The Lamp April 2011 by NSW Nurses and Midwives' Association

the

magazine of the NSW Nursesâ&#x20AC;&#x2122; Association

volume 68 no.3 April 2011

Birthrate Plus Print Post Approved: PP241437/00033

A major breakthrough for midwives

2 THE LAMP april 2011

About The Lamp

c o n t e n t s

Contacts NSW Nurses’ 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@nswnurses.asn.au W www.nswnurses.asn.au Hunter Office 8-14 Telford Street, Newcastle Ease NSW 2300 Illawarra Office L1, 63 Market Street Wollongong NSW 2500

Cover story

Birthrate Plus: A major breakthrough for midwives p12 Cover Judi Yeo from Dubbo Base Hospital Photography by Amy Griffiths

Agenda

8 New hospital for Orange Base 8 Scholarships available for aged care nurses 8 Unions welcome reform of equal opportunity workplace laws 9 NSWNA joins International Women’s Day rally 9 Ark Tribe honoured at ACTU awards 10 Forum to reveal how robots are helping in care of dementia patients 10 Union threaten strikes over pension reforms in UK 11 Nurses’ drugs guide launched as app 11 Students learn to ‘Be Union’

22 Public sector workers under attack in Wisconsin 27 Choosing a dignified end

18 Private Hospitals. Private sector gears up for new agreements 18 Public Health System. Implementation of ratios: How will it work? 19 Aged care. ACS template agreement up for renewal

Aged care 20 Productivity Commission urged to fix wages gap

The lamp produced by Sirius Communications T 9560 1223 W www.siriuscommunications.com.au Press Releases Send your press releases to: F 9662 1414 E gensec@nswnurses.asn.au

News in brief

Industrial issues

NSWNA communications manager Noel Hester T 8595 2153 NSWNA communications assistant Janaki Chellam-Rajendra T 8595 1258 For all Lamp editorial enquiries, letters and diary dates: Editorial Enquiries T 8595 1234 E lamp@nswnurses.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017

Fighting fit nurses

The Lamp Editorial Committee Brett Holmes, NSWNA General Secretary Judith Kiejda, NSWNA Assistant General Secretary Coral Levett, NSWNA President John Lyons, Baradine MPS Roz Norman, Tamworth Base Hospital Elsie May Henson, Barraba Multi Purpose Service 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 F 9662 1414 E ppurcell@nswnurses.asn.au Records and Information Centre – Library To find old articles in The Lamp, or to borrow from the NSWNA library’s nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnurses.asn.au

39 Get on your bike

The lamp ISSN: 0047-3936

Professional issues 28 Attracting new grads to aged care

OH&S 34 Bariatric patients ... weighing up the issues 37 NSWNA blocks move to cramped premises

NSWNA matters 40 NSWNA Branch News

Regular columns 5 Editorial by Brett Holmes 6 Your letters to The lamp 30 Nurse Uncut 33 Ask Judith 43 Nursing Research Online 44 At the movies 46 Books 49 Our nursing crossword 51 Diary dates

General disclaimer The Lamp is the official magazine of the NSWNA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNA. 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 NSWNA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised. Privacy Privacy statement: The NSWNA 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 NSWNA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission. Subscriptions Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $50. Individuals $73, Institutions $120, Overseas $130.

WIN

Credit: Tourism Queensland

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HERE’S HOW YOU CAN WIN 2 Cancel your payroll deductions and start paying your fees through direct debit and you will go into the lucky draw and/or 2 Convince your colleagues to convert from payroll deductions to direct debit, and you and each of your colleagues who switch to direct debit will go into the lucky draw and/or 2 Sign up a new member using the direct debit method of paying their fees, and you and the new member will go into the lucky draw. Direct debit is not only the easiest and most convenient way to pay your membership, but switching over could win you a luxury holiday! Don’t risk your membership lapsing from changing workplaces. With direct debit you are always protected on the job.

4 THE LAMP april 2011

Image supplied by Tourism Port Douglas and Daintree unless otherwise noted.

Membership Application forms or Direct Debit forms can be downloaded from our website www.nswnurses.asn.au. Alternatively call the NSWNA on 8595 1234 (metro area) or 1300 367 962 (non-metro area) for more information.

e d i t o r i a l BY BRETT HOLMES GENERAL SECRETARY

Global events give us perspective g Nurses in the NSW Public Health System have just won very good improvements in pay and conditions but vicious attacks on public sector workers elsewhere warn us that we can never be complacent.

here should be no doubt about where responsibility for the Global Financial Crisis lies. Corporate greed, poor regulation of the global financial system and the irresponsible behaviour of banks brought the world economy to the brink of catastrophe. There was always going to be a lag period between the financial meltdown and its social consequences but they are now beginning to manifest themselves in the United States and Britain, countries not dissimilar to Australia politically or in their level of development. What is evident is that the consequent pain is not being suffered by those who caused the economic crisis but by ordinary workers. Even more galling is that conservative forces in politics and the media in these countries are sheeting home the blame for the crisis to public sector workers.

In the US and Britain the public sector is being decimated Over 132,000 public sector jobs were lost in Britain in 2010 and the number of public sector jobs being shed is accelerating. Official estimates are that 330,000 public sector jobs could be lost over the next four years. British unions believe the figures will be much higher. The National Health Service is not being spared. The Conservative-led government is to cut £20 billion ($32 billion) from the NHS budget. The Royal College of Nursing estimates 27,000 health positions will be lost over the next five years.

It would be easy to think these things are happening far away and it could never happen here. That would be naïve and short-sighted. It is not that long ago since conservative forces in politics, business and the media were advocating and implementing similar policies in Australia. Several weeks ago Peter Reith, a former Minister for Industrial Relations in the Howard Government, pulled the metaphorical wooden stake out of his heart, resurfaced and urged Tony Abbott to show courage and put WorkChoices back on the political agenda. It is a timely reminder that for many in the Liberal party, destroying collective bargaining, workers’ rights and unions is an article of faith. It is an agenda that never goes away.

We need to heed the lessons

The decimation of the public sector is not just happening in Britain and the United States … We need to heed their lessons and avoid complacency. In the United States, public sector workers are being blamed for the crisis in state and local government budgets – while those responsible for the GFC continue to give themselves fat salaries and bonuses. In Wisconsin, the newly-elected Republican Governor is using the crisis to justify laws that would end collective bargaining rights for state employees (see p.22). Fellow Republican governors in a host of other states are poised to follow suit.

The decimation of the public sector is not just happening in Britain and the United States. It is happening in Ireland and Greece and other developed countries. We need to heed their lessons and avoid complacency. The NSWNA has become active internationally through the Public Services International and locally through the Better Services Better State campaign so we are prepared if similar attacks resurface in Australia. NSW nurses in the public and private sectors and in aged care have won very good improvements in pay and conditions in recent years. We have just won the commitment and the funding for about an extra 1,400 nurses in our Public Health System. We should have perspective about these gains. They are achievements that bucked global trends. They were hard fought for but they are always vulnerable to attack and need to be defended. Nurses need to stay united and the NSWNA needs to continue to build our numbers, strength and activism if we are to consolidate and build on these gains. n THE LAMP april 2011 5

l e t t e r s

Every letter published receives the Sydney Morning Herald and Sun Herald delivered 7 days a week for 26 weeks

letter of the month Felicity Eason

Sharing shift work is only fair I would like to reply to Danny Oakenfull’s letter in the March 2011 issue of The Lamp, ‘Flexibility will help address shortage of nursing staff’. I think it’s great you have graduated and have finally become registered to practise. It is frustrating dealing with the AHPRA but hopefully it will get easier and quicker as the new system sorts out some of the problems. Nursing has always been a 24-hour shift, seven days per week. I’m sure you would have known that when you decided to study nursing! I don’t think there is a shortage of nurses wanting to work. The problem is a shortage of positions available for these nurses. It all comes down to Government funding for these positions to be allocated. There certainly isn’t a shortage of nurses who graduate and only want to work morning shifts 7am–4pm as you

Meg Watson

More negotiation needed in recruitment I write with reference to Danny Oakenfull’s letter in the March Lamp. I think what Danny is getting at is the fact that in the nursing arena there is often no negotiation process that takes place in the recruiting of nursing staff. Nursing positions are advertised as full rotating rosters mostly and you know that this is black and white, set in concrete. It is my observation that while other professions have engaged negotiation consultants to teach their senior staff the 6 THE LAMP april 2011

mentioned. Did you ever stop to think that all nurses have families? A lot are single like yourself with children. Ideally, the majority of us would like to work all morning shifts but as I mentioned it is a 24-hour service. If all the morning shifts were allocated to you, other nurses are left having to do all the evenings and nights, which is very unfair. We all have to be away from our families to work. We all miss Christmas and Easter with our families. Unfortunately, this is reality with the profession you have chosen. When you start working with your colleagues and learn all about nursing you’ll start to realise that fairness and rotation of shifts is very important and accounts for good morale among staff. There are a lot of fantastic nurses out there who work hard and struggle through the shift work. If you become employed you may be another fantastic nurse to be added to the team. Maybe then you will realise the importance of fairness. Good luck on your journey. Felicity Eason, EEN

art of negotiation, it seems that this process is foreign to those involved in recruiting nursing staff. However, I concede that I may be misinformed but this is how I see the situation. I do not believe there is a shortage of nurses, just a lack of negotiation process to bring about a mutual agreement for each party. It goes without saying that this matter is close to my heart. Although I am getting close to the end of my nursing career, I, along with many other nurses, have seen gifted nurses leave employment because some NSW Health employers have been not prepared to negotiate to bring about a win-win result for both employers and nurses. Sadly, it is not only the nurse looking for work that loses out but his or her colleagues who work short-staffed. Meg Watson, RN

Subscribe to the Herald today to save 41% off the newsstand price and enjoy the convenience of the paper delivered to your home each morning. Visit www.subscribe. smh.com.au/ lamp for more details.

Strike action saved patients in long run I am writing in response to the article ‘More than 6,000 strike for ratios’ (Lamp, December 2010). I am working as a Registered Nurse on a medical surgical floor. I have eight to nine patients and the workload is very stressful. Having a safe patient-nurse ratio is a critical issue for patients, nurses, and hospitals. I am very proud of those nurses who gathered together at Sydney Olympic Park Sports Centre and fought for their patients by being real advocates. A lot of nurses would not support striking because it would harm the patients in the sense that nurses would be absent from work, but in the long run, it would save a lot of lives. Many studies show that the safe nurse-patient ratio plays a crucial role in better outcomes and decreasing patients’ death during a hospital stay. We hear multiple excuses why we don’t have safe nurse-patient ratios and one of them is ‘budget cuts’. In today’s economy, because of the budget cuts, hospitals do not hire enough nurses. However, according to the recent Health Affairs study, hiring more nurses could actually save a hospital money in the long run. The study found 6,700 patient deaths and four million days of hospital care could be avoided each year by increasing numbers of Registered Nurses (Health Affairs, Volume 25, Issue 1,204-211, 2006). Going on a strike was a major step and took a lot of courage for nurses to walk off the job and fight for safer patient care. If we sit there and take it, nothing is going to change. We as nurses must come together and make a more powerful stand. Mayya Bababyeva, RN

It’s definitely worth being in the union

Joseph Cidoni

Proud to be a unionist Today I write to you to say thank you on behalf of the thousands of American Union workers throughout the USA. I can tell you that when I saw your letter to Governor Walker I could hardly believe my eyes! I have been in touch with friends of mine in Wisconsin who are sickened and horrified by events that serve nothing but to alienate workers and rob them of their rights at work. I have featured the Wisconsin troubles on my Facebook page and have been warmed by the thoughts and sentiments expressed to me by some of my fellow nurses and others. Today, I find two reasons to feel my heart swell with pride. Not only am I a member of the NSWNA, but I am a proud American. To see the words of the leader of our Union directed at Government fat cats whose only agenda is feathering their own nests while the rest of us do without remind me of this fact: Together, we hold in our hands the greatest power ever known on earth; alone, we are less than nothing. We Yanks have gotten ourselves into a pickle lately. I wish to remind those who have forgotten that we have a long history of trade unionism. We have fought hard for and won our rights and with your words we are strengthened and will fight on. I have included a great link to a Youtube video that reminds us of the struggle that our American workers have waged against tyranny and oppression. It started with George Washington and will not end with me. My Uncle Paul was a union activist at John Deere Tractor in Des Moines, Iowa. He is proud of me for my union activities with the NSWNA. Today, I share that pride with you. http://www.youtube.com/ watch?v=kYiKdJoSsb8 Joseph Cidoni, RN

Thanks to being in the union, I had the opportunity to apply for a scholarship with the Edith Cavell Trust Fund. I never imagined going to university at my age and stage in life, let alone applying for a scholarship. Recently, I was awarded a scholarship to go towards my second-year studying a Bachelor of Nursing at UWS. I felt honoured and appreciation to the Union when I received the scholarship. My daughter was so proud of me, she brought me a beautiful bunch of flowers. My mum said I should buy a lottery ticket because I also just won a case on bullying and harassment. Occasionally, I hear nurses say they don’t need to be in the Union, but I can

Daniel Ruthers

Nursing is 24/7 and you need to do the yards I have something to say regarding a letter I saw in The Lamp last month. I have been a Registered Nurse for 25 years and have worked in a variety of clinical and managerial positions in that time. But I was surprised and angered to read the whiny nature of the letter from Danny Oakenfull, whingeing about the fact that no one would hire him/her because of the hours of work this person wanted because they were doing ‘Honours’. Let’s get something straight: nursing is not about jumping into an ‘Honours’ degree straight from completing an undergraduate degree in nursing. (Unless you didn’t want to be a nurse in the first place and are only doing it thinking it will be an out to get into something else you failed to get into in the first place!)

