in the public system and the aged care sector, have expressed their fear of the possible loss of penalty rates as a result of the Productivity Commission’s recommendations.

They are telling us that they will not be able to continue in nursing with such a severe decrease in their pay – in some cases up to a quarter of their wage.

It is vital that the general public and our politicians listen to our concerns, that our wages are not attacked and that conditions be improved, with ratios extended into all areas of nursing, including aged care.

The Labor Party has commissioned a Fair Work Taskforce. They are listening to the concerns of people in all states of Australia and will make recommendations from the data they collect.

On September 11 we were able to present our concerns about penalty rates, casualisation and the need to expand ratios at the first of the Fair Work Taskforce’s NSW hearings in Gosford.

Our presentation was well received by the panel.

We encourage nurses who would like to contribute their concerns to send them to: fairworktaskforce@alp.org.au.

We need to continue to make sure all political parties are aware of the devastating effect the loss of penalty rates would have on our profession and, in turn, our health system.

Michelle Cashman RN Killarney Vale and Rhianna Gymellas AiN/2nd year nursing student The Entrance

HAVE YOUR SAY 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.

Letter of the month The letter judged the best each month will win a $50 Coles Group & Myer gift card!

unionshopper.com.au 1300 368 117

YOUR LETTERS

One of the working poor This is a slightly shorter version of a letter I sent to my local MP, Peter Hendry (Liberal, Eden-Monaro).

Dear Dr Hendry I am sure I represent a fairly large proportion of disenchanted voters and welcome a chance to voice my concerns for the people who fall through the gaps in our current system.

I am 65 years old, responsible, married, still working part-time as a registered nurse, travelling an hour each way to work and, although we would qualify for a pension as we have little in the way of assets, I would like to work for a while yet. The truth is that I am one of the working poor.

My husband has been trying to find work since 2003.

He has not been eligible for any assistance for travel or costs for the many courses he has undertaken in the hope to gain employment. These costs have been borne by myself without tax deductions and kept us as working poor.

Issues 1. Long distance travel to work could be considered as a tax deduction for rural constituents or a fuel excise granted to assist with travel.

2. Selfhelp educational costs should: a. not have to be carried by a partner unless they can be claimed as a deduction; b. otherwise the person get a part pension to cover costs; or c. not considered to be unemployed but ineligible for unemployment benefits due to partner’s income level (although I think that should be capped so as not to be abused).

I totally support the idea of tax threshold reform.

Currently there is no incentive for me to keep working the shift work that I do, travelling long distances to perform my work, without fuel assistance and at detriment to my health.

Due to an injury a few years ago (which could have been deemed disability had I been of that temperament) I can no longer work full-time.

If I do a few shifts per fortnight, my after-tax pay is slightly more than the aged pension – without any of the perks of actually being on a pension.

I am willing and wanting to keep working. Any extra work is detrimental to our situation as it puts the tax bracket up and still we are poor because we cannot claim the fuel or wear and tear on our vehicles as a deduction.

We would be better off selling the farm, going into government housing in town and on a pension with one day a fortnight work for a bonus!

I hope you will consider that there may be others like myself who want to contribute to our fine land and will continue to work as long as possible if there is an incentive, or at least no disincentive.

Janine Power RN Oallen

RNs a vital safety net Thank you to the NSWNMA for undertaking the campaign to keep RNs in nursing homes at all times.

It was a pleasure to take part in the action outside NSW Parliament House (10 September) and listen to the short debate in the Parliament on this issue. It was disappointing that only five parliamentarians were able to speak and the Speaker refused to allow an extension so that others could be heard.

After 40 plus years working in aged care, I can assure everyone that the residents in nursing homes in 2015 are older, frailer and have incredibly complex health issues.

It is unbelievable that the Minister actually has this proposal under consideration.

A registered nurse on duty at all times in a nursing home is the only safety net in place.

There is no other required staffing level for RNs or AiNs and no ratios in aged care.

If the requirement for an RN 24/7 is removed, and when there is no professional nurse present, who is going to advocate for the aged residents and who is going to ensure their safety?

Lucille McKenna RN DoN Summer Hill Alliance brings parking relief I am a district nurse currently working in Sydney Local Health District. This covers several inner city areas that have an ever-increasing problem with restricted parking, something we nurses have been contending with for many years. Thanks to the Sydney Alliance taking up our cause, we have recently been granted special parking permits by Marrickville and Leichhardt Councils, which allow us unrestricted parking in these areas.

This is great news for the nurses who have been placed under extra stress due to this issue.

One of the main problems has been the distance we have had to park away from the client’s house to find parking long enough to give us the necessary time for the visit.

This not only adds extra time to the visit and puts pressure on us to make this time up, but also often means carrying large amounts of equipment some distance to the client’s home.

The safety of nurses on after-hours shifts has also been a concern in some areas.

As with all district nursing, the complexity of our workload is increasing and the visits are often long, particularly in palliative care where it is difficult to predict how long a visit may take.

It places stress on the nurse and the client when the visit has to be cut short or interrupted because parking time has run out.

When nurses did incur parking fines, which has often been the case, the nurse has been responsible for paying the fine. This is very distressing when it occurs in the line of duty!

We at Marrickville Community Centre would like to say thank you to Sydney Alliance and Marrickville and Leichhardt Councils for helping make our sometimes difficult job somewhat easier.

Barbara Ackroyd RN Maroubra NSWNMA RESPONDS The NSWNMA is an affiliate of Sydney Alliance, a diverse group of community organisations, unions and religious groups committed to creating a fair, just and sustainable city for residents.The Association’s Community and Political Organiser worked closely with members and the Sydney Alliance on this issue.

THE LAMP OCTOBER 2015 | 7

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NEWS IN BRIEF

Germany

Walk briskly, live longer Just 25 minutes of brisk walking a day can add up to seven years to your life according to new research from Germany.

The research conducted by a team at Saarland University found that aerobic exercise, high intensity interval training and strength training all had a positive impact on markers of ageing.

Endurance exercise and high intensity exercise may be more efficient than just lifting weights, as they further increase telomerase activity, which in turn helps to repair DNA as it ages.

Sanjay Sharma, professor of inherited cardiac diseases in sports cardiology at St George’s University Hospital’s NHS Foundation Trust in South London, told the Guardian that for the average person in their 50s and 60s, moderate exercise reduces the risk of dying from a heart attack by half.

“This study is very relevant. It suggests that when people exercise regularly they may be able to retard the process of ageing,” he said. “We may never avoid becoming completely old, but we may delay the time we become old.

“Exercise buys you three-to-seven additional years of life. It is an anti-depressant, it improves cognitive function and there is now evidence that it may retard the onset of dementia.”

He said exercise would bring benefits whatever a person’s age or condition and recommended everyone be doing at least between 20 and 25 minutes of walking a day, involving brisk walking or slow jogging.

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NEWS IN BRIEF

Britain

Long working hours increase stroke risk The largest study conducted on the risks of long working hours, carried out in three continents including Australia, found that those who work more than 55 hours a week have a 33 per cent increased risk of stroke, compared with those who work a 35 to 40-hour week.

They also have a 13 per cent increased risk of coronary heart disease.

The study, published in The Lancet pulled together 25 studies for coronary disease involving more than 600,000 men and women from Europe, the USA and Australia, who were followed for an average of 8.5 years. It also looked at 17 studies for stroke involving 530,000 people over an average of 7.2 years.

“Sudden death from overwork is often caused by stroke and is believed to result from a repetitive triggering of the stress response,” the researchers wrote. “Behavioural mechanisms, such as physical inactivity, might also link long working hours and stroke; a hypothesis supported by evidence of an increased risk of incident stroke in individuals who sit for long periods at work.

“Physical inactivity can increase the risk of stroke through various biological mechanisms and heavy alcohol consumption – a risk factor for all types of stroke – might be a contributing factor because employees working long hours seem to be slightly more prone to risky drinking than are those who work standard hours.”

People who work long hours are also more likely to ignore the warning signs, they say, leading to delays in getting treatment.

Britain

NHS could learn from supermarkets The NHS should learn from companies like supermarket chain Asda, which try to help staff achieve “pride and joy” in their work, says British health minister Lord Prior.

Lord Prior suggested the health service needed to “hit the panic button” over widespread bullying in order to improve its culture.

“Fear is toxic for both safety and improvement,” he told the Telegraph, highlighting recent staff surveys that show one-in-four NHS staff members say they have been bullied.

Lord Prior said the health service had “a lot to learn” from companies that were better at listening to their workforce.

“They just engage their staff – through visible leadership. They take staff seriously. The best companies in the world regard their staff and colleagues as their most important asset,” he said.

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For details visit: tresillianconference2015.com THE LAMP OCTOBER 2015 | 9

EDUCATION@NSWNMA

What's On October 2015

Aged Care Nurses Forum – 1 Day 16 October, NSWNMA, Waterloo For RNs, ENs and AiNs in residential, community and hospital aged care settings, across private and public sectors.

An opportunity to network with colleagues in your area from residential, community and hospital aged care settings, across private and public sectors.

Members $30 Non-members $50

Policy and Guideline Writing – 1 Day 5 November, NSWNMA, Waterloo

NEWS IN BRIEF

Australia

Asian heavyweights eye Australian hospitals Strong interest in Australia’s third largest private hospital operator Healthe Care, from some of Asia’s largest private healthcare corporations, highlights the profitability of the sector.

Chinese company Jangho is “circling” Australia’s third-largest hospital operator, Healthe Care, which has been put up for sale by its owners Archer Capital according to Business Spectator.

Healthe Care is valued at about $1 billion and has 17 hospitals across five states with 1500 beds.

Other Asian companies known to be interested in Healthe Care are Bangkok Dusit, IHH from Malaysia and China’s largest private conglomerate, Fosun.

Business Spectator reported that “a major operator out of the (Asian) region may be approaching some of Australia’s not-forprofit organisations, that operate some of the best hospitals in the country, with attractive offers to buy the assets, in an ongoing quest to secure critical mass in the industry”.

Members $85 Non-members $170

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– ½ Day 19 November, Coffs Harbour Seminar is suitable for all nurses and midwives to learn about CPD requirements and what’s involved in the process.

Members $40 Non-members $85

Legal and Professional Issues for Nurses and Midwives – ½ Day 20 November, Coffs Harbour Topics covered include the Health Practitioner Regulation National Law, potential liability, importance of documentation, role of disciplinary tribunals and writing statements.

Members $40 Non-members $85

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NEWS IN BRIEF

Australia

Climate change – the silent killer

In his latest book, Atmosphere of Hope, 2007 Australian of the Year Tim Flannery argues that the health implications of extreme weather resulting from climate change are not future scenarios, but a reality happening here and now.

He says that with the most recent reports of the Intergovernmental Panel on Climate Change (IPCC) and thousands of scientific publications, many details of climate science have been clarified.

“Few changes have been as profound or disturbing as the increases in extreme weather experienced right across the planet.

“A well-documented heatwave experienced in Melbourne in January 2009 shows in detail how heat affects health.

After four days of high nighttime as well as daytime temperatures, many people’s bodies had become overstressed and unable to shed the excess heat.

Mortality records reveal that, on average, around 90 people die annually in Melbourne between 26 January and 1 February.

“But during the heatwave of 2009, 374 “excess deaths” were recorded, the great majority occurring after four days of the extreme heat.

“Humanity’s first intimation of just how great a threat to health heatwaves could become arrived in the summer of 2003. Europe’s summer that year was the hottest since records began in 1540.

“In France, nearly 15,000 heat-related deaths resulted in a severe overload of mortuary facilities and a refrigerated warehouse outside Paris was used as temporary storage. Across Europe, more than 70,000 people died of the heat.

“At current rates of warming, by mid-century the conditions seen in the 2003 European heat wave are set to become the annual summer average.”

NOTICE

ADO DISPUTE: UPDATE Since late November 2014 the NSWNMA has been in dispute with the NSW Ministry of Health and HealthShare over incorrect allocated day off (ADO) balances for full time nurses and midwives. The NSWNMA discovered that there were two problems associated with the StaffLink payroll system that keeps a record of the ADO entitlements.

These problems resulted in nurses and midwives having negative and/or reduced ADO balances.

The first problem identified was incorrect programming which did not include additional annual leave (any leave above the basic four weeks per year) for accrual of ADO entitlements. The second problem in the view of the NSWNMA results from the flawed methodology which prescribes that 19 shifts must be completed to accrue an ADO. This error negatively impacts on members who are working combinations of shifts (such as 8 and ten hours) in a roster cycle. It results in these nurses and midwives having a reduced ADO entitlement.

This dispute is currently the subject of proceedings before the Industrial Relations Commission of NSW. Earlier in these proceedings Commissioner Newall made the following recommendation: “My view is that ADO’s should continue to be rostered, where they fall due, even in circumstances where the individual to whom they fall due has on record a negative balance. One is not yet sure whether that negative balance represents something real or illusory and whether those figures are accurate or not, one does not know.”