Got something to say? Send your letters to: Editorial Enquiries email lamp@nswnurses.asn.au fax 9662 1414 mail 50 O’Dea Avenue, Waterloo NSW 2017 Please include a photograph along with your name, address, phone and membership number. Letters may be edited for clarity and space.

honestly say no one knows when and where something may happen. Even if you think you will never use it, the Union has plenty to offer. For example, a variety of courses at a cheaper rate, discounts on insurances, access to products for the home at a discount rate, scholarships, and it has much more to offer. Also the union fees are tax deductible. I personally appreciate being a member and encourage other nurses to sign up as it is definitely well worth the security of being a member, and just knowing if you need or want advice, the Union with their valuable staff, are available and willing to listen, talk and support you. Kaye Begley, RN

You do not complete a finance degree and jump straight into an MBA! You may be able to give an academic answer to a clinical problem, but will you know what you are talking about? Nursing is a 24-hour/seven-day a week job and to expect any employer to bow to pressure that just because you have children or have unwisely accepted an opportunity to further study so very early in your career, they should provide you with the hours that YOU WANT is pure nonsense! My advice: Go and do something else and don’t waste university positions that could have gone to someone who actually wanted to be a nurse and accepts the fact that to work as a new Registered Nurse, you have to consolidate your skills and actually work after hours. Assuming you wanted to be a nurse, then you have to accept that this profession does not cater for silly requests such as this. Daniel Ruthers, RN

The letter judged the best each month will be awarded a $50.00 Coles Myer voucher courtesy of Moore equipment. Clever carts to help clever nurses. For details on the range of clax carts please visit www.mooreequipment. com.au or call (02) 9519 5540 THE LAMP april 2011 7

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Scholarships available for Aged Care Nurses

raining for aged care workers to develop necessary skills will be enhanced due to a new round of scholarships for higher studies in aged care, including professional development worth up to $30,000, announced last month by the Minister for Mental Health and Ageing Mark Butler. Mr Butler said around 130 scholarships are available for postgraduate or continuing education relating to care of older people. ‘Eligible study areas include clinical gerontology, behavioural management, dementia care, wound care, continence care, palliative care, infection control and leadership and management. ‘Registered Nurses can apply for scholarships of up to $15,000 a year for two years for postgraduate studies. Enrolled and Registered Nurses may receive continuing education scholarships of up to $3,000 to attend conferences, $5,000 for short courses or workshops and up to $6,000 over two years for re-entry courses,’ he said. The scholarships are made available through the Australian Government's $232 million Supporting a Professional Aged Care Workforce Program. ‘These scholarships encourage aged care nurses to extend their skills so they can improve the clinical care they provide, or to further their career paths in aged care,’ Mr Butler said. ‘Having access to further training and career advancement makes aged care a better career option and makes it easier to attract and keep quality staff, which in turn means better care for our increasing population of older Australians.’ Applications for the scholarships close on 27 April 2011. Information can be obtained from the Royal College of Nursing Australia on 1800 116 696 or at www.rcna.org.au

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Unions welcome reform of equal opportunity workplace laws

ACTU President Ged Kearney

The Federal Government’s announcement last month that it will reform Australia’s equal opportunity workplace laws after decades of inaction by employers has been welcomed by unions. With a gender pay gap of about 17% and appallingly low rates of women in senior positions in the workplace, it is time for employers to face stronger enforcement of equal opportunity laws, the ACTU said. ‘Employers have had several decades to deliver equal opportunity in workplaces but have failed to do it, so it’s now time for legislative enforcement,’ said ACTU President Ged Kearney. ‘We are pleased that the Federal Government is acting on recommendations made by unions to make reforms to the Equal Opportunity for

New hospital for Orange Base

Women in the Workplace Act. Equality in the workplace needs to be backed by accountability and enforcement. ‘These are long-awaited changes that unions welcome in principal, but we are keen to see more detail, particularly in reference to enforcement measures. ‘We will work to ensure these changes are properly implemented in workplaces so we can get real cultural change. ‘That change must address the barriers many women face in the workplace and must encourage a fairer balance of caring responsibilities between men and women workers.’ Ged said unions were particularly pleased to see action on meaningful data collection and reporting, greater corporate responsibility, greater employee participation in the reporting process and stronger enforcement and compliance. ‘These are measures the ACTU called for in our submission to the Government’s review of the Equal Opportunity for Women in the Workplace Act in 2009. ‘We know that the only way to effect real change is to make employers accountable and to ensure employees understand their rights. Until now, there has been little transparency about which employers comply with equal opportunity laws and therefore no accountability. ‘Without proper statistical data, we have no real way of knowing what is going on in Australian workplaces and what issues need to be addressed. These reforms should change that,’ said Ged.

the General Hospital, Acute Mental Health (Lachlan Building) and Forensic Mental Health (Windamere Building) as well as the refurbishment of four existing buildings: Administration, Clinical Services, Canobolas and Amaroo.

The new Orange Base Hospital opened its doors on 16 March, after several years of planning. The $250-million facility on Forest Road is now offering state-of-the-art health-care to Orange and other communities across the Western NSW Local Health Network. The old Orange Base Hospital on Dalton Street is now closed. The public private partnership (PPP) project has entailed the construction of Nurses in the ED at the new Orange Base Hospital. three new buildings including

Ark Tribe honoured at ACTU Awards

NSWNA joins International Women’s Day rally On 8 March women from across the globe celebrated 100 years of activism and campaigning by women for equal rights. International Women’s Day (IWD) is a global day celebrating the economic, political and social achievements of women past, present and future. The first International Women’s Day events were run in Austria, Denmark, Germany and Switzerland in 1911 and attended by over one million people. One hundred years on, IWD has become a global mainstream phenomena celebrated across many countries and is an official holiday in approximately 25 countries including Afghanistan, Russia, Ukraine, Vietnam and Zambia. Performer and social activist Annie Lennox led a mass march across London’s Millennium Bridge for charity, while in Sydney hundreds of women gathered at Town Hall for a rally. The theme of the rally was ‘Equal Pay: Big Changes, Not Small Change!’ and drew attention to community workers, 90% of whom are women, who have a case before Fair Work Australia to increase their pay. Representatives from the NSWNA joined women of all ages and from all walks of life to celebrate women’s progress and lobby for changes to address inequalities between the genders. Speakers addressed the crowd, which then marched, chanting and blowing whistles, from Town Hall to Martin Place, where there was entertainment and stalls.

‘We cannot lose sight of the fact that women make up 48% of the workforce but earn 18% less than their male counterparts.’ ANF Assistant Federal Secretary Yvonne Chaperon

ANF Assistant Federal Secretary Yvonne Chaperon said there was much cause for celebration on the centenary of IWD, but it was unacceptable that women continue to dominate in low-paid areas of work. ‘The introduction of paid parental leave was a landmark achievement for women in Australia. While we recognise and celebrate these achievements we cannot lose sight of the fact that women make up 48% of the workforce but earn 18% less than their male counterparts,’ said Yvonne. The campaign for equal rights would only be achieved when society recognised the value of work undertaken by women in all areas of employment, Yvonne said. ‘It is astounding that we continue to undervalue the enormous contribution of women working in aged care, in child care, teaching, and a host of other professions,’ said Yvonne. ‘Until we have recognition and a commitment to resolve this issue by government, business and the community at large, women will continue the fight for equal rights.’

Adelaide building worker Ark Tribe was honoured for his brave stand for his rights at work with a special award from the ACTU last month. Ark was given a Special Mention Award at the ACTU National Union Awards in recognition of his two-year fight for justice after he was charged for refusing to co-operate with the Australian Building and Construction Commission. After facing a six-month jail term, he was found not guilty in November. Ark was charged for refusing to attend a compulsory interview about a stopwork meeting he attended in 2008. The site had stopped because of serious concerns about worker safety. ‘Ark Tribe is the embodiment of union values,’ said ACTU President Ged Kearney. ‘At great personal cost, he stood up for what he believed was right for himself and his workmates. He never set out to be a hero, but he was prepared to go to jail in order to defend the rights at work of the 900,000 men and women who work in the Australian building and construction industry.’

Registration renewal due 31 May 2011 The majority of nurses and midwives in NSW are due to renew their registration on 31 May 2011. AHPRA has advised the NSWNA that the easiest way to renew your registration is online at http:// www.ahpra.gov.au/Registration/ Practitioner-Services.aspx A month after you have renewed, you will be sent a receipt, a certificate and a pop-out wallet-sized registration card. Queries can be directed to AHPRA on 1300 419 495 or via an online enquiry at: https://www.ahpra.gov.au/ about-ahpra/contact-us/makean-enquiry.aspx

THE LAMP april 2011 9

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Unions threaten strikes over pension reforms in UK Unions representing public sector employees have warned that industrial action is likely to occur if the government implements radical changes to workers’ pensions. Labour peer Lord Hutton sparked anger after recommending to ministers that public sector workers should be stripped of their final salary pensions and instead have schemes linked to average earnings, while paying more and working longer. ‘This will be just one more attack on innocent public sector workers who are being expected to pay the price of the [country’s] deficit, while the bankers who caused it continue to enjoy bumper pay and bonuses,’ said Unison General Secretary Dave Prentis. ‘On top of a pay freeze, and the threat of redundancy, they now face a pensions raid. This brings the threat of industrial action closer.’ Both the Royal College of Nursing and Royal College of Midwives expressed serious concern over the proposed changes. Jon Skewes, Director of Employment Relations and Development at the Royal College of Midwives, said members would be ‘appalled’ by the government’s ‘attack’ on their pensions. ‘On top of pay freezes, cuts to services and threats to the NHS itself, this will be seen as a slap in the face for hard-pressed midwives and maternity support workers. They will react with anger and dismay and many may vote with their feet and leave the NHS. This will only serve to exacerbate the current and critical shortage of midwives and have a negative effect on the care women and babies receive,’ he warned. Royal College of Nursing Chief Executive and General Secretary Dr Peter Carter said these proposed changes are ‘another hammer blow to the morale of dedicated nurses’. ‘NHS staff are not only facing a two-year pay freeze and widespread cuts to jobs and services, but now they will pay more, work longer and yet receive far less than expected in their hardearned pensions. We know the strength 10 THE LAMP april 2011

of feeling among members and will vigorously defend fair pensions for nurses and healthcare assistants at all times. ‘There is a risk under this proposal that there may be an exodus of hardworking staff before the normal pension age is increased to 65. These departures would have a significant effect on patient services and those NHS staff left behind to deliver patient care,’ Dr Carter said.

Forum to reveal how robots are helping in care of dementia patients Interactive robots are being used to improve the care and quality of life for people with dementia. If you want to find out how, an aged care and technology forum in Sydney next month will reveal the details. The inaugural Ageing – The Future Technology Challenge Forum will reveal some of the new advances in robot technology worldwide, the changing nature of relationships between humans and machines, the social benefits and the dangers. The event will close with a debate between aged care and technology experts who will examine if the use of interactive robots represents a disturbing turn in the treatment of the elderly or can be seen as an innovation in care giving. General Manager of Research and Innovation with Alzheimer’s Australia SA, Tim Wallace, will show the audience how robots are currently used in aged care facilities to support the care of people with dementia. ‘Robots are also increasingly being used in day care centres and health service facilities to help provide positive psychological, physiological and social effects for aged care residents,’ Mr Wallace said. Several studies are underway in Australia to measure the usefulness of automated electronic robot technologies designed to help improve the quality of care for dementia patients. Passive automated technologies like GPS and motion sensors are increasingly being

used to improve the management and safety of dementia patients living in the community. Mr Wallace said Alzheimer’s Australia SA had been investigating a new virtual reality tool developed by Flinders University called Memory And Navigation Assistant (or MANA Calendar), which has been developed for older people with early onset dementia to improve their quality of life while giving their care-givers peace of mind. The MANA system is a computergenerated ‘person’ that reminds people of appointments and prompts them to perform routine activities such as eating meals and watching their favourite television show. Mr Wallace said many older people with early onset dementia were often cared for at home and their care-givers were not always present to provide support. ‘The MANA Calendar allows care-givers to create a schedule of appointments and activities using Google Calendars. A computer with an in-built camera, microphone and speakers is set up in the home and, at a specified time, the head on the screen will “speak” a reminder,’ he said. Mr Wallace said Alzheimer’s Australia SA was keen to establish if systems like the MANA Calendar could also help care-givers who may otherwise feel they cannot leave the house for extended periods of time, and offered an opportunity for increased independence for people living with dementia. Speakers at the Ageing – The Future Technology Challenge Forum include Dr Bruce MacDonald, Director of Robotics Research Group at Auckland University and Associate Professor Rajiv Khosla, Director of Research Centre for Computers, Communication and Social Innovation, La Trobe University. The forum attracts 6.5 hours of Continuing Professional Development for The College of Nursing’s continuing development program. Registration is limited and can be made by visiting www.simavita.com or contacting Jenny Hungerford at Simavita on (02) 8405 6381.

s CPD workshop for RNs – 1 day 7 April, Tamworth 15 June, Coffs Harbour 6 July, Penrith Seminar is suitable for all Registered Nurses to learn about Continuing Professional Development requirements and what’s involved in the process. Members $75 • Non-Members $170 s CPD workshop for ENs – 1 day 8 April, Tamworth; 13 July, Penrith Seminar is suitable for all Enrolled Nurses to learn about CPD requirements and what’s involved in the process. Members $60 • Non Members $170

Left to right: NSWNA General Secretary Brett Holmes; students Thomas Schrader and Ashley Cosmo; NSWNA Officer Phillipe Millard; RN Lara Peters, and student Norman Williams.

Students learn to ‘Be Union’

Nurses’ drugs guide launched as app

Four nursing students and one RN took the Union Summer program this year and were placed at the NSWNA as part of the three-week internship run by Unions NSW each year. The program provides hands-on experience of what it is like to work within the union movement. Wenjia Cao (ACU), Ashley Cosmo (UTS), Thomas Schrader (USYD), Norman Williams (UTAS) and RN Lara Peters had the chance to visit several health-care facilities and universities as well as experience a visit to the Coroner’s Court and gain an overview of how their Association works from head office. ‘The cadets came to the Association at a very busy time and they were extremely helpful in assisting with the recruitment of first-year nurses and associate members,’ said NSWNA General Secretary Brett Holmes. ‘They gained a much better understanding of what it means to “Be Union”, as well as the importance of the need for people to join and become active, and how the power of collective strength can achieve great results for members.’

A practical and portable expert reference guide for nurses, Nursing Guide to Drugs, has been launched in the form of an app for both the iPhone and iPad. The app is a companion to the bestselling reference text of the same name by Adriana Tiziani and was designed and developed by digital media firm Aptara for Elsevier Australia, Australia’s premier publisher of nursing, health professions and medical textbooks. It provides instant access to critical prescription information, including dosages, proper administration, possible side effects, and drug interaction alerts. The Nursing Guide to Drugs can be purchased through iTunes, or for those who have already purchased the book, the app can be downloaded for free after securing a unique pin code distributed with the book via a custom web-interface on the Elsevier site. A new round of scholarships for higher studies in aged care, including professional development worth up to $30,000, was announced today by the Minister for Mental Health and Ageing Mark Butler. n

s Computer Essentials for Nurses and Midwives – 1 day 11 April, Prince of Wales Hospital, Randwick 3 May; 22 June Seminar is suitable for all nurses and midwives. Members $85 • Non Members $170 s Legal & Professional Issues for Nurses and Midwives – ½ day 15 April, Shellharbour 15 April, NSWNA, Waterloo 13 May, Armidale 27 May, Penrith Topics covered include the Nurses and Midwives Act 1991, potential liability, importance of documentation, role of disciplinary tribunals and writing statements. Members $39 • Non Members $85 s Appropriate Workplace Behaviour – 1 day 20 April, Wagga Wagga 19 May, Coffs Harbour 2 June, Newcastle 4 August, Armidale 25 August, Albury Topics covered include understanding why bullying occurs; antidiscrimination law & NSW Health policies; how to behave appropriately in the workplace; identify behaviour that constitutes unlawful harassment and bullying; what to do if subjected to unlawful harassment and bullying; how to use workplace grievance procedures; identify, prevent and resolve bullying. Members $85 • Non Members $170

THE LAMP april 2011 11

c o v e r s t o r y

Birthrate Plus

A major breakthrough for midwives g Birthrate Plus means a reasonable workload for midwives in NSW public hospitals.

he new public health system award includes a staffing tool for maternity services in NSW public hospitals implemented progressively from June this year. According to NSWNA Assistant General Secretary Judith Kiejda, ‘We’ve not only achieved ratios for Public Health System nurses but we’ve also won a major breakthrough for midwives so they can also control their workloads. It’s been a long and difficult gestation getting Birthrate Plus amended for the NSW context and approved but the benefits to midwives are well worth the effort.’ Judith said Birthrate Plus will deliver extra midwives in many birthing units across NSW and will assist in the planning of maternity services.

What is Birthrate Plus? Birthrate Plus is a midwifery workforce planning methodology developed in 1986 for maternity services in the UK. It provides a framework to assess the required midwifery workforce of a service. The NSWNA and NSW Health have worked extensively to adapt the UK model to NSW maternity services. Birthrate Plus focuses on women’s needs rather than midwife activity and is based on a standard of one-to-one midwifery care. Midwife time is increased

to reflect the additional needs of the higher risk categories of women. To establish required midwifery hours, data is collected over four to six months and captures all the activity within a maternity service including intrapartum care, postnatal and ante-natal care and parent education. Birthrate Plus will help in planning models of care. It may lead to reorganising some maternity services. Each service will have a project midwife that will collect, sort and check data.

Birthrate Plus® is a registered copyright

Birthrate Plus will be implemented in three phases. Phase one: Hospitals

Phase two: Hospitals

Phase three: Hospitals

that participated in the trial, with

that participated in the trial, but

that fit the criteria and did not

no significant changes to models

with significant changes to models

participate in the Birthrate Plus trial.

of care since the data collection

Birthrate Plus will be implemented

for the trial. Birthrate Plus will be

by June 2012.

implemented by June 2011.

implemented by December 2011.

Armidale • Shoalhaven • Orange

RHW • Lismore • St George

Mountains • Bathurst • Mudgee

Dubbo • Sutherland • Port

Nepean • JHH • Gosford

Manly/Mona Vale • Hornsby

Blacktown • Hawkesbury • Blue

Macquarie • Campbelltown • Wagga

Auburn • Bankstown • Canterbury

Wollongong • Maitland • Liverpool

Fairfield • Bowral • Queanbeyan

RPA • Westmead • RNSH

Goulburn • Tweed • Murwillumbah Mullumbimby • Coffs Harbour Grafton • Tamworth • Manning Base

Listing of hospitals provided by NSW Health 12 THE LAMP april 2011

Broken Hill • Moruya • Griffith

Birthrate Plus

‘It’s not perfect but it’s a big breakthrough’ Jan Dilworth, NSWNA Branch Secretary and CMC at RPA, has been a strong advocate for Birthrate Plus. ‘For some time we’ve needed a workload tool designed for maternity services. There has been no effective staffing tool.

1 A Birthrate Plus project manager is appointed at each maternity service. 2 The Birthrate Plus Manager from NSW Health visits the project manager at each service to provide information and plan the tool’s implementation. They decide the starting date for the collection of data.

‘Birthrate Plus helps in the planning of maternity services. Workloads in maternity services are unpredictable – you can’t plan exactly when a woman will be going into labour. Service planning and staffing needs to take this into account.

3 Data is collected by midwives for four to six months. The period for the collection is agreed with NSW Health.

‘Birthrate Plus focuses on a woman’s care needs, and contributes to measuring aspects of a midwife’s work providing this care. Birthrate Plus, while an effective tool for addressing staffing levels, does not examine skill mix issues when considering ratios of midwives caring for women and babies.

‘I think it’s important to consider that there may be teething problems implementing Birthrate Plus.

‘I am concerned that women and their babies are still counted as one unit and not separate in terms of providing care and staffing.

‘It’s been a long time coming and I’m very pleased to finally have this protection in the Award. It’s not perfect but it’s a big breakthrough.’

A workloads tool for NSW maternity services Birthrate Plus is a midwife planning tool that provides a comprehensive assessment of the staffing needed to provide the care required by a woman in maternity services. All aspects of midwives’ roles are considered from outpatient clinics and ante-natal services to birthing units and post-natal services. According to Julie Mate, Midwifery Manager of the Birthrate Plus Project, Nursing and Midwifery Office of NSW Health, ‘The tool provides a clear picture of staffing requirements for a service. It provides a retrospective assessment of all the events and factors arising in labour and birth using a score system based upon clinical indicators of the needs of women and their babies.

How will Birthrate Plus work?

4 Data is collated by the Birthrate Plus project manager.

‘Birthrate Plus is a big improvement for midwives but with any new system there’s a lot of learning to do.

‘Birthrate Plus will give managers of maternity services a tangible tool to help them staff their units appropriately. The tool will also identify problems in service planning and the deployment of midwives. There may be cases where Birthrate Plus shows there is correct staffing in a maternity service but midwives are still under pressure. This may be an indication that the distribution of midwives is a problem. Better planning and reorganisation of the service may be required. In these cases, NSW Health would recommend to managers that planning needs to be examined. ‘Birthrate Plus has been operating very successfully in the UK for the past 25 years. It’s provided great data that allows very effective planning of services.

5 Data is analysed by NSW Health. 6 The results reveal FTE numbers and determine the number of midwives required.

‘Each service will have a project midwife who will collect, sort and check data,’ said Ms Mate.

Careful adaption to NSW setting Agreement between the NSWNA and NSW Health followed a pilot project conducted in 20 hospitals to test the appropriateness of the Birthrate Plus tool in the NSW setting. The pilot project identified a number of facilities with serious staffing issues in maternity services. ‘It’s taken some years to get there. However, we’re finally here,’ said Judith Kiejda. ‘I know a lot of midwives are frustrated by the delay but fine-tuning was needed after the pilot in 2008. We needed to ensure the tool takes into account all facets of care required by women and babies and the range of complexities of care needs and acuity of patients. ‘We also needed to look carefully at how NSW services differ to those in the UK, and this required some changes to be approved for use by the tool’s UK owners,’ said Judith. THE LAMP april 2011 13

c o v e r s t o r y

1:1 is the minimum standard of care The Birthrate Plus pilot project determined that a ratio of one midwife to one woman should be the minimum standard of care in maternity services. Julie Mate explained that this ratio increases as risks increase.‘We have identified five categories of case mix from low risk to high risk. A woman’s case mix category carries right through from labour and birth to post-natal care. Staffing in these areas is based upon this case mix.’

A robust reasonable workloads process Judith Kiejda said, ‘We now have a workloads tool especially designed for maternity services in NSW, which will measure staffing needs and assess service planning. ‘Management will be responsible for filling staffing shortages identified by Birthrate Plus, and to improve service planning through the deployment of midwives and improvements in skill mix. Vacancies due to sickness or annual leave should be replaced with midwives of the same classification. ‘If management does not respond adequately to the identified staffing issues, members need to report it to the Reasonable Workloads Committee at their facility. The Reasonable Workloads

‘If management does not respond adequately to the identified staffing issues, members need to report it to the Reasonable Workloads Committee at their facility. The Reasonable Workloads process under the new award provides a robust process to address staffing issues.’ process under the new award provides a robust process to address staffing issues,’ said Judith.

Implementing Birthrate Plus Birthrate Plus will be implemented progressively in most maternity services in NSW between now and July 2012. It will be introduced first at the hospitals that participated in trial. ‘Implementation of the tool will mean more FTE positions in most maternity services. We’ll have a clearer picture when the testing has been completed in all maternity services in NSW that meet the criteria,’ said Judith. n

‘We’re very keen to see Birthrate Plus in place’ Birthrate Plus was trialed at RPA Hospital where Jacquie Myers works as a childbirth educator. Jacquie said the trial showed Birthrate Plus is a very comprehensive tool that covers all aspects of a woman’s care in maternity services. ‘Up until now we’ve had no effective mechanism to measure workloads and address staffing issues. Midwives are totally fed up. At RPA we’re very eager to see this in place. Birthrate Plus has been a long time coming. ‘The data collected for the trial shows RPA definitely needs more midwives on some shifts – especially after hours. Birthrate Plus provides a clear-cut mechanism that ensures a reasonable workload for midwives. ‘However, we need to ensure it takes into account all facets of care required by women and babies and the range of complexities of care needs and acuity of patients. ‘I hope it sets a precedent that flows through to the private sector.’

14 THE LAMP april 2011

Birthrate Plus takes into account case mix variations Judi Yeo loves her job working as CME at Dubbo Base Hospital and was part of the trial of Birthrate Plus in 2008. Judy said an important aspect of Birthrate Plus is that it takes into account variations in case mix. ‘It distinguishes between a normal case and cases with more complex care needs, higher acuity, with greater need for intervention. This is especially important in a rural setting where there are particular issues that impact on staffing. ‘Birthrate Plus also acknowledges the non-midwiffery duties required in caring for patients. ‘The trial indicated that there were staffing issues at Dubbo – with both staff numbers and the organisation

Birthrate Plus

of the service. Although Birthrate Plus hasn’t been implemented yet, management has made some staffing improvements since the trial, which have made a difference. Midwives have been deployed and skill mix improved. ‘Birthrate Plus is now part of the Award. We finally have an effective workloads tool that is designed for midwives. I can’t wait to see it implemented. ‘However, attracting and recruiting good staff may be a challenge.’

THE LAMP april 2011 15

c o v e r s t o r y

Timeline 2004 NSW Health and NSWNA commenced discussions about an Award entitlement for reasonable workloads for midwives employed in public health sector.

2005 Nursing and Midwifery Office and NSWNA began adapting and testing Birthrate Plus to reflect the NSW environment.

2006

‘We’ve not only achieved ratios for Public Health System nurses but we’ve also won a major breakthrough for midwives so they also can control their workloads. Judith Kiejda NSWNA Assistant General Secretary

16 THE LAMP april 2011

Birthrate Plus author was invited by NSW Health to NSW. A pilot commenced at 13 hospitals but was not completed as it was identified that further areas needed testing. The NSWNA and members identified problems and submitted areas needing change to NSW Health.

2008 Revised pilot project commenced at 20 hospitals, leading to adjustments.

2010 NSW health and NSWNA fine-tune tool for the NSW setting. NSWNA Organiser consulted with members at the trial sites

2011 The negotiated changes to Birthrate Plus were part of the proposed new Award voted up by NSWNA Branches in February.

ARE YOUR WORKMATES OR FRIENDS MEMBERS OF THE NSWNA? Why not ask them and if they aren’t, sign them up. Like you, they need the security of belonging to a strong and dynamic union. Not only will you be building your union by signing up a new member, you and a friend could win this fabulous holiday on Lord Howe Island. The more members you sign up, the more chances you have to win! The prize* includes a seven-nights’ stay with meals at Pinetrees Lodge, return flights for two on Qantaslink from Sydney, airport transfers on Lord Howe Island, and some activities.

Experience the natural beauty and tranquility of world-heritage-listed Lord Howe Island. Enjoy great food, good accommodation and outstanding hospitality at the historic Pinetrees Lodge. Pinetrees Lodge is situated on one of the prime aspects of Lord Howe Island as it has unsurpassed access to the lagoon. Cycling, reading, birdwatching, scuba diving, surfing, swimming and bush climbing – it’s up to you! And if you believe your cardiac health is up to it you can always attempt the challenging climb up Mt Gower. We have been told that this climb is worth every strenuous step as the views from the top are incredible.

So, if you are up for this sort of holiday where you will enjoy uncomplicated days, crystal clear waters and uncrowded and unspoilt beaches, make sure you ask the nurses and midwives you work with if they are members of the NSWNA!

HURRY! Call the Association now for a recruitment kit and recruitment incentive scheme details. Ph: 8595 1234 (metropolitan area) or 1300 367 962 (non metropolitan area) or go to www.nswnurses.asn.au DRA

WN 30 JUNE 2011

THE LAMP april 2011 17 *

Conditions apply.

i n d u s t r i a l

P r i v a t e

i s s u e s

h o s p i t a l s

Private hospitals gear up for new agreements

number of Enterprise Agreements in the private sector are due to expire in 2011, including Ramsay, which has 26 facilities in NSW. A Log of Claims Committee has been elected to identify terms for new agreements. During April and May, NSWNA officials will visit hospitals where agreements are expiring to discuss what members would like to be included in the new agreements. Jane Cooper, RN, at Figtree Private Hospital in Illawarra, was recently elected to the Log of Claims Committee. ‘Being employed in a private hospital I think it’s important we keep in the ballpark with the public system in terms of wages and conditions,’ she told The Lamp. ‘When you consider that our education is the same, our responsibilities are very similar and our skills are the same, it’s important we are properly remunerated and have conditions that ensure not only patient safety but also the health and wellbeing of our staff members. It’s easy for the private system to lag behind the public system unless we are proactive in securing good terms and conditions.’ In addition to pay rises, other peripheral issues are also important to secure in a new agreement, even though they may not affect all staff at the same time, according to Jane. ‘Take long service leave, for example. I work for Ramsay and we get the same long service leave benefits up to 10 years as the public system, but from 10 to 20 years working for Ramsay I’ll get two and a half months of long service leave, whereas if I worked in the public system, I’d get five additional months – and Ramsay is one of the better agreements. ‘This comes about from ignorance by members of their own agreement and that’s why it’s important that Association Delegates make their colleagues aware of where we stand, because not all issues come up for everyone all the time. Pay and

18 THE LAMP april 2011

‘It’s important we keep in the ballpark with the public system.’ Jane Cooper, RN, Figtree Private Hospital

overtime do, so people are aware of those, but they’re not aware of the less used terms of our conditions and how they compare with the public sector,’ said Jane. ‘In the private sector employees often fear that if they make too many demands of their employer their jobs will be threatened. It’s a fear members have and it’s important they understand that if they are able to form a Branch, the Branch works on their behalf, so if there’s an issue that is widespread throughout the hospital or organisation, the Branch is able to take it on board and have anonymity in terms of making some noise about it. ‘I’m one of the Officials in our Branch and I’m often asked by my colleagues about things they are unsure of. I can’t stress enough the importance of having a Branch at your facility,’ said Jane. n

P u b l i c

h e a l t h

How to form a Branch • Download a form from the NSWNA website • To form a Branch you need at least 10 financial members • Fill in the form and send details of these members to the NSWNA Council • Someone from the NSWNA will contact you to complete the process. n

s y s t e m

Implementation of ratios:

How will it work?

s members are aware, on top of nurse hours and equivalent ratios we have won pay rises of 3.9%, 3% and 2.5% over the next three years for public health system nurses. The first rise will be backpaid to the first full pay period in July 2010 and is being paid now. It will take time to sort out so stay tuned.