There are some members who have been advised that they have a negative ADO balance and as such have been forfeiting their regular ADO in an attempt to address this. This is incorrect and should cease immediately until the dispute is resolved.

The Ministry and HealthShare have recently agreed that the first problem (not including additional annual leave for ADO accrual purposes) is in fact an error and will require rectification. Their current intention is to have this resolved and ADO balances reconfigured later this month.

The NSWNMA is of the view that any rectification process should be undertaken when both problems have been resolved, thus resulting in a single recalculation of ADO entitlements from the inception of StaffLink.

The NSWNMA will continue to provide updates as this matter progresses.

THE LAMP OCTOBER 2015 | 11

COVER STORY

RN 24/7 campaign forces parliamentary debate

12 | THE LAMP OCTOBER 2015

A NSWNMA petition has triggered a debate in the New South Wales Legislative Assembly over the need for RNs on duty at all times in the state’s nursing homes.

MORE THAN 100 AGED CARE WORKERS, COMMUNITY supporters, local government representatives and relatives rallied outside state parliament before the debate, which was brought on by a petition of 24,000 signatures, collected by Association members and supporters throughout the past few months.

The petition called on the NSW government to retain the legal requirement to have an RN on duty 24/7 in all aged care facilities with high care residents.

The requirement is at risk following changes to Commonwealth aged care laws.

Health Minister Jillian Skinner passed an amendment in June 2014 to keep the requirement temporarily in place, while the Ministry of Health conducted consultations with the aged care sector and stakeholders.

An Upper House inquiry was launched in June 2015 into the matter and almost 80 per cent of the 165 written submissions received by the inquiry called for the legal requirement to stay. The committee is due to hand down its report by the end of October.

Addressing the rally outside parliament, NSWNMA General Secretary Brett Holmes said the state’s politicians had a responsibility to look after some of the most dependent, frail, aged people in our community.

“These are the people who need the oversight and expertise of registered nurses in their final days or years of life. The loss of this legislation would simply mean that we would rely on the goodwill of aged care providers, who in many cases are there to make a profit,” he said.

TOO BIG FOR POLITICIANS TO IGNORE Barbara Anson RN says she went to the rally “to be informed and to be up to speed on what is happening.

“I am an RN in aged care and have a personal interest and I wasn’t sure of the government’s or the providers’ stance on this issue.

“The politicians seem to be divided.The Labor Party supports RNs 24/7 but the Liberal Party seems to have reasons why not to provide it.

“I felt a bit sad because these people we are caring for are on the last leg of their journey.They have worked hard.They are a generation that has paid taxes all of their lives.They’re vulnerable but now we are saying ‘ok, you’re here but we can’t quite give you what you need clinically’.

Another aged care RN, Jennifer McGrath, expressed disappointment at what she saw as the government moving to shut down the debate.

“I thought the speech by the Blue Mountains MP Trish Doyle was clear, concise and compassionate. But she was cut off. Labor asked for more speakers but the Liberals denied it,” Jennifer said.

“When the Liberals spoke they skirted around the

What the politicians had to say TRISH DOYLE MP, ALP BLUE MOUNTAINS “People tell me that the very real difference that having enough staff, led by registered nurses, makes, is enormous to both the care that can be provided and the care that is received. This should be the core foundation of quality aged care.”

MARK COURE MP, LIBERAL OATLEY “I understand that concerns have already been raised by providers that this requirement could have implications for the viability of low-care facilities, particularly in rural areas. This needs to be considered.”

JAMIE PARKER MP, GREENS BALMAIN “Let us respect the dignity and quality care that people deserve. The government must ensure that services provided by registered nurses remain in place in nursing homes 24 hours a day, seven days a week.”

MELANIE GIBBONS MP, LIBERAL HOLSWORTHY “The New South Wales government is committed to ensuring that residents of aged-care facilities in New South Wales receive safe and appropriate care that meets their needs, including highquality nursing care.”

PRUE CARR MP, ALP LONDONDERRY “When loved ones are in nursing homes it can be a trying time. The care given by registered nurses around the clock provides comfort and confidence to families.”

Read the debate A transcript of the parliamentary debate on RNs in aged care can be found online at: www.parliament.nsw.gov.au/prod/parlment/hansart.nsf/0/E80F40C01607C021CA257 EBC007D683F. Our petition is discussed on pages 58 to 62.

issue. They talked about what they had achieved in the public system, which had nothing to do with our issue. I wasn’t impressed.”

Barbara agreed.

“I felt ashamed of some of the politicians in the way they were debating because they are supposed to be the decision makers and the adults in this situation.

“I think the Liberals were trying to waste time, making silly accusations and not really bringing anything to the

debate. I didn’t think their presentations were pertinent or relevant.

“They were saying ‘we’re taking RNs away from aged care but we’ll give you something in the public health system’.

“I was thinking ‘they don’t value aged care RNs’. I didn’t find it complimentary to the whole industry, staff or residents.

“The positive thing to come out of the debate is that it is too big an issue for the Liberals to ignore.”

THE LAMP OCTOBER 2015 | 13

COVER STORY

Speaking up for the aged In the debate over aged care, many elderly cannot speak for themselves while their families are often ignored. The Lamp spoke to three family members who wanted their stories and those of their loved ones to be heard.

“THE RN IS THE INTERFACE BETWEEN RESIDENTS’ NEEDS AND THE PROVISION OF HEALTH CARE.” Margaret Zanghi, carer and president, Quality Aged Care Action Group For just over three years I visited my husband in a nursing home on a daily basis. That is a long time to observe the daily happenings of life in residential care.

During that long period of time I became acutely aware of the complex health situations of the residents.

Most had dementia of one form or another at various stages of progression. However their situation was compounded by numerous other ailments associated with their frailty and failing health.

These illnesses included heart disease, lung disease, stroke, kidney disease and diabetes.

Often their dementia prevented them from describing their symptoms. They were completely reliant on the RN to observe and analyse their status.

To give a concrete example: my husband’s condition provoked frequent urinary tract infections. I, or another member of my family, would notice an increased level of agitation or confusion.

I would speak to the RN on duty, who would discuss a course of action to observe, monitor and carry out a preliminary test. I often left the nursing home in the evening with an invitation from the RN to ring back later at night for a report on his progress.

Residents of nursing homes have absolute reliance upon the RN. The RN is the most qualified health professional present at all times; they are the interface between residents’ needs and the provision of health care.

The RN has a knowledge base, training and skill which enable him or her to observe, interpret and monitor residents and to put in train an appropriate course of action.

The skill set of an RN is particular and specialised. Persons with lesser training cannot take up these duties.

The health, the comfort and the safety of nursing home residents would be seriously compromised if the requirement for an RN to be on duty at all times were to be removed.

“The skill set of an RN is particular and specialised. Persons with lesser training cannot take up these duties.”

14 | THE LAMP OCTOBER 2015

“WHAT IDIOT THINKS THAT PAIN AND OTHER SYMPTOMS DISAPPEAR AFTER HOURS?” Virginia Alidhe, palliative care advocate

My husband was diagnosed with pancreatic cancer six years ago. He didn’t consider that pancreatic cancer was necessarily a death sentence. He was determined to fight it all the way.

But it wasn’t long before he was floundering: symptoms appeared that I didn’t know how to manage, stress levels were rising. Problems always seemed to arise at night.

Finally we were referred to our local palliative care team.

This meant that I could phone at night to speak to a palliative care registered nurse on duty. I could get after hours help, advice and direction to help me make John as comfortable as possible.

It meant so much to have that service. This has to be available everywhere where people are in decline, where people are suffering.

It is incomprehensible that registered nurses may not be available aroundthe-clock in facilities where people

are sick enough to need nursing home care.

What idiot thinks that pain and other symptoms disappear after hours? There is a substantial body of evidence that life crises are more frequent in the early hours of the morning.

An enrolled or assistant nurse would have little option but to call an ambulance to transfer the patient to an already stressed hospital, some miles away.

As someone who has experienced these services with a loved one, and being on the cusp of needing them myself, I need the security of knowing that I can be looked after round-the-clock.

Isn’t it true that a society is judged by how it treats its most vulnerable?

But there aren’t enough registered nurses now. The suggestion that there are times of the day when a registered nurse is not needed is ludicrous, irresponsible and dangerous.

“It is incomprehensible that registered nurses may not be available around-theclock in facilities where people are sick enough to need nursing home care.”

“THE ACTIONS OF THE RN SAVED MY WIFE’S LIFE.” Des Hartree, carer When Irene first became a resident in a nursing home it was to be for respite care only. However after several weeks I noted that she appeared to be more disoriented than usual [and] she was leaning to the right and was having trouble with balance as she tried to walk.

I located the duty RN who’s comment was that the AiNs that had showered and dressed her that morning had not noted anything unusual.

The RN accompanied me to check out her observations. Within 30 seconds the RN said ‘Irene appears to have a urinary tract infection and is severely dehydrated’. The RN had Irene transported to a hospital. She was admitted and within an hour was on a drip and antibiotics.

Irene’s condition continued to deteriorate and within 24 hours she was in a coma for

“Just going to hospital with the unfamiliar faces and environment was a traumatic experience in itself.” some 14 hours and then started to recover.

I believe that had the RN not taken immediate and urgent action Irene would never have survived the coma.

Due to her balance problem and increased care assessment Irene became a permanent high care resident and some months later had a fall. She sustained a trauma to the back of her head. Irene was on warfarin and she bled profusely.

Triple 0 was called by the duty RN but was told ‘it is Friday night, all the ambulances are at a pub brawl in a nearby suburb – you are a registered nurse, handle it’.

The RN did everything possible. The paramedics arrived three hours later and Irene was transported to hospital. Once again I believe the actions of the RN saved my wife’s life. Basic first aid was never going to be enough.

On the two occasions that Irene was transported and admitted to hospital it was obvious that just going to hospital, with the unfamiliar faces and environment, was a traumatic experience in itself.

Irene is now gone but not forgotten and I will continue to support and promote the minimum requirement for RNs 24/7 on roster for any facility with high care assessed residents.

THE LAMP OCTOBER 2015 | 15

PRIVATE HOSPITALS

Member action protects Ramsay allowances NSWNMA members take action to protect longstanding payments at North Shore Private.

SHORTLY BEFORE RAMSAY HEALTH CARE announced a 27 per cent increase in annual profit, nurses and midwives at the company’s North Shore Private Hospital got a rude shock.

They arrived at work to find a management memo announcing that, in three weeks, longstanding staff allowances would be cut.

Nurses and midwives stood to lose up to $6000 a year.

The cuts were announced without any explanation to employees or the NSWNMA. NSWNMA members immediately went into action, organising a campaign that eventually forced management to abandon the cuts, for existing staff.

Ramsay agreed to give every nurse a written guarantee they would continue to receive current allowances and penalty rates as long as they worked at North Shore Private.

New staff however, will not receive the higher allowances and will be paid according to the enterprise agreement.

“This is a significant win for existing members at North Shore Private.

However, we are disappointed we could not secure the same outcome for new starters at the hospital,” NSWNMA Assistant Secretary Judith Kiejda said.

Ramsay is Australia’s biggest private hospital owner and one of the top five private hospital operators in the world. It made a profit of $385.5 million in the year ended 30 June 2015.

Left to right: Donna Parry, Catherine Solley, Emily Fowler and Lyn Whitlam

16 | THE LAMP OCTOBER 2015

The targeted payments are higher than those set out in the North Shore Private enterprise agreement. Some have been in place since the hospital opened more than 17 years ago and are paid to recognise local circumstances and recruitment difficulties.

Judith said the cuts would have impacted hundreds of nurses and midwives, including some of the most experienced within their teams and on each shift.

“YOU ONLY HAVE TO LOOK AT THEIR ANNUAL PROFIT TO SEE THE COMPANY IS NOT EXACTLY STRUGGLING.” — Emily Fowler CNS

“We are talking about the nurses and midwives who lead quality care in critical areas such as intensive care, operating theatres, maternity services and wards,” she said.

“Our members were right to object to Ramsay’s unprecedented proposal to significantly cut their allowances and to defend the longstanding loyalty they have extended to the hospital operator.”

Registered nurse Juliet Steptoe, who has worked in the intensive care unit for the past seven years, would have lost money as a result of a planned reduction in the 12-hour shift payment.

She helped collect signatures on a union petition condemning the cuts: about 500 people signed and the nurses’ fight for fairness was reported in the local North Shore Times.

“Staff and management met to discuss extensions to the hospital and nobody mentioned then that they were planning to cut our pay,” she said.“The weeks after the announcement of the cuts were very tense. You could feel people were angry.