Association Officers are currently working with the Department of Health to determine the implementation of ratios, with a high priority being given to areas of need. In the meantime, information sessions will be held across the State by Judith Kiejda, Assistant General Secretary, and other Association Officers. These sessions will provide members with

A g e d

c a r e

ACS template agreement up for renewal g The NSWNA is preparing to negotiate the renewal of the template agreement for members working in the not-for-profit aged care industry.

he benchmark-setting template agreement negotiated by the NSWNA, Health Services Union (HSU) and employer association Aged & Community Services Association (ACS) expires at the end of June. ‘We will be sending out a survey to members requesting their feedback on what they would like included in the new agreement, as well as telling us what isn’t working in the current one,’ said NSWNA Assistant General Secretary Judith Kiejda. A Log of Claims Committee was elected last month and is working on a strategy to retain existing benefits as well as secure extra, improved conditions. NSWNA officials will embark on a regional roadshow to talk to members about the proposed new agreement. Judith Kiejda stressed the importance of coming to a session or completing the Association survey.

information on the implementation of the new staffing arrangements and how Nursing Hours Per Patient Day translates into ratios. Most of the sessions at metro hospitals will be held throughout April, and rural and regional sessions are due to begin from mid-May. Full details of the information sessions will be available on the NSWNA website www.nswnurses.asn. au. Information will also be emailed to all members and hard copies will be displayed at each site. n

The first two-year agreement came into effect in 2007 and improved and protected the wages and conditions of thousands of members working in the not-for-profit aged care industry. It was secured at a time when the Howard Government’s WorkChoices legislation abolished the Nursing Homes &c. Nurses’ (State) Award. ‘We hope that employers will work with us to put together a third two-year agreement that will see aged care nurses in this sector continue to be valued for their hard work.’ Christine Spangler, AiN at St Anne’s Nursing Home in Broken Hill, was recently elected to the Log of Claims Committee. ‘I’m hoping I can make a positive contribution to our Log of Claims because I’m an AiN and all aged care nurses get a raw deal in aged care,’ she told The Lamp. ‘It’s important for members to take the time to fill the survey out and send their feedback to us on what they would

‘It’s important for members to take the time to fill the survey out and send their feedback to us on what they would like to see in the agreement.’ Christine Spangler, AiN, St Anne’s Nursing Home, Broken Hill.

like to see in the agreement. One issue we’ll be looking at, of course, is pay rises and also workloads and conditions. We’ll wait for the surveys to come back to dissect any other claims.’ Christine urged members without a Branch to form one at their facility. ‘You get a much better idea of what is going on with a Branch as you have access to NSWNA officials who come out to your site and explain the proposals in the agreement,’ she said. ‘I would strongly encourage nursing staff in aged care to form a Branch if they don’t already have one.’ n

New resource for calculating nursing hours The NSWNA has produced a spread sheet that allows members to calculate the number of nursing hours available per week for their ward. It enables members to model the impact of the new hours available on staffing on a shift-by-shift basis. To use the tool you enter the Nursing Hours per Patient Day (NHPPD) for your ward and the average number of patients. This gives you the

number of nursing hours that you are entitled to each week. The NUM, in consultation with nurses working on the ward, can use the tool to allocate nursing hours across the different shifts in the course of the week. The equivalent ratio will also be displayed after the NUM has allocated the nursing hours. The new calculator is available on the NSWNA website www. nswnurses.asn.au. n

THE LAMP april 2011 19

a g e d c a r e

ANF Federal Secretary Lee Thomas handed a petition containing 26,000 signatures from the public supporting the ANF’s claims to Productivity Commissioner Mike Woods.

Productivity Commission urged to fix wages gap g The ANF has highlighted the need for wages in aged care that are competitive with the public and private sectors in its final report to the Productivity Commission.

ged care needs a transparent, enforceable industrial instrument to deliver a competitive wage that will keep nurses in the sector, the ANF has said in its final submission to the Productivity Commission inquiry ‘Caring for Older Australians’. The ANF proposes that the sector comes together to create a national industrial framework that would specify the wages to be paid to nurses and other care staff. These wages would then be embedded in enterprise agreements. In its draft report released in January the Commission acknowledged that low pay and conditions were at the heart of workforce issues in the sector but it failed to set a clear direction to solve the problem.

20 THE LAMP april 2011

The Federal Minister for Ageing Mark Butler also recognises the centrality of workforce issues. ‘Continuity of care, fairness and the capacity to recruit and retain an adequate workforce are all wound up very clearly with this question of wages,’ he said. ANF Secretary Lee Thomas said the Productivity Commission needs to consider more fully the issue of wages. ‘It is not unusual for a nurse working in aged care to earn on average $300 week less than nurses working in other sectors. When times get tough and budgets get tighter, nurses need to make decisions and if they can earn up to $300 a week more by working in the public hospital down the road, then those decisions have to be made,’ she said.

ANF puts skill mix and licensing on the table In its submission, the ANF has also proposed minimum RN and EN staffing levels in aged care. It has proposed one nurse allocated to: • 4 residents per day shift • 6 residents per afternoon shift • 15 residents per night shift. The ANF argues that a minimum of 3.85 hours of nursing per is needed per resident per day. However, with the additional time required by nurses for indirect care responsibilities the ANF is recommending a guaranteed minimum of 4.5 hours of care per resident per day. Independent reports have found that an RN on average is currently delivering just 22 minutes of care per day per nursing home resident. In its initial draft report the Productivity Commission rejected the ANF’s proposal for national licensing of AiNs. The ANF has asked the Commission to revisit this decision given the public interest in the protection of frail and vulnerable residents that care workers look after. ‘All children’s services workers are required to meet this test, including volunteers, and the same protection should be afforded to older Australians,’ said Lee Thomas. The ANF also recommends that a Registered Nurse cover a facility 24 hours per day and that each facility that employs nurses must employ a full-time Director of Nursing. n

Nurses rally outside Productivity Commission in Melbourne Over 60 aged care nurses demonstrated outside the Productivity Commission building on 21 March in Melbourne demanding better wages and more quality care for older Australians. The nurses were met by the Productivity Commissioner Mike Woods, who was presented with a petition containing 26,000 signatures of support from the public by ANF Secretary Lee Thomas. A similar rally was to be held in Sydney just after The Lamp went to print.

ANF Federal Secretary Lee Thomas (third from left) and ANF (Victorian Branch) Assistant Secretary Yvonne Chaperon (next to Lee) joined members outside the Productivity Commissionâ&#x20AC;&#x2122;s offices in Melbourne to call for better wages and conditions for aged care nurses. THE LAMP april 2011 21

a g e n d a

Stop Press The Republicans rammed through their legislation that effectively ends collective bargaining in Wisconsin. To pass the bill, the Republicans removed all language about budgets, finances and fiscal impacts. This, they said, meant it had no financial impact and therefore didn’t require the 60% quorum required by Wisconsin parliamentary rules. Consequently, the bill passed without the presence of the Democrats.

Public sector workers under attack in Wisconsin g Republicans blame public sector workers for economic crisis.

passionate debate has erupted across the United States about the right to collectively bargain and a fight has started for the very existence of public sector unions. The epicentre of this battle is Wisconsin, a Midwestern state of six million people where the newly-elected Republican Governor Scott Walker has introduced a Bill – to Australians eerily reminiscent of WorkChoices – that would end collective bargaining rights for state employees. The Bill would also force employees to increase contributions to health and pension funds. Hidden deep in Walker’s new laws are provisions that would allow the privatisation of key public assets at the whim of the Governor and without legislative oversight.

22 THE LAMP april 2011

The Bill would end collective bargaining rights for state employees. It would also force employees to increase contributions to health and pension funds. American economist Richard Wolff says these draconian measures are part of a wider national campaign to make local public-sector employees pick up a major share of the costs of the economic crisis. Conservative governors in other states such as Ohio and Florida have flagged similar legislation. ‘The GFC has decimated federal, state and local budgets. Federal, state and local governments are staggering from reduced tax revenues because of unemployment, reduced production, lower investment and the housing collapse. There is a

growing drive to cut services, wages, benefits and employment,’ he said.

Unions fight back Walker’s vicious attack on public sector workers has provoked a backlash. Unions have mobilised public support with massive daily rallies in the centre of Madison, Wisconsin’s capital. Democratic Party politicians have tried to sabotage the Bill by fleeing to the neighbouring state of Illinois and preventing a quorum of the state legislature.

These draconian measures are part of a wider national campaign to make local public-sector employees pick up a major share of the costs of the economic crisis. Even the Oscars were punctuated by public gestures of support by award winners. The attack on public sector workplace rights has sparked a national discussion about unions and who should really be taking responsibility for the economic crisis.

• They oppose (56% to 37%) cutting the pay or benefits of public employees to reduce deficits; • 61% of those polled – including just over half of Republicans – said they thought the salaries and benefits of most public employees were either ‘about right’ or ‘too low’ for the work they do.

A majority of Americans support the unions’ cause

It’s about power not budget

A majority of Americans are opposed to cutting the pay and rolling back the rights of public sector workers in order to reduce state budget deficits, according to a New York Times/CBS News poll. • The poll found that: Americans oppose weakening the bargaining rights of public employee unions by a margin of nearly two to one (60% to 33%);

Paul Krugman, a Nobel Prize-winning economist writing in the New York Times, said the war by the Republican Party against unions in Wisconsin was not about the state budget but about a bigger issue of power. ‘On paper, we’re a one-person-onevote nation; in reality, we’re more than a bit of an oligarchy, in which a handful

of wealthy people dominate. Given this reality, it’s important to have institutions that can act as counterweights to the power of big money. And unions are among the most important of these institutions,’ he said. ‘You don’t have to love unions, you don’t have to believe that their policy positions are always right, to recognise that they’re among the few influential players in our political system representing the interests of middle- and working-class Americans, as opposed to the wealthy. Indeed, if America has become more oligarchic and less democratic over the past 30 years – which it has – that’s to an important extent due to the decline of private-sector unions.’ Krugman says it is ironic that the very people who caused the crisis in the first place are driving the antiunion agenda in Wisconsin. ‘The fiscal crisis in Wisconsin, as in other states, was largely caused by the increasing power of America’s oligarchy. After all, it was super wealthy players, not the general public, who pushed for financial deregulation and thereby set the stage for the economic crisis of 2008-2009, a crisis whose aftermath is the main reason for the current budget crunch. ‘And now the political right is trying to exploit that very crisis, using it to remove one of the few remaining checks on oligarchic influence.’ continued on page 25 THE LAMP april 2011 23

24 THE LAMP april 2011

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Union, collective bargaining under attack in Winsconsin

continued from page 23

‘They’re taking away the voice of the little guy’

Joe Cidoni, an American nurse who works as an RN at Gosford Hospital, says the feedback he is getting from his friends in America is one of disgust at the attack on public sector workers in Wisconsin. ’The [Wisconsin] government is trying to undermine the rights of workers to negotiate their conditions and their work environment. We are going back to the dark days when workers were dictated to,’ he says. ’We have a long history of trade unionism in the United States. It’s only through the labour movement that there is a voice for the little guy. Now they are trying to take away that voice.’ Joe says he is proud of the way public sector workers and their unions are fighting back. ’What is important is that people get organised, stay organised and stay the course. If we do, we will win as we did before.’ n

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Reith puts WorkChoices back on Liberal agenda Former Liberal Industrial Relations Minister Peter Reith has resurfaced from obscurity to urge Tony Abbott ‘not to be afraid’ or be ‘spooked’ by a scare campaign on WorkChoices and make labour market reform Australia’s number one priority. Reith’s restatement of a Liberal Party article of faith was warmly supported by a host of current Liberal Party backbenchers. ‘Peter Reith has been there, he’s done this stuff before. He is absolutely spot on the money,’ said South Australian Liberal MP Jamie Briggs. ACTU President Ged Kearney said that Peter Reith’s call to arms was further proof that WorkChoices was embedded in the Liberal Party’s DNA. ‘Tony Abbott’s claims during last year’s election that the Liberals would never go back to WorkChoices are a sham.’ n

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a g e n d a

Choosing a dignified end g How legislative change could provide more end-of-life choices for the terminally ill.

ying With Dignity, a group founded in the 1970s, wants to legalise medicallyassisted dying or Voluntary Euthanasia (VE) in New South Wales. It is currently an offence in this state to assist a person to die. Nurses, doctors or family members who assist a dying person to end their lives risk deregistration and criminal prosecution. Dr Sarah Edelman, a Clinical Psychologist and a member of Dying With Dignity, says the group’s main goal is to influence the political process to bring about legislative change. This would enable people who are hopelessly ill and suffering to exercise the choice to end their lives peacefully without fear of loved ones or medical practitioners being criminally charged. People who support Medically Assisted Dying recognise that legal safeguards should be in place – for example, against greedy relatives – so that people don’t feel pressured to end their lives. There are already several countries that have legalised VE including US states Washington (2009), Oregon (1997) and Montana (2010); the Netherlands (2000); Switzerland; Belgium (2002); Luxembourg (2009); and Albania (1999). Research and case studies show that the models are working well. Surveys and case studies also overwhelmingly show that public support for the issue has been steadily increasing over the past 20 years:

85% of Australians support VE

when a person is terminally ill and suffering (Newspoll 2009) w 75% of Christians support VE (Newspoll, 2007) w 58% of those with non-Christian religions support VE (Newspoll, 2007)

‘Dying with dignity is a very important goal of the care provided in palliative care.’ Sharon Wiley, a Palliative Care CNC at Sacred Heart Hospital.

91% of those with no religion support

VE (Newspoll, 2007) w 80% of nurses who responded to a NSWNA survey (1997) supported VE in some circumstances.

VE is talked about but rarely asked for Palliative Care is an important aspect of medically-assisted deaths and in Belgium and Oregon (the more recent converts to VE), the amount of spending and resources on palliative care have increased substantially. Sharon Wiley, a Palliative Care CNC at Sacred Heart Hospital, says euthanasia is often about control not just dignity. ‘From a palliative nurse’s perspective, dying with dignity is a very important goal of the care provided in palliative care. However, based on my own experience of caring for many

palliative care patients the topic of euthanasia is often raised but rarely requested. ‘Advances in palliative care have meant improvement in the available medications including opioids that are simpler to administer and are very effective in relieving suffering. Each request needs to involve open, sensitive communication in the clinical setting. This usually involves comprehensive palliative care support from a multidisciplinary team. The request for euthanasia is often about control rather than dignity.’ Dr Edelman agrees that palliative care is important. ‘We feel palliative care is really important. The issue for us is about choice and we feel that the option of end-of-life choices should be part of palliative care.’ n

Choosing a dignified end Dying with Dignity’s charter states that: People with a terminal or incurable illness that creates unrelievable, profound suffering shall have the right to choose to die with dignity in a manner acceptable to themselves and shall not be compelled to suffer beyond their wishes. No individual, group or organisation shall be compelled against their will to either participate or not participate in an assisted or supported death of a sufferer. It shall not be an offence to confidentially advise a sufferer regarding a voluntarily-chosen death, assist or support such a death, or to be present at the time of that death. Sufficient safeguards shall be in place to prevent abuse of the process. The charter is supported by the NSWNA. THE LAMP april 2011 27

p r o f e s s i o n a l i s s u e s

Attracting new grads to aged care g New grads entering the nursing profession are finding new opportunities in the aged care sector in rural areas.

t’s no secret that Australia is facing a shortage of nurses in aged care and is increasingly unable to meet the needs of a rapidly ageing population. ‘Wage disparity has led to a staffing crisis. Ignoring this issue means the problem of attracting nurses and Assistants in Nursing to aged care will continue long into the future,’ said ANF Federal Secretary Lee Thomas. Under current policy, the demand for aged care services is unable to keep up with its supply. Cracks in the system will most likely begin to show by 2012, according to an Access Economics’ report called Caring Places, Volume 2 and the draft Productivity Commission report. The report says that dementia-related illness will become more prevalent and will begin to put a strain on the aged care sector. Aged care nurses, qualified and ready, are needed now more than ever.