You can’t just take money away from staff after they have been paid it for so many years.

“Management made us feel like we were only numbers, that we weren’t valued.”

Staff meetings rejected management’s proposed “compromise” – phasing in the cuts over two years.

“In the end we got a good outcome – the union did a great job,” Juliet said.

“Management was clearly taken aback by how upset we all were. But what did they expect?”

She said the dispute showed the value of joining the union.

“If you don’t join, this is the sort of thing employers can do to you.The union has helped me a few times.You never know when you are going to need information, advice and support from the union.”

Clinical nurse specialist Emily Fowler said she was shocked to read the management memo announcing the cuts.

“You only have to look at their annual profit to see the company is not exactly struggling,” Emily said.

She works in the short stay unit and theatre admissions and would have suffered a cut to her in-charge allowance.

“In-charge is a serious responsibility and we deserve to be recognised for it.

By cutting the allowance it seemed management didn’t realise what our jobs entail.

“However all the nurses responded well. We got lots of help from the Association to organise a united response which showed management how we felt about the issue.”

Staff meetings with management were held over two days to cover various shifts.

“The meetings were well attended,” Emily said.“Management wanted to meet with only three representatives from each unit but we succeeded in pushing for open meetings so everyone could find out what was happening and have a say.

“It’s great that we will keep our current allowances but unfortunate that we weren’t able to achieve that result for new employees.

“A lot of people now realise the importance of being in the union. We are forming the first ever union branch at the hospital which is another good result.”

THE LAMP OCTOBER 2015 | 17

SAFE STAFFING

LHD defies Industrial Relations Commission Tamworth nurses and midwives want the state government to urgently intervene to ensure Tamworth Rural Referral Hospital is safely staffed.

THE CALL FOR INTERVENTION FOLLOWS a decision by the management of Hunter New England Local Health District to ignore recommendations of the Industrial Relations Commission of New South Wales (IRC).

Nurses and midwives have been raising concerns about understaffing in the maternity unit for 20 months and in the ED since February.

But the hospital’s general manager Brad Hansen continues to insist they are appropriately staffed, despite findings to the contrary of IRC Deputy President Rodney Harrison.

After inspecting the new Tamworth Hospital, Deputy President Harrison recommended an eight-week trial of an additional 10 nursing hours a night in the emergency department. He also proposed a compromise of 3.63 FTE additional staff in maternity, while a Reasonable Workloads Committee considered the question of whether ENs should be utilised and if so how.

“They (management) are ignoring the IRC and not talking to us. It is just appalling,” said Jill Telfer, secretary of the Tamworth Hospital branch of the NSWNMA. The branch is appealing for community support with a petition urging the government to intervene to ensure the facility has enough staff to deliver safe patient care and ensure a safe work environment. The petition warns of repeated instances of under staffing, particularly during night shift in the maternity unit and the ED. 18 | THE LAMP OCTOBER 2015

“WE HAVE BEEN GIVEN LITTLE RESPECT AND OUR CLINICAL KNOWLEDGE AND CONCERNS HAVE NOT BEEN ACKNOWLEDGED.” – Jill Telfer Tamworth NSWNMA branch

“Nursing and midwifery staff are regularly required to work extended overtime and are missing meal breaks to meet demand,” the petition says.

More than 100 people attended a community forum in Tamworth where nurses and midwives put their case for more staff.

Midwife Deborah Walganski told the forum the hospital’s maternity service had a 25 per cent increase in births in July this year, without any increase in staff.

Assistant General Secretary of the NSWNMA Judith Kiejda said midwifery staff were “at breaking point” and “seriously undervalued by management. In recent

days, there were five deliveries on the night shift, one actually happened in the emergency department and there were only three staff rostered in maternity.”

Judith told the forum it was unsustainable for a single nurse to cover both the resuscitation and triage roles in ED overnight.

“Both the maternity unit and emergency department have completely different footprints to the old hospital building and are physically larger – extra staff must be recruited,” she said.“You have a beautiful new state-of-the-art hospital, which has been built to best practice.The problem is that it has not been staffed to best practice.”

“EXTRA STAFF MUST BE RECRUITED.” — NSWNMA Assistant General Secretary Judith Kiejda

Judith said some nurses were considering quitting their jobs due to management’s refusal to accept an IRC recommendation that one more nurse be rostered in ED overnight for a two-month trial.

“If management can afford to just ignore this and say ‘alright, let them leave’, after they’ve put all the resources into training and educating them, if that’s okay to let them walk out the door, then they should not be in the responsible position of managing a health service.

“We cannot afford to let our highlyskilled nurses and midwives burn out and either leave the health system or become ill themselves. That is what will happen unless management urgently acknowledges its duty of care to its staff.”

Jill Telfer says the branch rejects management’s argument that problems in the ED would be solved by placing extra staff in a new short-stay unit.

“ED will still be running one short on night duty and the paediatric area will still only be staffed for eight hours a day,” Jill said.“The staff shortage on night duty creates the very real risk of something going terribly wrong.

“We are not here today to scare the public. We call on Hunter New England to provide the appropriate staffing levels to provide appropriate patient care.

“Nurses and midwives are working hard to ensure patient safety is maintained but their commitment to patient safety is coming at a huge cost to themselves.They do not get their regular breaks. They are working ragged. They are exhausted and some are at breaking point.

“Nurses and midwives have taken their concerns to local management in good

faith with no resolution. As a branch we are disappointed with Hunter New England’s response.We have been given little respect and our clinical knowledge and concerns have not been acknowledged.”

Jill said nurses and midwives were also concerned about the paediatric area in ED. “It is a beautiful area, very discreet and separate, as it should be,” but because it is staffed for only eight hours a day, children risked being “exposed to the person who has come in off ice or the elderly woman who might be in the process of dying.”

Jill says the new maternity unit is bigger than the old facility and divided into a birthing unit, post-natal ward and special care nursery, separated by closed security doors.

Night shifts usually had one midwife and one enrolled nurse working together on the ward, while one midwife was rostered to work alone in the labour ward in isolation from other staff, creating a security risk.

“Midwives are working in isolation on a very big labour ward at night and it is impossible for them to guarantee they can give one-to-one midwifery care to women in labour.”

She said the union calculated that Tamworth maternity unit was short of about six full-time-equivalent (FTE) midwives – “a huge number”.

However, management repeatedly manipulated the figures to purport it was meeting the required FTE. “There have been times when they count people on maternity leave, people on long service leave and people yet to be recruited who are not yet working on the campus.”

Board should intervene General Secretary of the NSWNMA Brett Holmes has criticised the board of Hunter New England Local Health District for choosing not to intervene in the Tamworth Hospital dispute and failing to speak directly with nursing or midwifery staff.

“It is extremely disappointing that the HNE board will not intervene in these unsafe staffing matters, given a core priority of the board is to ‘improve local patient outcomes and respond to issues that arise’,” Brett said.

“We’ve got nurses and midwives working beyond exhaustion at Tamworth Hospital, doing regular overtime – particularly on the night shift – and going home in tears.”

He said management had failed in its duty of care to staff and the broader Tamworth community and ignored IRC recommendations.

“If we took industrial action, HNE LHD would be straight to the Industrial Relations Commission saying ‘tell them to stop!’ and they would be demanding orders against us.

“This LHD, the board, chief executive officer and senior members of local management need to listen to the very real and scary concerns that local nurses and midwives have.”

THE LAMP OCTOBER 2015 | 19

PROFESSIONAL

Care gone missing Intense nurse workloads and poor access to resources are leading to “missed care” according to research conducted at Flinders University.

A RESEARCH TEAM FROM FLINDERS UNIVERSITY HAS BEEN investigating “missed care” or “required patient care that is omitted either in part or in whole or delayed”.

The team previously conducted quantitative and qualitative research in South Australia and New Zealand and in 2014 extended the research to New South Wales, undertaking surveys involving 4400 nurses and midwives.

One of the researchers, Dr Julie Henderson, says that when conducting their research the team examined three factors that contributed to missed care: Labour resources: not just enough nursing staff but also enough assistive staff such as ward clerks and wards people.

Material resources: having access to equipment, making sure the equipment works and being able to find medications.

Relationships and communication: care is missed because things are not passed on, not just within nursing/midwifery teams but across whole health teams.

Dr Henderson says nurses constantly find themselves having to prioritise tasks and “ration” their care.

“What we looked at was how nurses decide what is most important, what gets left out and the reasons things get left out. A lot of missed care comes from people doing tasks that are unnecessary.”

• • •

BASIC CARE FALLS BY WAYSIDE The five most common missed activities across the three shifts were: Morning: blood sugar level (BSL) monitoring, patient education, patient bathing and skin care, hand washing, PRN (as-needed) medication given within 15 minutes.

Afternoon: feeding patients while food is warm, providing emotional support, planning patient discharge, setting up patients for meals and administering medications within 30 minutes of schedule.

Night: fluid balance charts, vital signs, PRN medications within 15 minutes, setting up patients for care, patient bathing and skin care.

When analysing their data the researchers divided the types of missed care into three categories: Higher priority care: vital signs, BSLs, hand washing, checking IV/CV lines.

• • • •

• • • • •

Intermediate priority care: turning, feeding, toileting and hygiene.

Low priority care: documentation, patient education, discharge planning.

The study found: 63% of missed care was intermediate 23% was higher priority nursing care 21% was lower priority care

STAFFING AND POOR ACCESS “The reasons for missed care basically came down to staffing issues and workload,” Dr Henderson said. “Within the public system the top five reasons were: an unexpected rise in patient volume and or acuity on the ward; inadequate number of staff; an urgent patient situation; heavy admission or discharge activity; and inadequate number of assistive or clerical personnel.

“Within the private sector the primary reason for missed care was inadequate number of staff followed by urgent patient situations.”

She says lack of access to resources has a critical impact, particularly after hours and in rural settings.

“Not having access to linen, not being able to get hold of catering for meals, chasing medications: nurses are spending a tremendous amount of time just trying to find the resources they need to provide care and that accounts for 45 per cent of missed care.”

Communication issues accounted for 37 per cent of missed care and the predictability of workload across a shift were factors that could impede communication, the study found.

“If a nurse or midwife is confident, their communication is often better. If they aren’t confident they don’t approach people, their communication breaks down and that leads to missed care,” Dr Henderson said.

Workload intensity accounted for 32 per cent of missed care.

“We found that metropolitan tertiary hospitals were more likely to have difficulties with workload intensity, whereas rural hospitals and aged care facilities – while the work was intensive – were more likely to name access to resources as an issue.”

5 MOST COMMONLY MISSED ACTIVITIES MORNING SHIFT

AFTERNOON SHIFT

NIGHT SHIFT

BSL monitoring

Feeding patient while food is warm

Monitoring input/output

Patient education

Emotional support

Vital signs as ordered

Patient bathing and skin care

Patient discharge planning

PRN medications within 15 minutes

Hand washing

Setting up patients for meals

Setting up patients for meals

PRN medication within 15 minutes

Medication administered within 30 mins of schedule

Patient bathing and skin care

20 | THE LAMP OCTOBER 2015

“Nurses are spending a tremendous amount of time just trying to find the resources they need to provide care.”

What nurses say about missed care

— Dr Julie Henderson, Flinders University

“There is a huge amount to our role from when I first trained. We have fewer nurses than ever and our role keeps expanding. We can’t cover all the things we need to because of this.”

“Each government, in an attempt to save money, has compounded this problem by removing corporate knowledge (senior experienced staff that teach as well as supervise) and replacing them with inexperienced unqualified novices.”

“Nursing management are often out of touch with what is required on the ground to fulfil all nursing care procedures required to give high standards of care. Many managers have not worked clinically for some time and are more concerned about budget and ‘theoretical’ quality than actual standards of care which would lead to good quality care.”

“Most of the medically important care is done but documentation is often missed or retrospectively made up.

Not much actual nursing care that is not a direct treatment occurs. Not a lot of emotional support or basic nursing care is attended to.”

“I see staff right across the hospital miss meal breaks and work beyond their shift times without claiming overtime. It seems to be a common occurrence.”

TOP 5 REASONS FOR MISSED CARE PUBLIC SECTOR

PRIVATE SECTOR

Unexpected rise in patient volume and/or acuity on the ward/unit

Inadequate number of staff

Inadequate number of staff Urgent patient situations (e.g. worsening patient condition)

Urgent patient situations (e.g. worsening patient condition) Inadequate number of assistive and/or clerical personnel

Heavy admission and discharge activity

Unexpected rise in patient volume and/or acuity on the ward/unit

Inadequate number of assistive and/or clerical personnel

Unbalanced patient assignment THE LAMP OCTOBER 2015 | 21

PAID PARENTAL LEAVE

Calling on PM Turnbull to reject parental leave changes As all eyes turned to the Liberal Party leadership struggle, a Senate Committee report, which effectively rolls back hard won paid parental leave rights, was tabled in parliament.