Employers look for incentives Aged care employers are beginning to feel this strain with low wages and working conditions making recruitment of younger nurses and recently graduating nurses into the sector, particularly in rural areas, a challenge. ‘Aged care is not sexy. It is becoming more difficult to attract younger nurses to rural areas as they seek opportunities in big cities. It’s essential that RNs remain in aged care mainly due to our diagnostic skills,’ said Penny Temple, RN, General Manager Horton House and Warmington Lodge in Yass. Not-for-profit and for-profit aged care employers in rural areas, wanting to nip this problem in the bud, are offering recruitment incentives to RNs in the hope of attracting new blood into the sector. 28 THE LAMP april 2011

Aged Care Services (ACS), an industrial organisation of employers of aged care and community care providers in the not-for-profit and charitable sector, offers a one-day course for RNs designed to assist them entering into the aged care sector. There has been a growing demand for this course, particularly in rural areas. ‘We run courses in 10 regional areas from the far west to the far south coast and this course usually receives a lot of interest,’ said Margaret Bundred, Learning Centre Manager at ACS. The course looks at various components of aged care: the changing environment of aged care and how RNs need to adopt solutions to adhere to these changes; scope of practice principle – which looks at what other members of the care team, such as ENs and EENs, can do so that RNs don’t burn out; leadership supervision and delegation; responsibility and accountability; and the comprehensive assessment of an aged care client.

Not-for-profit and for-profit aged care employers in rural areas are offering recruitment incentives to RNs in the hopes of attracting new blood into the sector.

‘Due to the shortage of RNs in aged care, we have to increase delegation and strong teamwork with ENs, AiNs, and PC staff. The course was excellent in teaching us about competencies and finding the right skill mix for staff.’ Lyn Jones, aged care RN at Horton House and Warmington Lodge.

Courses and incentives to attract nurses Lyn Jones, an aged care RN at Horton House and Warmington Lodge in Yass, says it is difficult to recruit RNs to rural facilities due to the low pay scale, but courses like the one offered by ACS do prepare RNs to meet the growing expectations of the communities they live in and the ever-increasing challenges of the sector. ‘Due to the shortage of RNs in aged care, we have to increase delegation and strong team work with ENs, AINs, and PC staff. The course was excellent in teaching us about competencies and finding the right skill mix for staff,’ said Lyn. ‘There’s a big demand for this course in aged care, so it was also an opportunity for some of the newer RNs to attend this course and get a skills upgrade,’ she said.

clinical exposure as well as professional development sessions. Into its second year, the program started with 20 nurses who had just completed their Bachelor’s Degree in Nursing in aged care. Margaret Ryan, the Learning and Development Manager for BUPA, agrees there is a need for new blood in the sector but also saw it as an opportunity to develop existing staff. ‘About four participants in the program were existing staff members who had worked as AiNs. They were looking for those opportunities in aged care to progress and develop their leadership skills.’

Comprehensive RN training

Graduates from Bupa's training program in 2011 are ready to put their newly acquired skills into practice in aged care.

Horton House and Warmington Lodge, a community-based, not-forprofit facility, is trying to attract younger nurses, as its core group of dedicated RNs is getting older. Penny Temple told The Lamp that, along with her board of directors, she decided to take matters into her own hands to address this issue. They now offer a $5,000 dollar scholarship to second-year student nurses through the Australian Catholic University. The main criteria to qualify for the scholarship are having aged care as an elective and passing all subjects. Nurses, upon receiving their Bachelor’s Degree in Nursing would work for the facility for 12 months. They would be offered a full-time appointment and accommodation.

‘Our first recipient has just gone into third year. We hope we have an ongoing supply of younger and highly qualified nurses. It’s our way of trying to promote aged care as an option for younger nurses in rural areas,’ said Penny. ‘One of the problems with aged care is that we don’t have wage parity. If we had that, we would be able to attract and retain nurses,’ she said.

Developing existing staff BUPA also offers a Graduate Nurse Program that places newly registered nurses into BUPA facilities around the country as part of their training. The program, run in conjunction with The College of Nursing, is designed to attract recent graduate nurses to the aged care industry, giving them hands-on

Chesalon Care Beecroft, a not-for-profit residential aged care facility, offers an informal graduate program, which manager Sharon Cumming is hoping to formalise. ‘We’ve had three recent graduates in the past 12 months we’ve been training. They’ve taken to the profession like ducks to water and are performing really well. Two out of the three have stayed on to work for us,’ she said. The program at Chesalon Beecroft consists of initially partnering up recent grads up with more experienced nurses until they’re ready to work independently. Sharon considers the combination of clinical, counselling, palliative and management skills that working at an aged care facility offers as a winning combination for the comprehensive training of RNs. The program has been so successful for Chesalon Beecroft in terms of recruitment and retention of young RNs into the profession that Sharon now places in their job ads: ‘Graduates will be supported’. n

93% of residential aged care workers are women. 60% of residential workers are over 45. 70% of community workers are over 45. THE LAMP april 2011 29

n u r s e u n c u t

What’s hot on Nurse Uncut g Celebration of ratios and better pay for public health system nurses, parts two and three of national registration series, International Women’s Day, NSWNA encourages Wisconsin Governor to rethink, and private health insurance. Read all the latest happenings at www.nurseuncut.com.au. International Women’s Day 100 years of progress towards equality http://www.nurseuncut.com.au/ international-womens-day/

On 8 March, the world celebrated 100 years of progress towards gender equality. International Women’s Day, however, is both a day to celebrate and a day to draw attention to the challenges that remain before gender equality is truly realised.

We highlight readers’ frustrations with APHRA and discuss the Continuing Professional Development requirements. Many of readers’ questions, such as ‘Why is CPD necessary?’ are answered in the FAQ post.

Congratulations on ratios and better pay http://www.nurseuncut.com.au/ congratulations-on-ratios-andbetter-pay/

Public health system nurses and midwives are to be congratulated on their outstanding achievements, won after a hard-fought campaign. Following the vote by Branches, the NSWNA signed the agreement for the new public heath system award with NSW Health and formally ratified the award in the Industrial relations commission on 23 February.

NSWNA urges Wisconsin Governor to rethink, for the good of nurses and patients http://www.nurseuncut.com.au/ nswna-urge-wisconsin-to-rethink-forthe-good-of-nurses-and-patients/

In Wisconsin, Governor Walker has announced plans to reduce or remove collective bargaining rights of public sector workers including nurses.

Series on National Registration – Part 2 and 3

NC263354

http://www.nurseuncut.com.au/ series-on-new-national-registrationpart-2/ and http://www.nurseuncut. com.au/national-registration-part-3countinuing-professionaldevelopment-requirements/

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30 THE LAMP april 2011

c o m p e t i t i o n

Win a trip to What’S NEW IN THE FORUMS? Instrument nurse: RN or EEN?

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Blue Mountains

http://www.nurseuncut.com.au/forum/component/ option,com_ccboard/Itemid,24/forum,13/topic,640/ view,postlist/

I am interested in how many EENs are instrument nurses in the operating theatre. Please let me know on the ratio of RN to EEN. Where I work there are 38 RNs to 3 EENs. Do you still scrub? If not ,why? Have you had any bad and/or good experiences? What are the thoughts of RNs on having an EEN being the scrub nurse? Most of the RNs welcomed us and some did not want us to scrub.’

APHRA Registration Hassles http:/nurseuncut.com.au/forum/component/ option,com_ccboard/Itemid,24/forum,13/topic,632/ view,postlist/#ccbp3658

‘If they can’t cope now with a large volume of applications and renewals spread across Dec to Feb, why on earth would they want to move all the renewals to the same date? Surely that’s even worse?’

Understanding Nursing Interventions http://www.nurseuncut.com.au/forum/component/ option,com_ccboard/Itemid,24/forum,5/topic,636/ view,postlist/#ccbp3647

‘I’m in my second year of nursing and I am unsure what is meant by nursing interventions. I have an essay to do on gastro in a two-year-old and it is playing with my head as to what it means. I have asked the teacher and that wasn’t very much help, not once have we discussed what it means.’ n Visit our forums and www.one2four.com.au and show your support!

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Hospitals, Aged Care Facilities, Community

The Lamp is offering one lucky reader the chance to get away to the Blue Mountains where you can relax or get more physical with a game of golf. Break away from the city and take a moment to treat yourself and a friend at Fairmont Resort. The Fairmont Resort is an iconic destination set within the World Heritage-listed Blue Mountains. The Fairmont has a range of dining and leisure experiences with two restaurants and one bar. Prize includes: A night for two plus breakfast and dinner in Jamisons Restaurant with a bottle of wine, and a free game of golf at Leura Golf Club including the use of a motorised golf cart. Situated opposite the Fairmont Resort, Leura Golf Club is one of the Blue Mountains leading golf courses. The 14th hole is rated in the top 10 worldwide, with spectacular views over the Jamison Valley. As an exclusive offer for NSWNA members, Leura Golf Club is offering members a special price of $25 for 18 holes of golf and motorised golf carts for $25. For more information on the Leura Golf Club visit www.leuragolfclub.com.au. For more information on Fairmont Resort visit www.fairmontresort.com.au or for reservations email reservations@fairmontresort.com.au or call 02 4784 4141. To enter this month’s competition, simply write your name, address and membership number on the back of an envelope and send it to: Blue Mountains competition 50 O’Dea Avenue, Waterloo NSW 2017 Competition ends 30 April 2011 *Terms and conditions apply. Subject to availability.

THE LAMP april 2011 31

hen most people think of us, they think of guide dogs. But a guide dog is just one of the ways in which we can help people with impaired vision. For some, a GPS system that gives audible directions may also be helpful. It’s just as trustworthy but doesn’t need brushing. And just like a homing pigeon, it never gets lost. Everybody has different needs. That’s why here at Guide Dogs we provide a wide range of free equipment, training and mobility advice, designed to suit all types from all walks of life. To f ind out how Guide Dogs NSW /AC T helps people with impaired vision get around safely, call 1800-GUIDEDOGS or visit guidedogs.com.au today.

Q & A

ASK

JUDITH when it comes to your rights and entitlements at work, nswna assistant general secretary judith kiejda has the answers.

Surely aged care residents have rights? I am an RN in a nursing home where we have two starting times for day shift: 6am and 7am. The DoN has told me that I am to direct employees who start at 6am to get residents out of bed, showered and in chairs. While there are a couple of residents who like to get up early, the majority are not happy to be woken and showered at this time, and the nursing staff feel terrible doing this. Should this be happening? I thought the residents had rights.

Yes, you are correct. The residents do have rights. Under the Charter of Residents’ Rights and Responsibilities it provides that each resident of a residential care service (which includes an aged care home) has the right to be treated and accepted as an individual, and to have his or her individual preferences taken into account and treated with respect.

How often must I have a police check?

What leave can I get to look after a sick relative?

I work in a nursing home, and was required to undertake a police check when I commenced at the facility. Do these checks have to be renewed on a regular basis, or is it only on commencement of employment?

I am an RN working in the public sector. If I need to care for my sick mother-inlaw, am I still eligible for FACS leave and Carers leave under the award?

Police checks should be undertaken every three years. However, employees who are convicted of an offence within the three-year period between obtaining and renewing their police check have an obligation to notify their employer of the conviction.

Can rostering negatively affect my annual leave loading? I work rotating shifts in a public hospital and recently took some annual leave, but was placed on the roster as working Monday to Friday. This is not an accurate reflection of what I would have worked over a seven-day period and means that I am not paid the appropriate annual leave loading. I was paid a loading of 17.5% instead of the weekend penalties that I would have received had I worked a normal roster. Can my manager do this?

No. When putting a roster together, management needs to reflect what you would have worked had you not been on annual leave. This ensures that the appropriate annual leave loading is paid. According to section 15 of the ‘Annual Leave’ policy of NSW Health (PD2006_089), this is 17.5% of the penalties that you would have received had you been working over the period.

You are entitled to take Family and Community Services (FACS) Leave to care for your mother-in-law who is unwell according to clause 32, sub-clause (iv) of the Public Health System Nurses and Midwives (State) Award. This defines a mother-in-law as a relative by ‘affinity’ (ie. as a result of marriage). If your mother-in-law is a member of your household you can access personal carer’s leave for this purpose under this clause. If she is not a member of your household you can only take FACS leave for this purpose. However, you may be able to negotiate annual leave or long service leave with your manager.

What are my rights regarding taking long service leave? I am an EN in the public sector and have accumulated about 10 weeks of long service leave (LSL) and I am thinking of taking some of this leave. What are my rights in this regard?

The NSW Health Policy Directive re LSL PD2006_092 states at page 15, Section 12. the minimum periods of long service leave: Whilst the taking of long service leave is by mutual agreement between an employee and the employer, where an employee has accrued the appropriate entitlement the employer should ensure that there are no unnecessary constraints on that leave being taken at a particular time. n

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THE LAMP april 2011 33

occupational health and safety

Bariatric patients... weighing up the issues g As the number of bariatric patients continues to increase, so do the associated risks and costs. In addition to specialist equipment, there is also a need for systems to be in place to ensure a safe environment for both patients and nursing staff.

n 2001 37 bariatric patients were admitted to Manning Base Hospital in Taree. By 2010 that number had increased almost tenfold, with 332 patients weighing between 130kg to 293kg. This included a pregnant woman weighing 194kg. Over a 10-year period the average weight of a non-ambulant patient at the hospital was 164kg and the heaviest patient was a staggering 293.4kg. Clearly there is potential for manual handling incidents for nursing staff, and injuries to patients unless proper equipment and systems are in place to manage bariatric patients. ‘We are in a country area so if you want to fly a patient out of the north coast in a fixed-wing plane the weight capacity is 150kg. If you’re in a helicopter it’s 180kg,’ says Eddie Wood, manual handling co-ordinator at Manning Base. ‘If you take the case of the194kg woman pregnant with her first baby as an example, we have to look at the risk – in other words, what can go wrong and what is the best way to transport the mother and baby and the 32kg of equipment that has to go with them. We rang the Sydney Helicopter Service and they put a special heavy-duty helicopter on standby. In the end we didn’t need it, but these are the things you have to have in place in case of an emergency. ‘When I visit various hospitals and nursing homes and ask staff the weight capacity of their beds and lifters, often they don’t know. If you don’t know the weight capacity of your equipment, you can’t safely put a patient on a bed or use a lifter and maintain patient and staff safety,’ says Eddie. 34 THE LAMP april 2011

Developing a bariatric risk management plan To this end Eddie has developed a bariatric risk management plan. The plan includes the use of the Red Dot Mobility System that rates a patient’s mobility on a score of one to four red dots displayed above the patient’s bed. One dot means a patient can walk unaided, and four means they are non-ambulatory. For more information on the Red Dot Mobility System, call Eddie Wood on 02 6592 9393

In order to manage bariatric patients safely, hospitals need specialised equipment. ‘You’ve got to work it out from when the patient comes into ED,’ explains Eddie. ‘The patient may come in an ambulance or walk in. From the ambulance perspective, the first thing you must have is a bed you can put the patient on. The weight capacity of bariatric beds here at Manning Base goes up to 350kg. We have roughly 200 beds: 60% can take 250kg, 20% can take 200kg and the rest 350kg.