T HE AUSTRALIAN N URSING AND Midwifery Federation has called on new Prime Minister Malcolm Turnbull to reject the ironically named Fairer Paid Parental Leave Bill 2015, which enshrines a Coalition government decision to roll back hard fought for paid parental leave rights.

The Abbott Government announced, on Mother’s Day this year, that it would deny access to government-funded paid parental leave for Australian women who had some paid parental leave provided by their employer.

The PPL scheme was originally designed to complement paid and unpaid leave arrangements, negotiated by workers and their unions, with the aim of giving new mums and babies as close to 26 weeks at home with their baby.

Unions including the ANMF and the ACTU, non-government organisations and academics oppose the new bill; even 22 | THE LAMP OCTOBER 2015

employer groups are largely unsupportive of the new proposals.

ANMF federal secretary Lee Thomas says many thousands of nurses and midwives may lose the government PPL entitlement if they plan to have a baby after 1 July 2016, as a result of the Fairer Paid Parental Leave Bill 2015.

“As nurses and midwives we all know the health benefits for both mothers and babies if new mums can stay at home longer. They can bond with their babies, breastfeed for longer and not be stressed about returning to work,” she said.

“Nurses and midwives are asking the new PM to reject the bill and to protect and improve paid parental leave. Mr Turnbull must realise that PPL delivers a great number of benefits, including increased workforce participation by women, improved retention and improved productivity, as well as bringing

positive changes in long-term wages for both men and women.”

ACTU President Ged Kearney says the government’s proposed changes run “counter to the best interests of babies and will likely compel women to leave the workforce.

“The government’s proposed changes to the PPL scheme would leave as many as 80,000 parents a year worse off – some losing as much as $11,824,” she said.

“Australian families should not be forced to choose between their babies and their jobs.

“Forcing tens of thousands of women with newborn babies back to work sooner would put a massive squeeze on childcare, yet there is no recommendation on how this would be handled.”

Both Labor and the Greens oppose the bill.

“MATERNITY LEAVE GOES TO THE CORE OF WHAT IS REQUIRED TO HELP WOMEN STAY IN THE WORKFORCE.” — Viola Morris RN

Chequered history of Paid Parental Leave • January 2011, Australia’s first national Paid Parental Leave (PPL) scheme was introduced bringing Australia into line with almost all other OECD countries.

• August 2013, Federal Opposition led by Tony Abbott proposed expanding the PPL scheme. The Coalition’s PPL policy promised to deliver “a genuine paid parental leave scheme to give mothers six months’ leave based on their actual wage” to help women take time out of the workforce to establish a family while reducing financial pressures.

• Following election to government the Coalition revised its PPL policy, withdrawing their commitment from 26-weeks PPL to the 18-week scheme already in existence.

• A further PPL revision was announced as part of the 2015 Budget, seeking to withdraw eligible women’s access to both employer-funded and government-funded PPL.

Sydney RN Viola Morris gave birth to her youngest child Chloe after a difficult pregnancy that meant she had used her sick leave and almost all her employer-provided maternity leave before Chloe was born.

She was therefore grateful for the government-provided paid parental leave that allowed her to care for Chloe full time after birth.

Viola, who is still on maternity leave, spoke to reporters in Canberra during the Senate hearings.

“I explained that government paid leave gave me a very important buffer after Chloe’s birth,” she said. “It allowed me to properly establish breast feeding and bond with Chloe. I did not have to worry about finding childcare, which would have been very difficult for a baby so young.

“Having a baby is stressful enough without having to worry about money at the same time as you are adjusting to a new child.

“Our message seemed well received in Canberra. The nurses who spoke to the Senate inquiry were passionate about protecting these vital payments for working women.

“Australia is already behind most comparable countries on the issue of parental leave. What the government is now proposing is a regression – the loss of something that women and unions have worked hard for.

“I’m very concerned for what the future might hold for my daughters.

Maternity leave goes to the core of what is required to help women stay in the workforce.

“If maternity leave is cut back it just adds pressure on women trying to decide when they can afford to have a baby and even whether they will have children at all.

“I feel it’s quite typical of this government to try to take services away from people who really need them.

“We shouldn’t be fooled into thinking that Malcolm Turnbull is as progressive as he promises to be.

I hope that as a new leader he will give greater priority to women’s issues.”

THE LAMP OCTOBER 2015 | 23

PAID PARENTAL LEAVE

ANMF survey: nurses and midwives strongly support PPL An ANMF survey of nurses and midwives has found widespread use of paid parental leave that combines complementary government and employer schemes.

THE MAJORITY OF THOSE SURVEYED reported that the main reason they had accessed both schemes was to extend their time at home with their newborn (see Figure 1).

A significant number of participants (43%) reported that they had taken unpaid leave after the birth of a child. The overwhelming reason given was because they had no other option; they either had no access to maternity or parental leave or the amount of leave available did not provide them with the time they felt they needed to spend with their newborn.

Nurses and midwives were asked what were the key factors affecting their decision on when to return to work following the birth of child.

An overwhelming majority (90%) reported financial reasons as the key factor in their decision on when to return to work (Figure 2).

children soon, with 71 per cent reporting that the government’s decision to restrict access to both government-funded and employer-provided PPL would affect their decision to start a family.

The overwhelming majority (94%) indicated that the most significant impact of the proposed changes would be increased financial pressures that would subsequently impact on the length of time they would be able to spend with their newborn (Figure 3).

Many participants reported that they would need to delay their decision to have children and to wait longer between children. Several indicated that the changes could see them decide not to have children at all. Just over 80 per cent of participants reported that they would need to access other leave entitlements, primarily annual leave, to care for their newborn if the government’s PPL changes proceed.

FINANCIAL PRESSURES INFLUENCE PARENTHOOD More than 50 per cent of participants indicated that they were planning to have

SIX MONTHS IS OPTIMUM Almost 90 per cent of participants indicated their support for the World Health Organisation’s recommendation of six months

paid parental leave, with almost 80 per cent reporting that they believed women and families should have access to both employer-funded and government-funded PPL. The majority of participants (65%) did not believe that the amount of PPL offered by their employers was sufficient, with 76 per cent indicating that they believed a minimum of 26 weeks PPL should be available.

Almost 80 per cent of participants responded that they were very unhappy (59%) or unhappy (20%) with the federal government’s proposed changes to PPL; 78 per cent indicated that they would be prepared to take action in support of PPL. FIGURE 3

ideal length for ppl 1%

FIGURE 1

FIGURE 2

impact of ppl changes on participants and their families

key factors affecting participants’ decision to return to work

HARDER TO RETURN TO WORKFORCE

42%

NEWBORN WON’T RECEIVE MAXIMUM BENEFIT

87%

INCREASED FINANCIAL PRESSURE

94%

MISS TIME WITH NEWBORN RETURN TO WORK EARLIER

89% 91%

24 | THE LAMP OCTOBER 2015

90%

18.5%

CHILD CARE AVAILABLE

15%

25%

51%

16.3% 8%

FINANCIAL

4% 4%

READY TO RETURN

PERSONAL REASONS

More than 52 weeks Between 27 – 52 weeks 26 weeks Between 12 – 26 weeks Less than 12 weeks None

“PARENTAL LEAVE IS NOT ABOUT GRABBING WELFARE. IT’S ABOUT PROVIDING THE BEST POSSIBLE START TO LIFE FOR YOUR CHILD.” — Emily Shepherd RN From left to right: Annie Butler, Emily Sheperd, Lee Thomas, Anita Stirling with Gus, Viola Morris with Chloe and Ged Kearney

Key findings of PPL survey The ANMF survey received responses from 1244 nurses, midwives and assistants in nursing from all states and territories. It found that: participants had accessed both employer85.7% ofbased PPL and government-funded PPL to extend time at home with their newborn

90%

reported financial reasons as the key factor in their decision on when to return to work

71%

reported that the government’s decision to restrict access to government-funded PPL would affect their decision to start a family.

Health benefits of parental leave • New mothers experience improved mental and physical health as a result of taking leave.

• Better antenatal and postnatal care and strengthened parental bonding over a child’s life.

This provides long-term benefits that improve a child’s brain development, social development and overall wellbeing.

• PPL increases the level of breastfeeding, child physical and cognitive development, child immune function, with positive health and mental outcomes

• PPL decreases the number of premature births, the number of babies who are small for gestational age, infant mortality, C-sections, surgical complications, fatigue and exhaustion, stress and postnatal depression.

As a nurse and expectant mother Emily Shepherd was “disappointed and offended” to hear government ministers criticise mothers who took up their entitlement to both employer-funded maternity leave and the publicly funded scheme.

After the government’s Mothers’ Day announcement that it would cut entitlements to parental leave, both thenTreasurer Joe Hockey and his recent replacement Scott Morrison used the phrase “double dipping” to describe parents that access both schemes.

Scott Morrison called it “a rort”.

“As a nurse who understands the health benefits of mothers caring for newborns full time, it was so disappointing to hear mothers labelled as rorters and double dippers,” Emily, who gave evidence to the Senate inquiry into PPL, said.

“As nurses we strive to maintain the highest ethical standards in caring for others every day so it was really offensive to be labelled in that way.

“Parental leave is not about grabbing welfare benefits. It’s about providing the best possible start to life for your child.

I would like to think the Australian government would be

invested in that as well.”

Emily is a Nurse Unit Manager at Launceston General Hospital in Tasmania. She and her husband are expecting their first child in December. They will be entitled to access both sets of leave – giving Emily up to six months at home with her baby – because the government’s proposed restrictions do not come into effect until 1 July next year.

“We are grateful we have access to the current leave entitlements and we hope every other family considering having a child would have the same.

“Evidence-based research shows that spending up to six months at home with a newborn has a lot of health benefits for both mother and baby.

“Knowing you have access to six months leave post-birth has been shown to reduce caesarean rates.

There is also less risk of having a low birth weight baby and it reduces complications with attachment in association with breastfeeding.

“Adequate parental leave also reduces post natal depression and enhances the baby’s social, physical and cognitive health overall.”

THE LAMP OCTOBER 2015 | 25

PROFESSIONAL

Richer lives bring new health risks Nurses and midwives will be crucial in dealing with the crisis of non-communicable diseases (NCDs), which have overtaken infectious diseases as the leading cause of mortality worldwide.

26 | THE LAMP OCTOBER 2015

“A HUNDRED YEARS AGO NCDS WERE A non-event,” Dr Alessandro Demaio, co-founder of the social movement NCDFree and post doctorate fellow at Harvard Medical School, told 700 delegates to the annual conference of the NSWNMA. “So how on earth have we got to this stage?”

Beginning in the 19th century, improvements in hygiene and living conditions were followed by vast improvements in health status and life expectancy.

Now mass vaccination will soon wipe out whole diseases from the planet.

But at the same time, economic growth is leading to a range of chronic diseases in low and middle income populations in developing and developed countries.

The four main types of non-communicable diseases are cardiovascular (heart attack and stroke), cancers and chronic respiratory diseases (chronic obstructed pulmonary disease and asthma) and diabetes.

But there are also four modifiable causes – tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diet – that account for 82 per cent of the 38 million deaths each year from NCDs. “As countries get richer and go through the traditional epidemiological transition from infectious diseases to the new diseases – the pesky NCDs – they change their diet at the same time and the two are inextricably linked,” Dr Demaio told the conference.

FAST FOOD CONTINUES TO GROW He said Australia had one of the only fast food markets in the western world that was continuing to grow.

“But [Australia] actually has a twotiered diet. Wealthier and more educated Australians are eating better food, but that’s vastly outweighed [by the fact] that the diet is getting poorer in lower socio economic groups.”

He urged nurses and midwives to be “a voice for change, on urban health determinants – promote healthy lifestyles and physical activity. Champion opportunities for prevention, for early diagnosis, for counselling aimed at behavioural change and health literacy.

“We have cost effective solutions and most of us know what needs to be done.

But it’s translating this into political action through scientific evidence, which we have, and societal support and advocacy and that’s where [nurses and midwives] become crucially important.

“We have around two billion people on this planet who are overweight or obese.There’s too much evidence they are linked to the opportunities afforded to us when we’re born, in early childhood and in employment and in ageing and ultimately also in the way we die.

“Many of the risk factors are amplified by the products and practices of corporations that are powerful economic operators, namely the tobacco, food, beverage and alcohol industries. Market power readily translates into political power,” Dr Demaio said.

“And this comes back to the fact that, as [World Health Organisation director general) Margaret Chan has said a few times ‘the mosquito for malaria never had a lobby that pursued governments for taking action against it in the same way as food companies can and will and have’.

“Because of the lead time between risk and exposure and the development of these diseases, a child in the first 1000 days of life might be setting down the pre-disposing factors to heart disease in 40 years time,” Dr Demaio said.