‘The heaviest patient we had at Manning Hospital was 293kg – too large for some of our smaller, 20-bed hospitals to provide safe care where equipment has a weight capacity of 200kg.We have clear directives so that the ambulance takes them straight to a larger hospital where they can be managed in a safe manner with staffing and bariatric equipment.’ Eddie Wood, manual handling co-ordinator at Manning Base.

‘The second thing to consider is how you are going to weigh this patient. You can’t take them to the operating theatre unless you weigh them because the anaesthetist needs to know the weight of the patient. So you need a bariatric electric weighing device. We have six 300kg electronic omega lifters with an electronic weighing device, one on each floor of the hospital. ‘Bariatric patients here stay on the same bed for the whole hospital stay. So they go back on to the 350kg bed and are taken to ICU, where they will be nursed and a mobility plan put in place. ‘The patient will hopefully start getting better so they’ll need a chair to sit on. And you have to take them for a shower, so you need a 350kg capacity commode chair,’ says Eddie.

Good for nurses, good for patients Having this type of equipment is not only beneficial to patients, it can also reduce the number of manual handling incidents. Manning Base Hospital saw the number of staff injured in 2009 drop to just three, compared with 68 in 1996-1997. ‘We have 16 lifters – every single ward has a 300kg lifter and a 200kg lifter so there is no walking from one area to another to get it. They are all electric. We have standardised equipment throughout the hospital and training is done on the same equipment,’ says Eddie. ‘Staff don’t do any lifting – under no circumstances are nurses to lift patients. We position them but don’t physically lift them.’ Bariatric equipment is expensive, costing Local Health Networks (LHNs) millions of dollars. However, it is needed

for safe patient care. Equipment for bariatric patients is a lot more expensive because of higher engineering requirements. For example, a bariatric bed costs $8,900 and a regular bed $3,000. ‘At Manning, we have spent $325,000 on bariatric equipment and $478,000 on electric beds,’ says Eddie. Aside from financial costs, nonambulatory bariatric patients also require a higher number of staff to perform basic nursing and physiotherapy. For example, a non-compliant diabetic female patient admitted to Manning Base in September 2007 who remained there until February 2008 required a total of 10,912 staff attendances over the six-month period of care. According to Eddie, this many resources would not have been used with a non-bariatric patient. Not all hospitals are designed to cope with bariatric patients. However, thanks to pressure from the NSWNA, the Australasian Health Facility Guidelines now include the requirement for all new and renovated hospitals to have a proportion of oversized patient rooms and bathrooms that accommodate bariatric equipment. However, the guidelines are not always effectively followed. A common problem is placing toilets too close to the wall so that bariatric equipment and patients do not fit. This is partly a problem with too rigid compliance with Australian Standards for access in bathrooms and toilets. ‘Each facility must look at the physical dimensions of the hospital before they decide what equipment they get,’ says Eddie. ‘I’ve done a risk plan for Hunter New England so we have designated hospitals where bariatric patients go. The heaviest patient we had at Manning Hospital was 293kg – too large for some of our smaller, 20-bed hospitals to provide safe care where equipment has a weight capacity of 200kg. We have clear directives so that the ambulance takes them straight to a larger hospital where they can be managed in a safe manner with staffing and bariatric equipment. ‘If you don’t know what bariatric patients are coming in to your hospital you can’t manage them so you have to have simple flagging systems for ambulances, aircraft, helicopters and hospitals.’ continued page 36 THE LAMP april 2011 35

occupational health and safety

Bariatric patients... weighing up the issues

continued from page 35

Managing bariatric patients at smaller facilities As part of the redevelopment of Orange Base Health Service, a dedicated bariatric room was installed, in which staff are able to move patients out of bed with a hoist and take them to a bariatric toilet, shower and chair. But because the Far West and Western NSW Local Health Networks also have some very small facilities they developed a bariatric policy, which classified hospitals from A to D, with D facilities being those that could only take self-caring bariatric patients. ‘It’s not just about the equipment, it’s about the number of staff available,’ says Judy Robinson, risk manager for the Far West and Western NSW Local Health Networks. ‘If it’s outside a hospital’s available resources, the patient will be transferred to an appropriate facility to ensure the safety of both the patient and staff. ‘You must have a very clear guide for small sites to ensure they are empowered to manage the safety of both the patient and staff appropriately. Our hospitals know what their rating is and the policy states that at a D hospital you have to have

basic equipment such as a bed, toilet and lifter that has the weight capacity to manage the patient weight. At an A-rated facility we need to demonstrate the ability to manage a patients who may require high-level care such as intensive care, including capacity for X-ray, CT and theatre. This includes the ability to supply extra staff to care for the bariatric patient. ‘B and C facilities are in between, so B may do high-dependency care but probably not surgery. C is probably the majority of our hospitals where patients are self-caring with not a high level of care required because a lot of our hospitals only have two staff on a shift, so you can’t have really heavy patients because even with the lifters and specialised equipment you still need several staff to help manage the situation,’ says Judy. As the Emergency Departments at each facility replace their beds, the aim is to ensure that at least one bed is bariatric. The LHNs also have a small loan pool of equipment that they lend to small sites which is suitable for short-term and self-caring bariatric patients.

In terms of manual handling injuries, Judy says these are still common but are far less severe than in previous years. Judy Robinson, risk manager for the Far West and Western NSW Local Health Networks

In terms of manual handling injuries, Judy says these are still common but are far less severe than in previous years. ‘Rather than disc or bone or high-level injuries where people could be medically retired, we’re seeing more soft tissue injuries and a day off or no time off. This is due to having proper equipment and training and increased awareness.’ n

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www.nursing.edu.au CON LAMP 11.03 The Lamp 84x176.indd 1 36 THE april 2011

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occupational health and safety

NSWNA blocks move to cramped premises 6 Action taken by the Association addresses OHS problems for community teams at Bulli Hospital.

n May last year the then Illawarra Area Health Service was pushing ahead with plans to move the Aged Care Assessment Team (ACAT) and Transitional Rehabilitation Aged Care Service (TRAC) teams at Port Kembla Hospital to a new building at Bulli Hospital. But the new premises were way too small – in fact, only big enough for one team. After members raised the alarm, the NSWNA conducted an inspection and raised a number of OHS concerns with the AHS.

After months of negotiations, the AHS has rectified the OHS issues raised by the Association. The NSWNA inspection identified several problems. The major issue was that the space was too small and OHS officers found that the AHS proposed to move far too many people into it. ‘The entire area was too small, including individual workstations,’ said NSWNA Assistant General Secretary Judith Kiejda. ‘Management kept saying it was suitable and we insisted it was not. It would have meant that staff were practically on top of each other, and there was no room for storage.’

Security was another issue: there were no locks on the windows, no duress response and no alarms in the building. The circulation of air throughout building was also problematic because there was insufficient air conditioning. ‘Concerns were also raised about where to put the photocopier and fax machine – both because of the lack of space and because there was not proper ventilation in the room where they wanted to put the machines, so staff would have been exposed to heat and fumes,’ said Judith. Even the perimeter of the building was unsafe, with uneven ground and a slip hazard at the front of the building. During the eight months of negotiations, the NSWNA had to call a dispute to force management to address the issues. Eventually the AHS rectified the problems and agreed to relocate only one team: ACAT. This meant that instead of almost 40 people being crammed into the space, only 23 moved. n

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38 THE LAMP april 2011

f i g h t i n g

F i t n u r s e s

Get on your bike g Olivia Picton, RN at the Langton Centre in Surry Hills, cycles to work most days – and drops her twoyear-old daughter, Zoe, off at childcare on the way.

Be our ‘fighting fit nurse of the month’ What do you do to stay fit and healthy? Whether you’re into extreme sports, or just like to walk around the hospital block and anything in between, we want to know! Email your story and tips in the first person (500 words) to lamp@nswnurses.asn.au.

got a bike last year and I’ve been cycling to work from the Eastern suburbs for about six months now. To be honest, I hated it to begin with! I wasn’t very fit so I found it quite hard – every time there was a slight steep hill I really felt it but now I’ve got used to it and feel much better because I’ve built up my stamina. It’s definitely worth pushing through the initial pain barrier. Now I love it! You turn up to work and you’ve got your blood pumping already so it’s a bit of an adrenalin rush – you’re awake and ready to go. I got a bike because I share a car with my husband so I don’t always get the car and the traffic was driving me crazy. It’s

not a huge distance and it’s pretty much cycle path most of the way and fairly flat. My two-year-old daughter, Zoe, sits in the baby seat on the back of the bike and she loves it. I’m lucky that the childcare centre is on the way to work. There are lots of benefits to cycling. My colleagues said that I was looking quite slim and healthy. I feel a lot healthier for doing it. I might miss a few days then get back to it but I don’t feel like I’m starting from scratch. I still keep my fitness up even though I don’t cycle every day. On the days I don’t cycle, I often walk so I’m still keeping fit. Cycling to work is more appealing than trying to go to the gym, because it’s convenient, and being a mum you don’t

get the luxury of going to the gym. It also gets me to work a lot quicker than in the car. You go in the car, you get stressed; you go on the bike, you get de-stressed. You can also incorporate it into your day rather than having to set aside a separate time for exercise, so it’s very practical. I work in a drug and alcohol clinic, so admittedly I’m not moving around so much – it’s not like working on a ward where you’re rushing around all day. I also have access to a shower if I need it. Cycling helps me in my work as a nurse because on the days I cycle I arrive in a better mood and get things done more quickly. It has a really positive effect on the rest of my day. I’d definitely recommend cycling to work if you can and to stick it out once you start. It’s horrible in the beginning with burning at the back of your throat, all your legs aching, but it really does get better and you will feel great once you do it regularly. There’s also the added benefit that I’m not spending money on petrol or bus fares, so it’s cost effective, and I’m doing my bit for the environment – I can feel very self-righteous! n THE LAMP april 2011 39

+ Let them eat cake

n e w s i nMATTERS NSWNA b r i e f

Third-year nursing students from the University of Newcastle, Port Macquarie Campus, celebrated the end of their studies at a dinner held at Tommyâ&#x20AC;&#x2122;s Restaurant at Flynns Beach, Port Macquarie. The Association sponsored the celebration cake to mark the special occasion.

NSWNA Branch News litically active c Besides getting po Ps during election and meeting local M took some time to season, Branches also d graduations and celebrate reunions an rsonal travails of a commemorate the pe fellow nurse.

) Scholarship for pain management course

Pictured, standing in the back with sign is Bernhard Racz, RN, reunion organiser. Front row: daughters Lieselle and Tahlia Racz helping with registration.

B Lidcombe Hospital Reunion Over 300 people attended the reunion at Lidcombe Hospital, which was a nice surprise for the organisers who had only expected 200. Six professors (including two in nursing), over 40 doctors, many DoNs, and expatriates from WA (five), QLD (29), TAS (six), UK (two), as well as many from NSW attended the event. 40 THE LAMP april 2011

+ Friendship quilt presented To commemorate the long journey back to health of one of their colleagues, Sonia Daley who was diagnosed with leukaemia last year, members at Parkes Health Service hand embroidered a friendship quilt for Sonia in her favourite colour purple with words of encouragement. The quilt was presented to Sonia at a special afternoon tea on 8 December.

Photo courtesy of The Parkes Champion Post

Forefront, left to right: Lions N5 District Governor John Harrison and Jacqueline Jenson, RN.

NSWNA member Jacqueline Jenson, RN, was presented with a 2011 Lions Scholarship by the Lions Nurses Scholarship Foundation to attend a pain management course from the Pain Management Research Institute from the University of Sydney. Jacqueline said undertaking the course will enable her to gain up-to-date specialist pain management knowledge and skills to assist in assessment, monitoring, implementation and evaluation of the individualâ&#x20AC;&#x2122;s pain and their pain management strategies at the Sacred Heart Rehabilitation Unit.

Pictured front row, kneeling left to right: Dawn Wakefield, RN; Fiona Maxwell, EN; Sonia Daley, EN; Michelle Finnegan, EEN; Marie Crossley, EN; Tracy Longhurst with baby Phoebe. Kneeling middle row: Barbara Stokes, midwife, RN; Sally McClurg, RN; Rebecca Evans, RN; Tanya Barnes, RN. Back Row, standing Pat Hele, RN; Teresa Holland; Kate Thomas; Chris Rutter; RN; Wendy Van Der Wel, EN; Colleen Frogley, RN; Jenny Mahon; Katrina Mulligan, RN; Chris Hele, NUM; Debbie Abela, EEN; Merrilyn Rodgers; Helen Evans, RN; Helen Nash, RN. Absent from photo are Rene Thompson; Lois Godden, EEN; Janine Hando; Tanya Bayliss, RN; and Kris Smith, RN.

, Blacktown nurses lobby MP Nurses at Bungarabee House, at Blacktown Mental Health Branch and Blacktown Hospital Branch, met with MP John Robertson to lobby for various pressing issues. The nurses at Bungarabee House were concerned about PECC staffing, and moving the PECC unit for safety reasons and re-locating it to the ED. The hospital Branch spoke to him about the need for nurse-to-patient ratios and skill mix for safe patient care.

FAR LEFT: Back row, left to right: Ashley Baker, CNS; Johanna Feeney, NUM Bungarabee House; MP John Robertson; Dani Ivankovic, EN, Blacktown City Mental Health Branch President. Front Row, left to right: Chye Ong (OHS rep); Jouko Viemero, RN; Kieran Griffiths, EEN. LEFT: Back row, left to right: Colleen Mullens, NUM, ED; Aileen Tadiaman, RN; MP John Robertson; Frances Hoult, NUM, Branch Delegate; Ruth Murray, RN. Front row, left to right: Elvie Bembo, RN; Estela Failagutan, RN; Kirstie Kwaitkowsk, EN; Laura Yelavich, EEN.