“The nursing profession can transform … how health care is delivered. No one can afford to ignore your potential to change things for the better.”

— WHO director general Margaret Chan

“Already more than 50 per cent of NCDs occur in people under 70 and there’s no one in the community that knows better than nurses.We are seeing patients younger and younger with what were adult onset diseases not very long ago.”

A FAN OF THE FAT TAX Eighty five per cent of NCDs occur in the world’s poorest populations but not just in in the world’s poorest countries.

“Australia has its food deserts,” he said.

“Poorer suburbs have poor access to health care, poor access to good food, poor access to safe places to exercise, poor access to programs for kids to be learning from an early age how and what to eat, how to live a healthy lifestyle.

“All of these things compound each other and poverty ends up causing diabetes, heart disease, cancer. But the enormous toll of a lifelong illness, a lifelong disability, in turn has an enormous economic toll on a family, not just in Bangladesh but also here in Sydney.”

Dr Demaio is a fan of so-called “fat taxes.”

“When Coca Cola sells a can of coke they sell water and sugar wrapped in petroleum, three of the cheapest commodities on earth: and they sell it for $4.”

Then they spend millions of dollars on advertising.

“There’s good evidence to link soft drinks to diabetes; there’s no safe level,” Dr Demaio said. “We bear the cost in the health care system, in cleaning up our environment. We need to make the costs of the product truly reflect the cost to society.

“Then, if people choose to drink Coke let them. But build in the true cost and use that money to pay for health and environment effects. I don’t believe it’s a tax it’s the true cost of the product.

“When Nestle spends $100million a year on advertising and Coca Cola $50 million telling people how and what to eat, I would argue it absolutely is the role of doctors and nurses and the public health community to at least be giving people better information.

“As a group we should be championing opportunities much more for prevention, for early diagnoses and for counselling aimed at behavior change and health care literacy. We’re obsessed with food, we’ll watch it endlessly but largely we’ve forgotten what it is and how to use it.

MORE COLLABORATION IS KEY “Looking at how we design cities, how we make health the easier default, as opposed to almost impossible for people, is going to be a really important thing for the health care community to get involved with.

“NCDs are not diseases of laziness.Yet the health care community and the urban planning community never talk and that’s completely insane. It is changing but it needs to change more quickly.”

In her keynote address to the International Council of Nurses Global Conference in Korea, in June, WHO director general Margaret Chan called for a “less rigid dichotomy between the autonomy of nurses and doctors, and more collaborative teamwork.

“Physicians who continue to believe that expanding the scope of nursing practice will have an adverse effect on the quality of patient care have not looked at the evidence. Mounting evidence shows that this opposition is more about competition than competence.

“Nor can we afford to ignore other lines of evidence. Hospitals with a higher ratio of nurses-to-patient have lower mortality.

“The nursing profession can transform the way health services are organised and how health care is delivered. No one can afford to ignore your potential to change things for the better,” she said.

THE LAMP OCTOBER 2015 | 27

PROFESSIONAL

Protecting the fragile antibiotic Australians are among the world’s highest consumers of antibiotics and nurses and midwives have an important role to play in the fight against growing numbers of antimicrobial resistant organisms — the so-called Super Bugs.

AS JONI MITCHELL SANG IN THE SEVENTIES “don’t it always seem to go, that you don’t know what you’ve got till it’s gone.”

“In some ways that applies very well to the paradox of antibiotic use and antibiotic resistance,” Dr Tom Gottlieb, an infectious disease physician at Concord Hospital, told the 2015 NSWNMA annual conference.

“Half the antibiotics given to hospital patients are inappropriate or inappropriately used,” he said. “They’re often in the wrong dose, which means they’re too little and the bug can become resistant, or too high.

“They’re often given for long durations when they’re not needed for that duration of time. And we’re often using broadspectrum agents, which knock out other bacteria that you don’t need to treat, and that drives antibiotic resistance.

“In the US, 80 per cent of antibiotic use is in food production, given to animals as a growth stimulant where often there is 28 | THE LAMP OCTOBER 2015

absolutely zero need for antibiotics in the first place.”

The US also sees two million resistant infections a year kill 23,000 people.

“We’ve used antibiotics very well for patient care sometimes, but also very profligately both in medicine and in animal care and I think we’re paying for it,” Dr Gottlieb said.

In June this year Australian ministers for health and agriculture announced a program to manage antimicrobial resistance. But while regulation is a powerful top-down solution, there Dr Gottleib believes antimicrobial resistance needs to be managed globally and health professionals have a role to play.

JUST-IN-CASE MEDICINE “The bottom-up solution is that all of us need to focus on how we use antibiotics and think every time we are about to use them ‘do we really need them?’.

Dr Gottlieb says “defensive” prescribing

of antibiotics is a behavioural problem.

“We want everyone to get better and so we use just-in-case medicine. Everyone feels they can prescribe an antibiotic, whatever their level of experience, because antibiotics are feel good drugs.

“So that risk of individual failure is much more powerful than what we project as the long-term loss of efficacy in the future for those antibiotics. It’s the immediate care that drives our use. And that leads to more, longer duration and broader antibiotics.”

Dr Gottlieb says antibiotic prescribing is unique because it has a “societal” effect.

“If you take an antihypertensive it’s between you and the drug. When you take an antibiotic it has an effect on you and on your gut flora and eventually you shed those organisms and these are often passed to everyone around you.

“Many bacteria are part of our commensal flora so we try to get rid of bacteria but we shouldn’t, because they’re part of

“EVENTUALLY WE GET TO SOME BACTERIA THAT HAVE MUTATED TO THE LEVEL WHERE THEY BECOME EXTREMELY RESISTANT AND VIRTUALLY UNTREATABLE.”

what we live with. Staph is on the skin, eColi is part of our gut flora: that’s normal.

“Also they’re normal flora in lots of animals and they get into our food and our environment and they become problematic when they become resistant.”

PROMISCUOUS BACTERIA “Bacteria transfer genetic material to their daughter cells, their daughter bacteria, but they can also transfer genetic material to any bacteria in proximity. So bacteria talk to each other in the gut and they transfer this genetic material between each other.

“So you can say this antimicrobial material is very promiscuous because resistance spreads very, very easily.

“These resistant enzymes protect bacteria from antibiotics so the more resistant the bacterium is, the more likely it will survive and continue to be spread.And the more antibiotics are inhibited the more multi-resistant these bacteria become.

“Eventually we get to some bacteria

that have mutated to the level where they become extremely resistant and virtually untreatable.”

Dr Gottlieb says the solutions to antibacterial resistance are multi-faceted.

“We need political will. We need incentives for pharmas to come back into antibiotic production.”

“Because they are for short-term use, as opposed to more profitable drugs like anti-hypertensives that are taken for life, pharmaceutical companies have not developed new classes of antibiotics since 1987”, Dr Gottleib said. “Fifteen of the 18 major pharma companies no longer supply them.

“We need good diagnostics so we know when we’ve got a viral infection and we don’t need antibiotics and we need to reward innovation.

“We need to somehow promote that antibiotics have a fragile nature and we need to protect them.We have to identify those behavioural triggers.

“I think it is very important associations like the NSWNMA take this into account and drive better antibiotic use.

“We all need to look at our infection control, sanitation is important world wide, and we need to involve all our specialty groups, not just in infectious diseases. At university level we need to have antibiotic resistance in all our curricula.”

NSWNMA professional officer Angela Garvey told The Lamp: “Nurses and midwives are required by their professional standards to speak up if they have concerns about a treatment.”

But, she says, in clinical ward rounds, depending on the management of the round, communication between healthcare professionals on the team can be difficult.

“But a good nurse with concerns will speak up on ward rounds and ask ‘is there any need for this?’,” she said.

THE LAMP OCTOBER 2015 | 29

ADVERTORIAL

The first line of defence is offense Digital technologies are transforming the healthcare sector and as a result your business holds a huge amount of private information online.

Securing that information is critical.

Keep in mind that every piece of patient information you collect, including names, email addresses and financial information must be managed in a way that adheres to the Privacy Act 1988.

Medical information such as patient records, reports and results is particularly sensitive to risks from within your business and outside it -- from external viruses and other malicious software that can damage or steal data or expose it to further threats.

The first line of defence The first line of defence is a firewall which only allows connections with trusted computers. You should also install anti-virus and anti-malware software and update it regularly.

Employees should only be given access to the specific data systems that they need to do their job and should not be able to install any software without permission. Ask employees to use unique passwords and change them regularly.

Protect information out of the office The increasing use of mobile devices such as laptops, notebooks and smart phones means that sensitive

information is taken out of the office where it is vulnerable to loss or theft.

The information on the devices themselves can also be intercepted.

You must have robust passwords, data encryption and the latest mobile security software, web browsers and operating systems. Businesses that access information remotely can set up a virtual private network (VPN) which allows users to securely access applications via a web browser. Be wary of public Wi-Fi networks which can expose your data to outsiders.

Communication systems security vital Communication systems security is particularly important in healthcare.

Clinical information should only be shared across clinical software using a secure messaging system which automatically records the communication on a patient’s medical record. Any other means of communicating information such as email and phone, must be secured.

Encrypting email converts the information into a secret code for transmission over the internet so that unauthorised people cannot see it.

Staff should be taught how to use email safely because incoming emails can contain malware and viruses. Up to date security software should also be installed.

Healthcare organisations collect confidential information about their

patients, employees, products, research and finances over the phone every day. Internet telephony, such as Voice Over Internet Protocol (VoIP) is popular but is vulnerable to many of the same threats as computer networks and must be secured accordingly.

Business continuity plan vital No matter how many online security measures you implement, there will always be circumstances beyond your control. The need for a business continuity plan in the face of information loss, and a regular, secure back up of your data, is essential. You must back up regularly and automatically and store the copies offsite or in the cloud.

Remember, the online security measures you take today can not only help protect your business from existing threats but also from ones that are yet to emerge.

The Australian Government’s Stay Smart Online Programme offers advice to small businesses and other Australians about being secure and safe online. The Programme also offers a free email Alert Service for people who want to keep up to date with current online threats and how to address them. To sign up for the free Alert Service and further information visit the website at www.staysmartonline.gov.au

Authorised by the Australian Government, Capital Hill, Canberra.

Printed by Offset Alpine Printing 42 Boorea Street Lidcombe NSW 2141 Australia.

30 | THE LAMP OCTOBER 2015

ask judith

when it comes to your rights and entitlements at work, nswnma assistant general secretary JUDITH KIEJDA has the answers.

Realignment could lead to deletion I was recently told that “realignment” was occurring at the Local Health District where I work and my position would likely be deleted. What are the requirements on the LHD in such circumstances?

Under clause 6 of the Public Health System Nurses’ and Midwives’ (State) Award 2015, the employer has an obligation to notify the Association and employees who may be affected if a decision has been made to introduce change that will likely have significant effects. This includes, but is not limited to, changes that will lead to jobs being deleted; changes to the size or composition of the workforce; alteration of working hours for a group of employees; and the transfer of jobs to other locations and the restructuring of such jobs.

Regardless of whether the LHD calls any proposed change a restructure, a realignment or a rearrangement, the obligation rests upon them to consult appropriately and provide all relevant information about the change and the likely effect on existing employees and services delivered.

If you become aware of any such proposed change notify your NSWNMA branch and the Association so we can ensure you receive proper consultation in the manner intended under the award and related policy directives.

Recognising prior service I recently started work at a UnitingCare aged care facility. I did not produce documents about my prior service in other aged care facilities at the time, and now I want to know how to have my prior service recognised for payment purposes?

Clause 17 of the UnitingCare Aged Care and Residential & Community Services Agreement (NSW) 2014-17 sets out the manner that prior service in a comparable aged care provider is recognised. In short, any progression will only apply from the date the evidence is received by the employer.

Any change to your classification will only be backdated for accepted prior service if the employer receives the evidence within three (3) months of your initial engagement.

It is always best to make all your employment history and records available to a new employer at the time of commencing employment, to negate any future debate or delay.

BREAKING NEWS The latest report from the Bureau of Health Information has been released and shows patient numbers presenting to emergency departments has risen by 25 per cent in the past five years and, not surprisingly, the time taken to treat many of these patients is increasing.

NSW Minister for Health Jillian Skinner was recently forced to concede (at a NSW Parliament Budget Estimates Committee hearing) that hospital emergency departments are under extreme pressure – something that is not news to our members and other emergency department workers who struggle each and every day to provide a first world service.

City or country, we continue to receive reports from members of unreasonable expectations and inappropriate staffing levels in emergency departments, which cripple their capacity to provide safe and effective care.

Put simply, we need more beds and increased staffing levels in emergency departments. But it does not stop there. All inpatient services, along with those provided within the community, need to be resourced and staffed appropriately to ensure that patients receive the care they need in a timely fashion, and follow up care is available.