, Triple Zero morning tea NSWNA members were on hand to lend their support to the Newcastle Better Services ‘OOO’ breakfast BBQ where local candidates were invited to support their emergency service workers and sign the Better Services charter. Pictured left to right: Joanne Walsh, CNS, Branch President, Calvary Mater Hospital; MP Sonia Hornery; Robyn Keath, CNC, Branch Secretary, Calvary Mater Hospital

+ Newcastle Australian Red Cross Blood Service revamps Branch This was the second Branch meeting for the Newcastle Australian Red Cross Service. Renewed interest and enthusiasm for the NSWNA over growing issues of rostering and workloads meant nurses made an effort to attend the meeting, some even on their day off. ‘We had a Branch in the past but it fizzled out due to lack of interest. But we’ve had some issues and finally a few of us got together and realised we needed to do something about it,’ said Narelle Houlcroft, EEN and Branch Delegate.

, Blacktown Hospital lunchtime BBQ NSWNA member Maureen Cooper (front row, right) showed her support for Better Services by attending a lunchtime BBQ at Blacktown Hospital with John Robertson, MP for Transport and candidate for Blacktown (centre, next to Maureen).

, Medications in Aged Care Forum

Pictured left to right: Kim Jones, RN; Roz Armstrong, EN; Jenny Legge, RN. Back row, left to right: Narelle Houlcroft, EEN, Branch Official; Fiona Gardner, RN; Jessie Hunter, EN.

Held at the NSWNA offices in Waterloo, the workshop for aged care nurses attracted RNs, AiNs and ENs in aged care who have medication-related duties. ‘The information presented here in the workshop will be very useful for us when we go back to the facilities,’ said Godzanani, RN, Solutions Nursing Agency (left), pictured with Lucia Mlcombacchoto, RN, Sir Moses Montifiore. THE LAMP april 2011 41

Don’t miss the nursing and midwifery event of the year. Book your tickets now! MONDAY 9 MAY 2011 6.30 PM NSW Nurses’ Association, 50 O’Dea St Waterloo 6.30PM TO 7.30PM COCKTAIL PARTY 7.45PM FILM FESTIVAL TICKETS $15 Proudly sponsored by:

42 THE LAMP april 2011

PLEASE NOTE: CHANGE OF VENUE

Parking available on site For bookings and full details of the 2011 film festival go to: www.nswnurses.asn.au or call Glen Ginty on 02 8595 1234.

nursing research online

Nothing lucky about protecting gambling g Around 115,000 Australians are serious ‘problem gamblers’ and 280,000 moderate ‘problem gamblers’ – a condition associated with a wide range of mental and physical health problems. This month Nursing Research Online examines gambling in the Australian social context, recent policy research on problem gambling and some of the issues in terms of public health. The Deal 360 Documentaries, ABC Radio National, 12 March 2011 Producer: Regina Botros

Over 80% of Australians gamble every year. This program explores the relationship between gambling and performing through the stories of musician Tim Freedman, comedian Ciel Stowe and performance poet Tug Dumbly. With some help from Dostoyevsky, Charles Bukowski and Sigmund Freud you'll experience the highs, the lows, the wins, the losses and then there’s the gambling. http://www.abc.net.au/rn/360/ stories/2011/3155597.htm

Gambling Research Australia Gambling Research Australia (GRA) is an initiative of the Ministerial Council on Gambling (MCG). The Council’s objective is to minimise the adverse consequences of problem gambling via the exchange of information on responsible gambling measures and by acting as a forum for discussion and facilitation of the development of an effective interventions framework. The MCG agreed on five research themes to guide the GRA in planning for research projects for its second five-year program. The five themes are: w Helping individuals set their limits including access to cash and precommitment w Responsible gambling environments w Gaming machine standards – developing better consumer protection w A preventative and early intervention strategy targeted at those at risk of problem gambling

Development of harm minimisation

measures for interactive gambling. Gambling Research Australia maintains a gambling research database with a list of over 1,700 gambling research publication titles and their origins – searchable via topic, title, author or category. http://www.gamblingresearch. org.au

Gambling Help Online Gambling Help Online is a program operated by Turning Point Alcohol and Drug Centre in Victoria. As well as counselling services, assistance is available for health professionals dealing with clients with gambling issues. This assistance includes a risk assessment tool for identifying problem gambling and information, assessment and intervention strategies such as: w Recognising the signs of a gambling problem w How gambling problems develop. Gambling problems tend to develop as people progress from ‘social’ to ‘heavy’ and then to ‘problematic’ levels of gambling. People may also go backwards and forwards in the cycle. w The relationship between gambling and other mental health concerns including depression, anxiety and alcohol use. w Strategies for regaining control including cognitive, behavioural and money management strategies. w The impact of gambling on others. It is estimated that for every person with a gambling problem, five to seven other people are affected. http://www.gamblinghelponline. org.au

Gambling Inquiry Report Productivity Commission, 2010

Gambling was substantially liberalised in most Australian states and territories in the 1990s. Subsequent years saw not only a surge in gambling expenditure and industry growth, but also adverse impacts on many Australians and their families. The consequent backlash within the community led to the first independent national public inquiry by the Productivity Commission in 1999. Since then, there have been significant changes in the gambling industry and its regulatory environment, with a greater policy focus on community awareness and harm prevention and minimisation. Yet, community and political concerns remain evident. There have also been developments within parts of the industry, which have a more national character than before. The Council of Australian Governments accordingly asked the Commission to conduct a follow-up review, with a focus on problem gambling and the scope to consider other aspects of the industry. The Commission has not sought to replicate the coverage and depth of its earlier research, but rather to concentrate on providing evidence-based advice to governments about policies that would improve outcomes for gamblers and the community as a whole. A key challenge is to identify policies most likely to be effective in reducing the harms associated with gambling, while preserving most of the benefits. This is a complex task for public policy. The coverage and design of regulation require particular care to ensure that the benefits exceed the costs, and that account is taken of what is often imperfect evidence. n THE LAMP april 2011 43

a t

t h e

m o v i e s

Brighton Rock g A dark and compelling drama of gang wars and social politics set in the 1960s, based on Graham Greene’s 1939 novel of the same name.

he story revolves around Pinkie (Sam Riley), a psychopath who reveals his violent, sadistic personality with the brutal revenge murder of a traitor. Unknowingly, Rose (Andrea Riseborough) links Pinkie to the murder by way of a holiday photo snap. The gang leaves Pinkie the task of retrieving the photo slip from Rose, a religious, naive, young waitress with

Review by Cathie Montgomery, CNS, Concord Hospital & Greg Kennedy, RN, Moorebank RAP. idealistic views of life, love and devotion. Rose quickly becomes infatuated with Pinkie and the attention he bestows upon her. During this twisted courtship Pinkie is struggling for control of his gang while

The Tempest

g This new adaption of Shakespeare’s play is brought to life by changing the gender of the main character, who is played by the evercaptivating Helen Mirren.

n a tribute to mark over 400 years of Shakespeare’s The Tempest, a play believed to the Bard’s last that he wrote alone, director Julie Taymor brings a beguiling and powerful dynamic to a play centred around the themes of power, revenge, compassion and reconciliation; themes that resonate through time to the present day.

44 THE LAMP april 2011

She achieved this by changing the gender of the main character, Prospero, to that of a female, Prospera. The setting is the 16th century with its historical beliefs and ideas about alchemy and witchcraft. This dazzling big-screen adaptation sees Helen Mirren as Prospera, the popular Duchess of Milan who is a widow and heir

fighting to maintain territory from a more successful rival gang. Rose’s boss, Ida (Helen Mirren), sees Pinkie as the dangerous character he is and enlists the help of an old friend Phil Corkery

Review by Anni Cameron, Clinical co-ordinator, Nursing Station, St George College of TAFE. to the deceased Duke of Milan. Having studied the alchemical arts in secret, she is accused by her ambitious and treacherous brother, Antonio (Chris Cooper) of witchcraft – punishable by death at the stake and exiled to an uncharted barren island with her young daughter, Miranda (Felicity Jones). There is no society on this island and their only company is the brutish, earthy, deformed Caliban (Djimon Hounsou) and the mischievous air spirit, Ariel (Ben Whishaw). It is no coincidence that a gruelling shipwreck finds members of the very royal Milanese court that had Prospera banished washed ashore on various parts of the island where she can unleash her powers against these men. Not only does she want to regain her former title and position but also she wants to create a love match between her daughter and the King of Naples’ son, Prince Ferdinand (Reeve Carney). However, when Miranda and Prince Ferdinand lock eyes, it is love

Our reviewers and tipsters receive a delightful ABC Classics CD for uplifting enjoyment! Gifts so good, you won’t want to give them away. There is an ABC Shop near you. For locations visit abcshop.com.au or call 1300 360 111. Ask about our rewards program.

(John Hurt) to try and intervene between the fated lovers. These events take place with the backdrop of social unrest involving the mods and rockers of the time. Andrea Riseborough portrays female suffering, passion and unquestioning devotion with a captivating performance while the ever brilliant Helen Mirren brings compassion and wisdom throughout. Brighton Rock is not a feelgood film, but a dark and menacing insight into relationships – an experience that grips your attention as the complicated characters struggle with belief, faith and where a person’s loyalty should lie.n In cinemas 14 April at first sight – the kind of magic that even Prospera is unable to control. A concurrent plot has Caliban treacherously conspiring with the royal party’s drunken butler (Alfred Molina) and the cowardly tailor (Russel Brand) to kill Prospera and take Miranda for themselves. Caliban’s complex character symbolises for Taymor ‘nature personified – both beautiful and grotesque’ and casting an African in the role also highlights themes around colonialisation. Hounsou’s Caliban is a terrifying but oddly sympathetic character and his soliloquies are delivered with a touching passion while Ariel represents the embodiment of human emotion, vulnerability and compassion in spirit form. The special visual effects surrounding Ariel are brilliant as is the hauntingly beautiful music. Mirren skilfully portrays Prospera’s many conflicting impulses: her erratic fury and desire for vengeance, cold authority, cruelty and steely determination to her maternal warmth, compassion and forgiveness. Her nuanced performance as the sorceress Prospera is marvellous. The rest of the cast is uniformly excellent with Trinculo (Russell Brand) providing comic relief as a loveable buffoon. n In cinemas 14 April

giveaways for NSWNA members

My Afternoons with Marguerrite It’s the story of one of those improbable encounters that can change the course of one's life: the encounter, in a small public garden, between Germain (Gerard Depardieu), 50 and barely literate, and Margueritte (Gisèle Casadesus), a little old lady passionate about reading. Forty years and 220 pounds separate them. One day, purely by chance, Germain sits down beside Margueritte. She'll go on to read aloud extracts from novels and thereby allow him to discover the magic of books, from which Germain imagined he was excluded for life. Until then, his family circle and drinking buddies took him for an idiot; stupidity will now change places! But Margueritte is losing her sight. For the love of this charming, mischievous and caring grandmother, Germain will teach himself and show her that he's capable of reading aloud to her when she is no longer able to do so herself. At the movies 7 April

Biutiful Thanks to Madman Entertainment we have 20 double passes to giveaway to BIUTIFUL, nominated for two Academy Awards: Best Actor, Javier Bardem, and Best Foreign Language Film. BIUTIFUL is the latest masterpiece from Alejandro González Iñárritu (Babel, Amores Perros, 21 Grams). The film is an emotional exploration of one man’s spiritual journey. It tells the

story of Uxbal (Bardem) – devoted father, tormented lover, mystified son, underground businessman, friend of the disposed, ghost seeker, spiritually sensitive. He is a survivor at the invisible margins in today’s Barcelona. Uxbal, sensing the danger of death, tries to reconcile with love and save his children, as he tries to save himself. A redemptive, powerful tale of love, BIUTIFUL is spearheaded by an emotionally-charged performance by Academy Awardwinner Javier Bardem (No Country for Old Men). In cinemas now.

Incendies When notary Lebel sits down with Jeanne and Simon Marwan to read them their mother Nawal's will, the twins are stunned to receive a pair of envelopes: one for the father they thought was dead and another for a brother they didn't know existed. In this enigmatic inheritance, Jeanne sees the key to Nawal's retreat into unexpected silence during the final weeks of her life. With Lebel's help, the twins travel to the Middle East to piece together the story of the woman who brought them into the world, discovering a tragic fate forever marked by war and hatred as well as the courage of an exceptional woman. A powerful and gripping film, Incendies received a Best Foreign Language Film nomination at the 2011 Oscars. n The Lamp has 20 double passes to give away to My Afternoons with Marguerrite and BIUTIFUL and 15 double passes to Brighton Rock, and 30 sneak preview double passes to Incendies (valid at participating cinemas over the weekend 15-17 April). To enter, email lamp@nswnurses. asn.au with your film preference, name, membership number, address and contact number. First entries win. THE LAMP april 2011 45

b o o k s

Where to get this month’s new releases

Book me Midwifery: Preparation for Practice (2nd ed.) by Sally Pairman, Sally Tracy, Carol Thorogood and Jan Pincombe, Churchill Livingstone (available though Elsevier Australia), RRP *$104.40 : ISBN 9780729539289 In this updated edition of Midwifery: Preparation for Practice the text is intended to provide an up-todate evidence and practice-based resource for midwives who work in partnership with women in woman-centred models of midwife-led care. There is a greater emphasis on the development of critical thinking and researching skills and some of the key chapters have been re-written to reflect recent changes in government legislation while current research and pertinent examples are included throughout the text.

Essentials of Law for Health Professionals (3rd ed.) by Kim Forrester and Debra Griffiths, Mosby Australia (available through Elsevier Australia), RRP *$71.10 : ISBN 9780729539159 ‘Essentials of Law for Health Professionals has been thoroughly revised and updated throughout to reflect the most recent changes in legislation relevant to the provision of health care services in Australia. Employment status of health professionals and issues of work cover, health and safety obligations, and antidiscrimination issues are clearly outlined and discussed in the new edition. Legal issues surrounding genetics, fertility and surrogacy are reviewed in conjunction with the current position on abortion and wrongful deaths.’ (Provided by publisher) 46 THE LAMP april 2011

The Clinical Placement: An Essential Guide for Nursing Students (2nd ed.) by Tracy Levett-Jones and Sharon Bourgeois, Churchill Livingstone (available through Elsevier Australia), RRP *$35.95 : ISBN 9780729539586 Written in an interactive and engaging style, The Clinical Placement Guide explores the complex dilemmas and concerns of the professional nurse and associated clinical issues. Its aim is to provide the student with suggestions of how potential problems can be prevented or resolved. There are a number of new sections in this edition that address contemporary issues such as patient safety, clinical reasoning, therapeutic communication, inter-professional communication, clinical handover, emotional intelligence, information and communication technology, and social networking.

Professional Skills in Nursing: A Guide for the Common Foundation Programme by Rita Debnath, Sage Publications (available though Footprint Books), RRP *$40.95 : ISBN 9781847873972 Professional Skills in Nursing introduces students to the basic skills they need in the first year of prereg nursing training and focuses on the essential knowledge and skills needed for effective patient-care. Each chapter focuses on a key aspect of nursing care backed up with practical tips, examples drawn from all branches of nursing, and also incudes a range of study activities to help the student reflect on their learning and get the most from practice placements.

These books are all available on order through the publisher or your local bookshop. Members of the NSWNA can borrow any of these books and more from our Records and Information Centre. For borrowing information, contact Jeannette Bromfield, 8595 2175, jbromfield@ nswnurses.asn.au or Cathy Matias, 8595 2121, cmatias@nswnurses.asn.au Reviews by NSWNA librarian, Jeannette Bromfield. Disclaimer: Some of the items featured in Book Me are based on information received and have not been independently reviewed.

Publishers’ websites c Elsevier Australia: shop.elsevier.com.au c Sage Publishing: www.sagepub.com/home.nav c Footprint Books: www.footprint.com.au/ c Radcliffe Publishing: www.radcliffe-oxford.com/ books/ c Hachette Livre Australia: www.hachette.com.au/

How Drugs Work: Basic Pharmacology for Healthcare Professionals (3rd ed.) by Hugh McGavock, with forward by Hugh McKenna, Radcliffe Publishing (available through Elsevier Australia), RRP *$52.95 : ISBN 9781846194788 How Drugs Work introduces the science of various types of drugs and focuses on the aspects of pharmacology that are relevant to everyday prescribing, including drug absorption, distribution, action, metabolism, excretion, adverse effects and interactions. The text aims to condense complex information into the essentials to help readers make prescribing and medication reviewing safer and more effective. *Price in Australian dollars at time of printing

SPECIAL INTEREST TITLE

Man with a Pram: The Blokes Guide (From Conception to Birth) (All the stuff you need to know, do, prepare and pack for the best moment of your life) by Jon Farry and Stephen Mitchell, Hachette Livre Australia, RRP *$24.99 : ISBN 9780733625053

What a completely brilliant delivery of everything you need to know about conception, pregnancy and birth written for the Australian context. The authors manage to maintain a most entertaining style while delivering a wealth of current information. Even better is that the book does not take a particular stance but covers all options, along with their pros and cons. For example, midwife versus obstetrician-led care and delivery. Options are laid out for the parents-tobe in a non-judgemental yet factual way, allowing the reader to make the choices that work best for them without guilt. All aspects are covered including what to expect and what can go wrong with the best laid plans and hopes. Interest is maintained by many facts, figures and quotes, some historical but no less

fascinating such as the biggest baby ever recorded tipped the scales at 10.3 kilograms, and, for those who like a little spice in their life, a recipe for cooking placenta with polenta. Unlike many non-fiction books, it is so good it can be read cover to cover. However, for readers who prefer to dip into topics or want to go back to re-read a segment, there is a comprehensive index. Talking from the perspective of a consumer rather than a professional, it is a marvellous adjunct for parent education for those planning to embark on parenthood â&#x20AC;&#x201C; a five-star book. (Review provided by Trish Butrej, NSW Nursesâ&#x20AC;&#x2122; Association Professional Officer) n

THE LAMP april 2011 47

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A message to all our Central Coast Nurses and Midwives, are you travelling out of the area? Your communities need you!!

Gosford and Wyong Hospitals Positions available – Temporary, Casual, NSR, Part time and Full time. Central Coast Local Health Network Nursing & Midwifery staff enjoy: • Flexible and self rostering • Access to a social club • Education and CNE support • Salary packaging

• Great multidisciplinary teams • Great new café at Gosford • Free parking at Wyong

Come on... Give us a ring Donna Joel, Wyong: 4394 8076 Tanya Bradbury, Gosford: 4320 2010 Ask us about our flexible (NSR) Nursing Support Roster Teams at both hospitals

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comPlementarY anD alternatiVe meDicine in PregnancY Evidence-based clinical considerations for Midwives Midwives in Australia are frequently confronted with questions from pregnant women about the safety and efficacy of complementary and alternative medicines (CAMs). The workshop will cover the principles, philosophies, use and standards of practice of common therapies accessed by pregnant women and their midwives. This course is approved for 14 MidPLUS points for enquiries or enrolment Please contact us P: 0420 231 700 E: enquiries@embraceholistic.com W: www.embraceholistic.com 48 THE LAMP april 2011

Boo K e a r lY & saV e !

Prices

Dates for 2011

earLy bird: $450.00 Student (FT): $350.00 Full price: $595.00 15% discount with group bookings of 5+ Early bird ends 6 weeks prior to course date. Courses run over two full days: 9am to 5.30pm

Mackay 4th & 5th April cairns 6th & 7th April FULL! sydney 6th & 7th June canberra 8th & 9th June MeLboUrne 20th & 21st June Hobart 22nd & 23rd June noosa 8th & 9th Aug toowooMba 18th & 19th Aug

Crossword Test your knowledge in this monthâ&#x20AC;&#x2122;s nursing crossword. 1

9 10

11 12

19 20 21

across

1. Thinking (11) 7. The central line of the body (4) 9. Unwell, sick (3) 10. A pain suppressant released by the brain (9) 12. A greyish white element having a metallic lustre and forms poisonous compounds (7) 13. Eating of raw food, including meat and fish (9) 16. The formation of hormones (14) 19. In Asian medicine, the force of energy existing in all life form (3) 21. The act of sticking to something (9) 22. Indulge with rich food, comforts (6) 23. Vomiting of intestinal worms

through the mouth (14) 24. Loosening or separation of epiphysis from the shaft of a bone (14) 26. Any major mental disorders (9) 27. The female sex cell (6) s

down

1. Treatment of disease by means of chemical substances or drugs (12) 2. An image produced by x-rays (10) 3. Contraception (5.7) 4. Artificial Insemination (Homologous) (1.1.1) 5. International Council of Nurses (1.1.1) 6. A gaseous element that constitutes about four-fifths of the atmosphere and present in all living tissues (8) 7. Anatomical structure that has the

form of a hollow cavity (7) 8. To cut with a knife (6) 11. Intravenous injection (1.1.1) 14. The occurrence of multiple comÂplexes of small vascular channels, each resembling a glomus (12) 15. Laxative (8) 17. Subcutaneous (1.1) 18. An optic instrument used to inspect interior portions of the body (10) 20. A person suffering from a partial loss of memory (8) 22. Wing-shaped (7) 23. Hirsutism (5) 24. Emergency medical practitioner (1.1.1) 25. Oncology Nursing Society (1.1.1) Solution page 51 THE LAMP april 2011 49

Want to work as a General Practice Nurse? FREE INFORMATION SESSION FOR ALL NURSES – dinner included

Registered Nurse Drained by the demands of general hospitals? Are patient loads troubling you? Want an interesting and challenging job, but one that is manageable? Disability Enterprises is seeking Registered Nurses to support the needs of our clients within community homes located in Penrith and Wentworth Falls.

Learn more about Practice Nursing and meet practices that are interested in employing a Practice Nurse. Date: Wednesday, 11th May 2011 Venue: WentWest Offices Level 1, 85 Flushcombe Rd Blacktown Time: 6.30–7.30pm (Practice Nursing Information Session) 7.30–8.30pm (Dinner and Presentation) 8.30–9.30pm (Opportunity to meet Practices) RSVP: By 29th April 2011 to WentWest on (02) 8811 7100 or email: support@wentwest.com.au

50 THE LAMP april 2011

You will use your nursing knowledge and skills to practise autonomously with young people with complex health care needs. You will be well supported by our Nurse led Health Support Team and working alongside Support Workers. This is a ‘Hands on’ role with efficient manual handling equipment in all houses. The role involves: responsibility for and provision of excellent client care; collaboration with families, GPs, community pharmacists, allied health staff; and mentoring of Support Workers. Excellent staff to client ratios - friendly and supportive work environment – tax free salary packaging – comprehensive training programs - opportunities for professional development. For an information pack please contact Dianne on (02) 4784 1118.

Diary Dates

DIARY DATES

Conferences, seminars, meetings SYDNEY, Hunter & Illawarra Kenmore Hospital Museum Exhibition & Tours Date: 12 March – 1 May 2011. NSW Urological Nurses Society Study Day Dates: 8 April 2011 Venue: Burwood RSL Contact: Karina So ph. 9767 5000 or 9767 6627 (Voicemail); karina.so@ ssawhs.nsw.gov.au. Professional Breakfast Dates: 16 April Venue: Cornerstone Bookshop, Erina Contact: Jane 9449 4868. Trauma & Emergency Nursing Skills – 2-day seminar for general nurses Dates: 28 & 29 April 2011 Venue: Quality Hotel Cambridge, Surry Hills. Contact: www.ausmed.com.au or ph 03 9375 7311. Critical Care Nursing Course – One evening a week for 10 weeks Date: Thursday evenings, 5 May to 7 July 2011, 6.30-9.30pm Venue: Westmead Private Hospital, Westmead Contact: (03) 9390 8011 or info@ criticalcare.edu.au or www.criticalcare. edu.au. Basic & Advanced Cardiac Life Support – 1-day update Date: 6 May, 7 May 2011 Venue: Westmead Private Hospital, Westmead Contact: (03) 9390 8011 or info@ criticalcare.edu.au or www.criticalcare. edu.au. 4th Neurosciences Symposium Date: 16 May Venue: Kerry Packer Auditorium at RPA Hospital on Missenden Road, Camperdown Contact: Nadia Schweizer on 02 95156111, pager on 88073. NSW Health & Ambulance Employees Date: 22 May Venue: Revesby Workers’ Club, Brett St, Revesby. Contact: Paul Sillato, Anatomical Pathology (SWAPS), Liverpool Hospital, 9828 5391. Leadership and Management for Health Professionals – Sharing the Experience Date: 27 May 2011 Venue: NSW Parliament House, 6 Macquarie St, Sydney NSW Australia

Contact: To register go to: http://www. changechampions.com.au/seminar/ leadership-and-management-for-healthprofessionals--sharing-theexperience_112.

Enrolled Nurses Professional Association Annual Conference Date: 22-23 September Venue: Armidale, NSW Cost: $240 ENs wishing to present a paper please contact Ph: 1300 554 249. Interstate and overseas Ausmed Conferences Venue: The Pavilion, Qld Cricket HQ, 1 Bogan Street, Breakfast Creek, Brisbane Contact: www.ausmed.com.au or ph 03 9375 7311. Nurse Practitioners Keeping Our Patients Between The Flags Dates: 12 & 13 May 2011 Venue: Calypso Resort, Coolangatta, QLD Price: $50 pp Contact: Anne.moehead@ncahs.health. nsw.gov.au. Australian Dermatology Nurses’ Association (ADNA) 10th National Conference Dates: 14-15 May 2011 Venue: Perth Convention & Exhibition Centre, Perth WA Contact: ADNA Secretariat 02 4739 2673 adna@westnet.com.au. The Frontiers of Pain Venue: Australian Pain Society 31st Annual Scientific Meeting Dates: 12-16 June 2011 Venue: Darwin Convention Centre, NT Contact: (02) 9954 4400, aps2011@ dcconferences.com.au www.dcconferences.com.au/aps2011. The Future Role of Support Workers and Assistant Practitioners 2nd National Conference Date: 30 June 2011 Venue: LONDON Contact: www.mkupdate.co.uk to see complete listing of events, dates and venues in the UK. Advanced Emergency Skills Masterclass Date: 21 June 2011 Venue: Manor Hospital, Walsall, UK Contact: bookings@mkupdate.co.uk, tel: 017687 73030. Teaching and Training Skills Date: - 28-29 July 2011 Venue: TBC Contact: enquires@mkupdate.co.uk, www.mkupdate.co.uk.

Diary Dates is a free service for members. Please send diary date details, in the same format used here – event, date, venue, contact details, via email, fax and the web before the 5th of the month prior, for example: 5th of May for June Lamp. Send information to: Editorial Enquiries Email: lamp@nswnurses.asn.au Fax: 9550 3667 50 O’Dea Ave, Waterloo NSW 2017 Please double-check all information sent is correct. The Lamp cannot guarantee that the issue will always be mailed in time for the listed event.

12th International Mental Health Conference Date: 24-26 August 2011 Venue: Radisson Resort, Gold Coast Contact: http://www.anzmh.asn.au/ conference2011 for full details. 7th International Meeting On Intensive Cardio Care Date: 31 October-1 November 2011 Location: Tel Aviv, Israel Abstract deadline: 300 word abstract by 1 August 2011 Secretariat: The Secretariat 7th International Meeting On Intensive Cardiac Care P.O. Box 574, Jerusalem 91004, Israel Tel: ++972-2-6520574 Fax: ++972-2-6520558 conventions@isas.co.il Homepage: www.isas.co.il// cardiac-care2011. 3rd Rural & Remote Mental Health Symposium Date: 14-16 November 2011 Venue: Mercure Hotel, Ballarat VIC Contact: Laura Hancock Conference Secretariat ruralhealth@anzmh.asn.au The call for abstracts is open till the 2 May 2011. Please be sure to submit your work via the Symposium website www.anzmh.asn.au/rrmh11.

Due to high demands on the page, some dates too close to publication or too far in the future may be cut. Only Diary Dates with an advised date and contact person will be published. Special Interest Groups Special Interest Groups is now part of Diary Dates. If you are a special interest group, you now must send information about your event as above. Diary Dates are also on the web – www.nswnurses.asn.au/events

Send us your snaps If you’re having a reunion, send us some photos and any information from the night, and we’ll try to publish them.

Contact: Toni Gwynn-Jones (nee Treloar) email: mrsgwynnie@gmail.com or 0412 880 894

Western Suburbs Hospital Graduate Nurses’ Reunion Date: Saturday, 28 May, midday Venue: Ryde-Eastwood Leagues Club Contact: Robyn Daniel 02 9644 9692, Margaret Gane 02 9584 8801

NSWNA Events

Check venue locations with Lyn Stevens on 02 8595 1234 or 1300 367 962. For more information on NSWNA Education Courses contact Carolyn Kulling at the Association. Ph: (02) 8595 1234 or free call 1300 367 962 or visit the Association’s website http://www.nswnurses.asn.au/ topics/2761.html

Crossword solution

Reunions St Vincent’s Hospital Darlinghurst April 1961 PTS 50-Year Reunion Date: 6 April, 12 Noon Venue: Marriot Hotel, 30 Pitt St Sydney (Circular Quay) Contact: Pat Kistle (Hynes), 9533 1224, patk43@tpg.com.au, Joy Beattie (Frew) 9144 6578, jaybeattie@iinet.net.au, Trish Chatfield (Fardy) 9817 3523, trishchatfield@yahoo.com.au. Royal North Shore Hospital September ‘81 30-Year Reunion Date: Saturday, 30 April Venue: TBC – North Sydney/St Leonards Cost: TBC

THE LAMP april 2011 51

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