Careful use of work mobile I am an RN in a public hospital and have been provided a work mobile device that can access the internet. I was told that I should not use it “inappropriately”. What does that mean?

Inappropriate use of communication systems is defined as being activities ranging from excessive personal use through to possession or transmission of offensive or inappropriate images or information.

Ministry of Health policy directive (PD2009_076 Use and Management of Misuse of NSW Health Communication Systems) sets out that the use of NSW Health communication systems and devices is prohibited for: (i) inappropriate use; (ii) use involving pornographic, sexually explicit or offensive material; or (iii) unlawful use,

which involves breaches of Commonwealth or state laws.

As a general rule, NSW Health communication systems and devices must not be used to create, transmit, store or access any material that could damage NSW Health’s reputation; the material transmitted or received could potentially result in victimisation, harassment or bullying; or such material is discriminatory and could be said to harass or vilify colleagues, patients/clients or the public.

Great care needs to be taken with such communication and internet devices provided by the employer to ensure your use does not stray into areas that are simply “no go zones” regardless of whether this occurs within or outside of work time.

Leave to attend ceremonial business I am an RN working in a rural area under the Nurses Award 2010. Occasionally I attend traditional Aboriginal ceremonies: what are my rights to be released from work to attend these?

Clause 33 of the Nurses Award 2010 provides that an employee who is legitimately required by Aboriginal tradition to be absent from work for Aboriginal ceremonial purposes is entitled to up to 10 working days unpaid leave in any one year.

Do ADOs move with me?

I work in a public hospital and have successfully applied for a position in another LHD. I noticed that my leave entitlements have been transferred but not my ADOs. Is this correct?

Clause 17 of the relevant NSW Ministry of Health policy directive (PD2014_029 Leave Matters for the NSW Health Service) sets out that accumulated allocated days off (ADOs) cannot be transferred to another government agency or between divisions of the NSW Health Service. When an employee is to transfer to another part of the NSW Health Service, or another government agency, all reasonable steps should be taken to use up ADOs prior to leaving.

Remaining ADOs are to be paid out to the employee by the division they are transferring from and, under Clause 4 of the Public Health System Nurses’ and Midwives’ (State) Award 2015, ADOs paid out on termination are paid at ordinary rates.

THE LAMP OCTOBER 2015 | 31

32 | THE LAMP OCTOBER 2015

Recruit a new member & go in the draw to visit

B g n i a z n a g m k a o k! e

NSWNMA is pleased to announce the NSWNMA’s 2015 – 2016 Recruitment Incentive Scheme Travel Prize

The winner will be flying off to the amazing Bangkok!

You and a friend will be flying Scoot’s brand new 787 Dreamliner from Sydney to Bangkok via Singapore, staying 5 nights in a superior room at Centara Watergate Pavillion Hotel Bangkok with breakfast each day, airport transfer and a city tour.

Centara Watergate is a trendy modern hotel located in the heart of the shopping district of Pratunam and close to Siam Square. Attached to Watergate Shopping Mall, the Centara Watergate has perfect accommodation for couples and families, including rooms with double beds and family suites with bunk beds. Stunning outdoor bar and dining areas with roof top ‘Walk’ lounge bar with stunning views across Bangkok, resident DJ and huge outdoor screen. A short walk to the Airport train link station for easy access from Bangkok International Airport.

Every member you sign up over the year gives you a ticket in the draw!

RECRUITERS NOTE: Nurses and midwives can now join online at

www.nswnma.asn.au!

If you refer a new member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entitled to your vouchers and draws in the NSWNMA Recruitment Incentive Scheme.

PRIZE DRAWN 30 JUNE 2016

NURSES & MIDWIIVES

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Speakers include: Margaret Cunneen SC, Danny Green, Sam Kekovich, Oscar Yildiz, Dr Sophie Henshaw, Geena Leigh, Belinda Neil, Cameron Brown, Melanie Thomas, Nerio Baldini, Tom Snow, Alan Hannaford, Colin Emerson and The Class Act Theatre Company.

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social media | nurse uncut

www.nurseuncut.com.au Do you have a story to tell? An opinion to share? nurse uncut is written by everyday nurses and midwives.

We welcome your ideas at nurseuncut@nswnma.asn.au

WHAT’S

A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES

HOT THIS MONTH

Nurse Uncut is also on Facebook: www.facebook.com/NurseUncutAustralia and on Twitter @nurseuncut

Jess: paediatric nursing with Syrian refugees Paediatric nurse Jess recently returned from working in a refugee camp in Iraq. Handling frequent burns to children was a big challenge. www.nurseuncut.com.au/jess-paediatric-nursing-with-syrian-refugees/

Future nurses – the unspoken truth Final year nursing student Jenyfer shares her thoughts about nursing students, bullying and academic integrity. www.nurseuncut.com.au/future-nurses-the-unspoken-truth/

Amazing souls – a young patient’s perspective on nurses Medical student Nikhil had leukaemia as a teenager and credits his nurses as the ones who got him through. www.nurseuncut.com.au/nurses-are-amazing-souls-a-young-patients-perspective/

My first and last cardiac arrests Ann-Marie remembers her first cardiac arrest as a young nurse. She played a very different role at her last arrest before retiring. www.nurseuncut.com.au/my-first-and-last-cardiac-arrests/

The Shift – podcasts for nurses and midwives Introducing The Shift, our new series of thought-provoking podcasts, including speakers from Professional Day. It’s also available on iTunes. www.nurseuncut.com.au/the-shift-podcasts-for-nurses-and-midwives/

Narelle retires from theatre Narelle Wright retires from St George operating theatres after training at and working in the same hospital since 1966. www.nurseuncut.com.au/narelle-retires-from-theatres

New on SupportNurses YouTube channel paid parental leave hearing Mothers take their babies to Canberra to speak at a Senate hearing into cuts to PPL. >>youtu.be/3fxMeLrf-QQ tamworth hospital staffing concerns Serious concerns about understaffing. >>youtu.be/mVqp2dPSBKI

NSWNMA on Instagram!

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 OCTOBER 2015 | 35

TO ORDER FAX: Myrtle Finlayson, (02) 9662 1414 POST: NSWNMA, 50 O’Dea Avenue, Waterloo NSW 2017 EMAIL: gensec@nswnma.asn.au

www.nswnma.asn.au

WEB

ORDER FORM NSWNMA Navy Polo Shirt with embroidered logo $20 Quantity: Size: Ladies Size 14 (to fit sizes 8-10) Ladies Size 16 (to fit sizes 12-14) Unisex S Unisex M Unisex L Unisex XL Unisex XXL Unisex XXXL

NSWNMA Navy Polo Shirt with embroidered logo $20

NSWNMA Navy Canvas Duffle Bag $25 Quantity:

Available in Ladies size 14 (to fit sizes 8-10) and 16 (to fit sizes 12-14); and Unisex sizes S, M, L, XL, XXL, XXXL

NSWNMA Bone China Mug $10 Quantity: Total cost of order $ Please include postage & handling of $3/order for NSWNMA mug and $5/order for other merchandise. Bulk orders will be charged accordingly.

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Large main zippered compartment; cotton webbing heavy duty double carry handles, removable adjustable shoulder strap, 1 side end slip pocket.

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LIONS NURSES’ SCHOLARSHIP Looking for funding to further your studies in 2016?

The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships for 2016.

The Lions Nurses’ Scholarships open on 1 Augu Nurses eligible for these scholarships must be re and employed within the State of NSW or ACT. You must currently be registered with the Nursing Midwifery Board of Australia and working within th nursing profession in NSW or the ACT, and must a minimum of three years’ experience in the nurs profession – the last twelve months of which must have been spent in NSW or the ACT. Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and application forms are available from: www.nswnma.asn.au/education The Secretary Lions Nurses’ Scholarship Foundation 50 O’Dea Avenue, Waterloo NSW 2017 or contact Matt West on 1300 367 962 or mawest@nswnma.asn.au COMPLETED APPLICATIONS MUST BE IN THE HANDS OF THE SECRETARY NO LATER THAN 31 OCTOBER 2015.

36 | THE LAMP MARCH 2015

social media | facebook

WHAT NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Radical restructure in the Riverina Some nursing managers across the Murrumbidgee Local Health District face a pay cut or forced relocation if they want to keep their jobs, under a radical restructure of nursing management across the Riverina.

Male midwife makes news Cameron Littlewood, midwife at Westmead Hospital, featured in an article about men in nontraditional occupations. “It’s refreshing that women and their families are much more concerned about the skills and abilities of the person caring for them rather than their gender.”

Silence is dangerous Nurse Alanna Maycock spoke in the media about her traumatic work visit to the Nauru detention centre – and the aftermath. “When you silence doctors and nurses you’re getting into dangerous territory.”

A degree of professionalism Do nurses really need a degree? A nursing academic says that is the question she is most frequently asked – and it certainly set our commenters on fire.

How is a manager expected to manage multiple sites on less pay! Typical NSW HEALTH antics!

Interesting how the administration of some groups keeps getting larger! But the real frontline folks, doing the hard, face-to-face work, are not appreciated as they should be.

Another cancerous bite into our health care system.

It’s the clinicians who run the units, who get in and get their hands dirty when the unit is short staffed, they are frontline staff who have to juggle the admin and paperwork and the staff and the patients. They are the real deal and losing them will create chaos.

Good but the name should be changed to midhusband not midwife.

Midwife means “with women” so Cameron is indeed a midwife.

Good to see more men in areas such as this.

I had a male midwife when I had my first child 30 years ago; he was fantastic.

No one thinks a male obstetrician is odd, in fact most people expect them to be male.

Keep up the great work! We need more great midwives, male and female!

I agree. I think silencing anyone is the breeding ground of corruption and abuse, both systematic and personal.

Good on her, very brave. I am against illegal immigration but I am also against what is happening in Nauru ... process these people for goodness sake.

Just to clarify (for those who still believe the myth of “illegal immigration”) it is not illegal to seek asylum. Regardless of what mode of transport they use to escape persecution, they should be afforded the right to protection under international treaties that Australia is a signatory to.

It's like asking if teachers need a degree. If we want to be recognised as a profession, then we do. Hospital training finished back in the 80s, it is not time to go back 30 years.

We lived and breathed our hospital training for three years and graduated as knowledgeable confident RNs. I've never been afraid to tackle any test my profession has thrown at me.

Yes they certainly do need uni. It forms a good basis for critical thinking and multidisciplinary team work early in their career.

The issue of sufficient quality supervised clinical practice should not be at the expense of the required theoretical knowledge. To achieve both maybe it is time for a 4 year degree rather than trying to cram more and more into 3 years of study!

Bring back hospital-based training before it's too late! They may have lots of knowledge but putting it into practice is a whole new ball game. Worst thing that ever happened, taking training away from hospitals. After all it is actual people we are looking after not a case scenario! Big difference!

I have done both and the hospital training beats uni hands down.

This debate is long past. Move on! Every autonomous professional needs a degree.

PHOTO GALLERY

These two AiNs came along to the Parliamentary debate on registered nurse staffing in aged care.

Northern Rivers health professionals took a stand against the Border Force Act on the beach at Byron Bay.

Nurses in Tweed Heads delivered 5000 signed RN 24/7 petitions to their local MP – making a total of 27,000.

A popular meme adopted from a penalty rates tv ad made by the ACTU.

THE LAMP OCTOBER 2015 | 37

Nurses and midwives have unique stories to tell

Conditions of Entry Z Z Z Z Z

Z Z Z Z Z

FIRST PRIZE OF $2000

2 RUNNER-UP PRIZES OF $500

READERS CHOICE AWARD OF $500

How to enter Z Z Z Z Z Z

Deadline Winners

Entries close 5 pm Friday 18 March 2016 Winners will be announced on 3 May 2016.

Readers Choice winner will be notiďŹ ed on 10 June 2016.

www.nswnma.asn.au

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Across 1. An instrument for measuring the degree of sensitivity to a painful stimulus 6. An illness that occurs when certain bacteriaâ&#x20AC;&#x2122;s toxins enter the bloodstream (1.1.1) 9. A colorless compound used to keep blood samples from clotting before tests are run (1.1.1.1) 10. Cathode ray oscilloscope (1.1.1) 11. Becoming swollen; swelling 12. Slow to heal, grow, or develop 13. A male human 14. A long-chain polymer available in monofilament and multiple filament forms 15. Quick to learn or understand

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16. A gene that has to do with regulation of cancer growth 17. To supply with necessities such as tools or provisions 20. Tester 21. To restore the ability to function or the effectiveness of 22. Trousseau spot (10.6) 27. Pulmonary stenosis (1.1) 28. The unguis of the handâ&#x20AC;&#x2122;s first digit 32. The caudate and lentiform (lenticular) nuclei 33. One of the four primary tastes 34. Pitted 37. Not in use or operation 38. A powerful hallucinogenic drug (1.1.1)

Down 1. Before death 2. Partial division of a primordium, as of a single tooth germ forming two teeth 3. The midgut 4. A digit of the foot 5. Inflammation of retina and optic disk (16) 6. Biologists who specialise in the classification of organisms into groups on the basis of their structure and origin and behavior 7. Induration of the subcutaneous fat 8. A narrowing that reduces the flow through a channel 18. The sensation of having been stung by nettles 19. That is (1.1)

23. Resembling a sieve 24. To cover completely in a liquid; submerge 25. Discharge phlegm from the lungs and out of the mouth (4.3) 26. Exertions of physical or mental power 29. Nanosecond 30. The symbol for iridium 31. A double chromosome resulting from the halving of a tetrad 35. Symbol for aluminum 36. An area of a hospital especially equipped and staffed for emergency care (1.1)

THE LAMP OCTOBER 2015 | 39

nursing research online There are 60 million people around the world displaced by war – the highest number since records began. According to UN refugee agency, UNHCR, globally, one in every 122 humans is now either a refugee, internally displaced or seeking asylum. Around the world nurses and midwives are taking up the challenge of providing healthcare to them.

Promoting Refugee Health: a guide for doctors, nurses and other healthcare providers caring for people from refugee backgrounds (3rd ed) Foundation House, 2012 Recognised as the only comprehensive refugee health resource in Australia, these hard copy and online booklets provide comprehensive information on the who, why and how-to of caring for people from refugee backgrounds in primary, specialist and allied health care settings. The guides contain practice-based research and information on the following topics: • Why focus on refugee health?

• Cross-cultural communication.

• Trauma and torture experiences – psychological and physical sequelae, management and psychological approaches.

• Health concerns of adult refugee clients.

• Child and adolescent health.

• An approach to refugee health assessment.

• Strategies for supporting new arrivals to access health services.

• Health entitlement and settlement support.

• Country profiles and refugee health information websites.

• Referral and further information (state-by state). http://refugeehealthnetwork.org.au/promotingrefugee-health-a-guide-for-doctors-nurses-andother-health-care-providers-caring-for-peoplefrom-refugee-backgrounds-3rd-ed/

Syria’s refugees: time to get serious about preventing a lost generation of Arab youth David Madnicoff I chat with several articulate young women about how high school is going. They tell me that classes don’t always interest them, their families can’t help much with homework and the exams

that they have to take to get into university are very difficult. My conversation with these ambitious students could be taking place anywhere, but for the lack of reliable electricity and the tiny size and low roof of the temporary house in which we stand. In fact, the crowded conditions and desert surroundings make clear that I am at Za’atari, the largest camp for Syrian refugees in Jordan and among the largest such camps in the world. I recently visited Za’atari as the academic director of a non-governmental organisation.

My short time in the camp, amid not only human misery but also youth aspiration, underscored the key role that action to improve displaced Syrians’ lives can play in addressing instability in the Middle East in the coming years. http://theconversation.com/syrias-refugeestime-to-get-serious-about-preventing-a-lostgeneration-of-arab-youth-43568

Migration Policy Debates: Is migration good for the economy?

OECD, May 2014 Whatever its source migration has impacts on our societies and these can be controversial. The economic impact of migration is no exception.

Benefit or burden – what’s the reality? To answer this question, it can be helpful to look at migration’s impact in three areas: the labour market, the public purse and economic growth. www.oecd.org/migration

Working with refugee young people: a nurse’s perspective Nyaradzai Garakasha, RN, MCN (Immigration Nursing); CNS New South Wales Refugee Health Service. AJAN, Vol 32, No 2

Wars, conflict and persecution have forced more people than at any other time since records began to flee their homes and seek refuge and safety elsewhere, according to a new report from the UN refugee agency.

“We are witnessing a paradigm change, an unchecked slide into an era in which the scale of global forced displacement as well as the response required is now clearly dwarfing anything seen before,” said UN High Commissioner for Refugees António Guterres.

Since early 2011 the main reason for the acceleration has been the war in Syria, now the world’s single-largest driver of displacement. Every day last year on average 42,500 people became refugees, asylum seekers, or internally displaced: a four-fold increase in just four years.

Young people comprise 12 per cent of the refugee population who arrived in Australia between 2012-2013. Some of these young people entered Australia unaccompanied and some with their families. Common health problems for refugee young people are different from the health problems for the general population, due to exposure to various traumatic experiences including mass murder, rape, extreme deprivation and torture. The common health problems for refugee young people include: post-traumatic stress disorder; infectious diseases, poor nutrition, dental problems, undiagnosed chronic conditions and physical trauma. Their vulnerability increases when faced with barriers associated with migration such as language and culture. Refugee young people require culturally appropriate and trauma sensitive services.

Nurses are often the main health contact for these young people. It is vital that nurses working with refugee young people are equipped with knowledge and skills to deliver quality, effective care.

www.unhcr.org/558193896.html

www.ajan.com.au/Vol32/Issue2/3Garakasha.pdf

Worldwide displacement hits all-time high as war and persecution increase UNHCR, June 2015

Thursday 8 October 5.30 – 8pm

Explore our flexible postgraduate programs, meet academic staff and obtain individual career advice about your nursing specialty.

Sydney Nursing School The University of Sydney 88 Mallett Street Camperdown NSW

If you’re ready to take your career to the next level, Sydney Nursing School has the expertise and experience to get you there.

Find out more and register at sydney.edu.au/nursing/postgrad

15/5333

Postgraduate information evening

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Sydney Nursing School

THE LAMP OCTOBER 2015 | 41

easy!

BEING A MEMBER OF THE NSWNMA IS

Update your membership details online and go into the draw to

a

Hunter Valley

Escape

Condition apply: ^ Voucher expires 10 April 2016, non-transferable; *Dinner voucher excluding beverages Competition entries from NSWNMA members only.Competition opens 1 October 2015 and closes 31 October 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/15/00192.

Log into the Association’s online portal at www.nswnma.asn.au to check your membership details are correct, and change if necessary.

You will not only enjoy having the choice to do this at a time that suits you – but your name will automatically go in the draw to WIN A HUNTER VALLEY ESCAPE! So close to Sydney yet truly a world away, the Hunter Valley is the birthplace of Australian wine.

Wine Country – as the Hunter Valley is known – is a dynamic wine region with more than 150 premium wine producers, 60 tempting restaurants and 180 inviting places to stay. It has all the ingredients for a perfect getaway, from gourmet regional produce, boutique breweries, indulgent spas and action-packed adventures, to acclaimed gardens, galleries and heritage towns. Wind your way between old delights and new surprises as you relax and unwind in this remarkable region.

You and a friend will stay at Pokolbin Village for two-night midweek in a deluxe queen suite room^.

This fantastic package also includes a bottle of Hunter Valley wine on arrival; late check-out of 12pm; discount vouchers for on-site shops and Audrey Wilkinson/Cockfighter’s Ghost; a 3 course dinner for two people* at the Mill Restaurant; entry for two people into Australia’s largest display gardens, the Hunter Valley Gardens; and to see the Hunter Valley from a different perspective, weaving in and out of the vines on a Segway tour, thanks to East Coast Corporate Xperiences.

For a chance to win, simply register with your membership number, name and email address and create your own password.

From then on use your member number and password to log in directly to the Members login area on the website.

You can now change your details at any time – address, workplace, credit card number, mobile number, etc. You can pay fees online, print a tax statement or request a reprint of your membership card – it’s simple.

All those who use our online portal from 1 October – 31 December 2015 will be automatically entered into the draw.

www.nswnma.asn.au MEMBERSHIP ONLINE VIA

book me All the latest Book Me reviews from The Lamp can now be read online at www.nswnma.asn.au/library-services/book-reviews.

Each review includes a link directly to that item in the library catalogue plus instructions on how to request a loan.

25% off for members Health Care and public Policy: An Australian Analysis (5th ed.)

George Palmer and Stephanie Short Macmillan Science and Education www.palgravemacmillan.com.au.

RRP $89.95. ISBN 9781420256888 This book explains how our complex and chaotic health system has developed, as well as the reasons for the current debates and conflicts in health care. This latest edition reaches Federal Labor’s establishment of the National Health and Hospitals Reform Commission and the National Health Reform Agreement in 2013. Since then the landscape has changed, however this book still offers many valuable insights into the political, economic, social and epidemiological contexts within which health policies develop, and the forces that promote and oppose change. It provides a framework for interpreting and understanding the trend towards privatisation in the public health sector. Drawing on insider accounts, it also investigates the politics of health, whereinterest groups influence policymaking, how conflicts are resolved and what factors inhibit governments from solving the numerous problems in health services today.

Essentials of Pharmacology for Nurses (2nd ed.)

Paul Barber and Deborah Robertson McGraw Hill Education: www.mhprofessional.com.

RRP $79 (NSWNMA Member Discount Available).

ISBN 9780335245659 This ideal starter kit for nurses aims to make pharmacology and drug calculations less intimidating. It does not assume previous knowledge of pharmacology and so does not contain detailed types of formulae – rather it provides a basic structure on which to build. Chapters cover pharmacodynamics and pharmacokinetics, adverse reactions and key drug types such as analgesics, antimicrobials, anti-inflammatories and anticoagulants. Additional sections address chronic conditions, mental health, patient concordance, and legal and professional issues. Each chapter includes case studies and clinical tips as well as multiple choice questions to prompt and develop reflective practices.

Caring Science, Mindful practice: Implementing Watson’s human caring theory Kathleen Sitzmanand Jean Watson Springer Publishing (through Footprint Books): www.footprint.com.au. RRP $69.99. ISBN 9780826171535 This is the first text to help students and practicing nurses translate and integrate the philosophy and complexity of Human Caring Theory into everyday practice. It brings caring theory to life focusing on multiple ways of knowing and incorporating guided mindfulness and artistic practices.

It draws upon the contemplative and mindfulness teaching of Thich Nhat Hanh, a renowned Buddhist monk. Through case examples and guided activities, the book helps readers more fully comprehend the meaning and use of each of the 10 Caritas Processes developed RN Jean Watson.

The Library is pleased to announce that McGraw Hill Publishers are now offering members a 25% discount off the RRP! The offer currently covers medical as well as a range of other professional series books. Please see the online Book Me reviews for a link to the promotion code and further instructions, or contact the Library directly for further information.

special interest A Doctor’s Dream: A story of hope from the Top End Dr Buddhi Lokuge and Tanya Burke Allen & Unwin www.allenandunwin.com.au.

RRP $32.95. ISBN 9781760110987 A Doctor’s Dream is a compelling story of how to address inequality in health care. Dr Buddhi moved to Arnhem Land from Sydney in 2011 to roll out a government health program aimed at eradicating scabies among Aboriginal children. Six months into the program he realised it was going to fail. In the face of powerful opposition from high profile experts, he listened to the Elders and took the slow road. Through painstaking observation and working with patients and the community, together they established an innovative approach that places learning at the very centre of building relationships with Indigenous people.

Fast Facts for the Neonatal Nurse Michele Davidson Springer Publishing (through Footprint Books): www.footprint.com.au. RRP $34.95.

ISBN 9780826168825 This book provides a basic reference for nurses caring for newborns and high-risk newborns as well as care considerations for families. Content is divided into key topic areas including physiological adaptations to birth, newborn assessment and basic care, nutrition, common and high-risk neonatal conditions, plus caring for both infants with birth disorders and families facing life-altering situations. Further sections are based on a family-centered care model that addresses parent assessments, needs and discharge instructions.

All books can be ordered through the publisher or your local bookshop. NSWNMA members can borrow the books featured here via the Library’s Online Catalogue: visit http://www.nswnma.asn.au/library-services.

Call 8595 1234 or 1300 367 962, or email gensec@nswnma.asn.au for assistance with loans or research. Some books are reviewed using information supplied and have not been independently reviewed.

THE LAMP OCTOBER 2015 | 43

VA L E

Cathie Haynes 1952 — 2015

[e\ Cathie Haynes was one of those RNs who had a nursing “vocation”: it was in her DNA. She was the finest example of a nurse putting herself second to those in her care.

So many days over the last year, she should have been putting herself first and she didn’t.

Cathie worked right up to being hospitalised for diagnostic tests. Unfortunately she passed away on Sunday August 2.

Cathie did her RN training in Prince Henry Hospital in 1972. She was a workplace trainer and assessor for Taree Adult Education and was a preceptor for undergraduate students with the University of New England in Armidale.

She began work at Bushland Place Nursing Home in July 1991 and became deputy director of nursing (DDON) in December 2007.

Cathie was a guiding hand and a voice of support and comfort, as well as a fierce defender of residents’ rights and care.

To her being DDON was not a career choice — it was a life choice.

Cathie had a strong sense of who she was: she never pretended to be anyone other than herself.

It was this honesty that earned her the respect of everyone who came across her, from our board of directors to the management team, her staff and her peers.

She was the proverbial “straight shooter” and would be there for anyone if she thought they were being fair dinkum with her.

Cathie had an amazing sense of humour – some would call it a dry wit – which can be a useful attribute as a DDON in aged care.

To many of our staff she was a mentor, a mother: her door was always open if you needed to sit and have a chat to talk something over. She always gave people the benefit of the doubt.

Cathie achieved much in her 24 years at Bushland Health.

Mostly though, she loved her residents.

She was “old school” and this meant she would never look for thanks or seek out kudos.

Through her work with Taree Community College she saw many new recruits through the ranks: she was very proud of this, and rightly so.

A big challenge came in October 2008, not just for Cathie but for all of us, when we commissioned Karingal Gardens Facility: relocating 89 seriously ill aged people (more than half with dementia) into a brand new environment over three days.

For a few days we had to run two facilities, moving everyone in slowly so they could settle.

At first, Cathie’s days in hospital were spent telling me who was on duty and who was a “Bushland” nurse (they would always be Bushland nurses in her eyes).

It would have been difficult for her, to be cared for and be so crook. But equally so, she was very grateful for the care those staff gave to her.

There is a cloud of sadness now over Karingal that will take time to lift: each of us will feel her loss and show it in different ways. Cathie has left big shoes to fill.

To me she was also a friend. We had an amazing working relationship but we also shared pride in what we achieved together. I could only do my job because the likes of Cathie were there, day-in, day-out. I will miss her terribly.

She will always be “Bushland”.

Cathie, on behalf of our director of aged services, Errol Curran, the board of management the staff, and most of all, the residents: we thank you for your years of service and dedication.

Bernadette Burke, director of care, Bushland Health Group

CONFERENCE

Educating

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Friday 27th November, 2015

Book by 15.10.15

A must for child and family health professionals and those working with families Northside Conference Centre, Crows Nest.

44 | THE LAMP OCTOBER 2015

For details visit: tresillianconference2015.com

movies of the month

Director Catherine Hardwicke (Twilight) adds flashes of humour and warmth to two contemporary nuisances; the creation of life and the preserving of it, writes Loretta Musgrave.

Friendship is truly tested is this modern take on the classic Beaches drama. This tale of two lifelong best friends plays out as they battle both cancer and infertility. Surprisingly the movie manages to be sad and funny, with the timeless take-home message that we should retain our optimism, no matter what life deals us.

Toni Collette stars as Milly, the wild child who ends up with it all: successful career, rock-star husband Kit (Dominic Cooper) and two beautiful children. Drew Barrymore stars as Jess, a bohemian community gardener/planner who lives on a houseboat with boyfriend Jago (Paddy Considine) and dreams of having a family.

Childhood friends, Jess and Milly can’t remember a time when they didn’t share everything (including boyfriends) and their friendship exemplifies the saying that “opposites attract”: it is clear that their differences bind them together.

When Milly discovers she has breast cancer and needs Jess’s support more than ever, it is only a matter of time before the pressure on their bond takes its toll.

Jess summons all of her strength and kindness (and selflessness) to support her ailing friend “Frankentits” while trying to balance her own life and obsession with conceiving a baby.

Rock and Roll Hall of Famer Joan Jett’s title track reflects the film’s themes of loss and the preciousness of memories in a razortoothed surge of guitars with a hot chorus.

If you are looking for a tearjerker that charts the obstacles life throws at us, this is the film for you. It celebrates the bond of friendship that cannot be broken, even in life’s toughest moments, whether it be shopping for baby clothes or a new blonde wig.

Loretta Musgrave is a Midwife Educator at the Sydney LHD Centre for Education and Workforce Development IN CINEMAS OCTOBER 8

METROMEMBERGIVEAWAY Email The Lamp by the 5th of the month to be in the draw to win a double pass to Miss You Already thanks to Entertainment One. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

DVD SPECIAL OFFER Based on the award-winning debut novel by British author Susanna Clarke, Jonathan Strange & Mr Norrell tells an alternative history of England, set during the Napoleonic Wars. Magic, considered to have died out several hundred years earlier, is discovered being practiced in the north of England

by Mr Gilbert Norrell (Eddie Marsan), a chap who is able to make statues talk. He is convinced to move to London to help in the war against France, where he attains fame and respectability by conjuring a fairy to bring the fiancée of a government minister back from the dead. In London Mr Norrell meets Jonathan Strange (Bertie Carvel) a wealthy gentleman who becomes his apprentice.

This seven-part BBC series has been highly recommended for its script, costumes, special effects and performances by a strong British cast.

RURALMEMBERGIVEAWAY Email The Lamp by the 15th of this month to be in the draw to win a dvd of Jonathan Strange & Mr Norrell thanks to RLJ Media. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

THE LAMP OCTOBER 2015 | 45

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 Safeguarding Yourself – Recognising and Responding to Vicarious Trauma 6 October 2015 Sydney www.asca.org.au Nursing and Midwifery Unit Managers Society Annual Conference 9 October 2015 Terrigal www.numsociety.org.au Diabetes Update Day – Diabetes NSW Annual Conference 10 October 2015 Sydney www.diabetesnsw.com.au Blacktown and Mt Druitt Women’s, Children’s and Youth Health Conference 15 October 2015 Rooty Hill Lisa.white@health.nsw.gov.au Respite and Community Care National Conference 15-16 October 2015 Sydney www.nationalrespiteaustralia.com.au/nationalconference/national-conference-2015/ 2015 Australian Nursing and Midwifery Conference 15-16 October 2015 Newcastle www.nursingmidwiferyconference.com.au Nurses Christian Fellowship 20 October 2015 Sydney ncfansw.org 0412 862 776 Working Therapeutically with Adult Survivors of Complex Trauma 22-23 October 2015 Parramatta www.asca.org.au Safety and Injured Workers Conference 22-23 October 2015 Sydney rdocwra@unionsnsw.org.au Pain Interest Group Nursing Issues – Inside Joint Pain 23 October 2015 Sydney www.dcconferences.com.au/pigni2015 Dementia Strategy Summit Akolade with Alzheimer’s Australia 27- 29 October 2015 Sydney www.akolade.com.au/events/dementiastrategy-summit ASPAAN Twilight Seminar 27 October 2015 Auburn www.aspaan.org.au Nurses Christian Fellowship 29 October 2015 Strathfield ncfansw.org 0412 862 776 Obesity and Recovery: A Nursing Perspective Conference 29-30 October 2015 Sydney www.ausmed.com.au/course/obesity-andrecovery-a-nursing-perspective Perinatal Mental Health: An Introduction.

Self paced 30 October 2015 Sydney www.cce.sydney.edu.au/course/PMHC Australian Association for Infant Mental Health National Conference 29-31 October 2015 Sydney www.aaimhiconference.org Nurses Christian Fellowship Conference Nursing Teams: What makes them work best?

3 November 2015 Sydney www. ncfansw.org/conference 2015 Australian and New Zealand Orthopaedic Nurses’ Association Conference Climbing to the Summit 11-13 November 2015 Sydney www.anzonaconference.net Beyond the Basics – High Dependency Nursing Conference 20 November 2015 Westmead Ryan.Thomas@health.nsw.gov.au

Australian College of Critical Care Nurses (NSW) Seminar 20 November University of NSW www.acccn.com.au Nurses Christian Fellowship Professional Breakfast Experience with AHPRA Audits 21 November 2015 West Ryde www.ncfansw.org Inaugural Australasian AYA Oncology Congress 3-5 December 2015 Sydney www.youthcancerevent.com.au ASPAAN Seminar 5 December 2015 Wollongong www.aspaan.org.au Nurses Christian Fellowship Christmas BBQ 7 December 2015 Waverton www.ncfanw.org

ACT Second National Complex Needs Conference 17-18 November 2015 Canberra Rex Hotel complexneeds.org.au/events 2015 Australian STOP Domestic Violence Conference Australian and New Zealand Mental Health Association 7-9 December 2015 Canberra Rex Hotel www.stopdomesticviolence.com.au

INTERSTATE Australian College of Midwives 19th Biennial Conference 5-8 October 2015 Gold Coast www.acm2015.com 13th International Conference for Emergency Nurses 7-9 October 2015 Brisbane www.cena.org.au ACMHN’s 41st International Mental Health Nursing Conference 7-9 October 2015 Brisbane www.acmhn2015.com Dermatology Nurse Education Australia 10-11 October 2015 Coolangatta www.dnea.com.au National Nursing Forum (Australian College of Nursing) 14-16 October 2015 Brisbane www.acn.edu.au/Forum_2015 2015 CRANAplus Conference 15-17 October 2015 Alice Springs www. crana.org.au 2nd Biennial National Enrolled Nurse Association of Australia (ANMF SIG) Conference 21 October 2015 Adelaide www.nena.org.au/2015NENAConference.html 7th Australian Rural and Remote Mental Health Symposium 26-28 October 2015 Creswick, Victoria www.anzmh.asn.au/rrmh ACHS/ACHSM Joint Asia-Pacific Congress 2015 – Health leadership 28-30 October 2015 Melbourne achsm.org.au/events/2015Congress.html Place, Spirit, Heart – Exploring Experiences of Ageing 4-6 November 2015 Alice Springs www.aagconference.asn.au 2015 Annual Scientific Alcohol and Drug Conference 8-11 November 2015 Perth www.apsadconference.com.au ASPAAN National Conference 13-14 November 2015 Melbourne www.aspaan.org.au

2015 National Indigenous Health Conference 1-3 December 2015 Darwin www.indigenousconferences.com

INTERNATIONAL 6th International Conference on Ageing and Spirituality 4-7 October 2015 Los Angeles, CA, USA. www.6thinternationalconference.org International Psychogeriatric Association Congress 13-16 October 2015 Berlin, Germany www.ipa-online.org/wordpress 9th European Congress on Violence in Clinical Psychiatry 22-24 October 2015 Copenhagen, Denmark www.oudconsultancy.nl/Copenhagen2015 2nd Annual World Congress of Orthopaedics 2015 24-26 September 2015 Xi’an, China www.bitcongress.com/wcort2015/default.asp 4th World Congress of Clinical Safety 28-30 September 2015 Vienna, Austria www.iarmm.org/4WCCS EMS Conference (for paramedics and acute care nurses) 18-22 January 2016 Hokkaido, Japan www.emsconferences.com.au 2nd Asian Congress in Nursing Education Innovative Nursing Education for Universal Health Care 26-29 January 2016 Tainan, Taiwan www.2016acine.org NCFI Quadrennial International Conference Healthy Lives in a Broken World – a Christian response to nursing 6-10 June 2016 Tagaytay City, Philippines www.ncfi.org

REUNIONS Sydney Hospital Graduate Nurses Association Annual Reunion Lunch 7 October 2015 Parliament House, Sydney Jeanette Fox bekysa@tpg.com.au 02 4751 4829

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Community Health in the Lower Hunter 40-Year Reunion 1975-2015 Maitland, Cessnock, Singleton, Dungog and Port Stephens 24 October 2015 East Maitland Bowling Club chreunion@yahoo.com.au Ruth King 4934 3364 Kathryn Bennett 0432 136 060 NEC Prince Henry/Prince of Wales 40-Year Reunion October 1972–1975 PTS 24-25 October 2015 Margret Brignall (nee Samuel) 0418 646 959 Margaret.Samuel@sswahs.nsw.gov.au Sonia Keeling (nee Graf) 0407 221 407 mskeeling@bigpond.com Gill Gillon (nee Horton) 0401 048 205 gillgill@optusnet.com.au St Vincent’s Darlinghurst PTS Class January 1976 40-Year Reunion 19 March 2016 fnethery@gmail.com.au or jacquie.scott@btopenworld.com Auburn Hospital October 1976-1979 40th Reunion Sharon Byers 0419 144 965 sbyers01@bigpond.net.au Margaret Borg (nee Mueller) 0431 159 964 margaret_borg@bigpond.com Tamworth Base Hospital February 1976 intake 40-year reunion sandra.cox@hnehealth.nsw Sean O’Connor 0408 349 126 Gerard Jeffery 0417 664 993 Prince Henry Hospital Trained Nurses Association Nurses’ Reunion 31 October 2015 Randwick Jenny Tynan (nee Phillips) 0403 129 343 Closed Facebook group: search “Prince Henry and Prince of Wales Hospital” phhpownursesreunion@outlook.com Lewisham Hospital Graduate Nurses Association Annual Lunch 7 November Ryde.

Chris Majewski 0401 866 377 chris.majewski@bunzl.com.au Luke Bohun 4371 7098 lukebohun@netkey.com.au

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