The Lamp April 2015

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 72 No.3 APRIL 2015

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CONTENTS

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

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

VOLUME 72 No.3 APRIL 2015

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

COVER STORY

12 | 10,000 rally to protect penalty rates

NSWNMA Assistant General Secretary Judith Kiejda and General Secretary Brett Holmes.

PHOTOGRAPH: SHARON HICKEY

REGULARS

5 6 8 37 39 43 45 47 48 50

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

PUBLIC HEALTH

20 | Public Health System award campaign

More than 800 nurses took to the streets of Sydney and Newcastle on March 4 to show their opposition to the federal government’s attack on penalty rates and workers’ rights.

COVER STORY

16 | Cutting penalty rates is cutting pay Meg Pendrick RN highlighted the importance of penalty rates to the nursing and midwifery professions when she addressed a rally of 10,000 people.

ENVIRONMENTAL HEALTH

30 | Holiday in the Hunter: a guide for the cautious traveller The impacts of a massive increase in coal mining are threatening to destroy not just human health but the thoroughbred, wine, tourism and agricultural industries.

COMPETITION

8 | Win a pair of Ascent Duty shoes

GALLIPOLI 100 YEARS

32 | Nurses confronted full horror of modern war

For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee • Brett Holmes, NSWNMA General Secretary • Judith Kiejda, NSWNMA Assistant General Secretary • Coral Levett, NSWNMA President • Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital • Michelle Cashman, Long Jetty Continuing Care • Richard Noort, Justice Health Advertising Patricia Purcell T 8595 2139 or 0416 259 845 or F 9662 1414 E ppurcell@nswnma.asn.au Information and Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, Coordinator T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Privacy Privacy statement: The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information please contact the NSWNMA office.

If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission.

Subscriptions for 2015 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $55.

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

On the 100th anniversary of the Gallipoli landing The Lamp reproduces an account of the experiences of nurses among the carnage.

THE LAMP APRIL 2015 | 3

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

Ratios remain the key to patient safety Both major political parties promised more nurses for our public health system in their state election campaigns — which we welcome — but we need a bipartisan position on ratios to ensure patient safety.

“Any effort to boost overall nurse numbers in our state’s public health system must be matched with a commitment to improve nurse-topatient ratios.”

Four years ago a chronic shortage of nurses and midwives was putting a massive strain on our public health system and was the catalyst for our first ratios campaign.

Not only was the situation dire but the forecasts for increased stress on the system from population growth and the demands of an ageing population were ominous.

Those demographic challenges remain.

It should be a source of great pride to NSW nurses and midwives that our strong campaigning for ratios has led to both major parties committing more resources to nurse and midwifery numbers.

Despite this progress there remains a lot for us to fight for.

Any effort to boost overall nurse numbers in our state’s public health system must be matched with a commitment to improve nurse-to-patient ratios using the ‘nursing hours per patient day’ model and mandated statewide through the introduction of legislation.

There is also a strong need to extend ratios into new wards and to improve them in country hospitals and community care.

Our first ratios campaign moved an initially reluctant Labor government to embrace ratios in a wide range of public health settings.

In this election campaign (just finishing as The Lamp went to print) Labor has moved even more, committing to enshrine nurse-to-patient ratios in law so future governments and health department officials will have to ensure numbers are protected and not traded away.

Labor also promised to implement ratios of

1:3 in our EDs by recruiting an extra 735 nurses across the state. A similar commitment was made to our paediatric wards.

The Liberal-National government elected in 2011 honoured the agreement that Labor and the NSWNMA signed up to before the election that saw ratios implemented into the medical, surgical, rehabilitation, palliative care and acute adult inpatient wards of metropolitan and large regional hospitals for the first time in NSW. Since then, the Liberal-National government has refused to discuss any expansion of nurse-to-patient ratios even using their own language of nursing hours per patient day, let alone legislating the existing ratios/NHPPD to prevent them being removed by future governments.

It’s to be regretted that the Coalition doesn’t listen directly to the needs of their frontline nurses and midwives and seriously put patient safety first by expanding and improving mandated nursing hours.

According to their own figures 320,000 extra patients will attend an emergency department over the next four years, yet there is currently no nurse-to-patient ratio guaranteed in those emergency departments to keep patients safe.

The Association intends to continue our campaign to improve ratios in NSW. Our log of claims for the public health system in our 2015 pay and conditions campaign contains the same ratios claims that were in the 2014 campaign. There are also some new areas that we believe need and are deserving of ratios.

Ratios for us have always been and continue to be about patient safety.

It is a worthy crusade which we will not abandon.

THE LAMP APRIL 2015 | 5

YOUR LETTERS

L ET T ER OF T H E M ONT H

The personal meaning of Medicare Recently I was asked to speak at a Save Medicare forum and it got me thinking about what Medicare really means to me.

As a nurse and midwife of nearly 40 years it means being able to give quality healthcare to all my patients regardless of their ability to pay.

If I deliver a baby who unexpectedly needs admission to Special Care, I don’t have to worry about the economic circumstances of the parents. I just have to worry about caring for the baby. If I have a mum who is unwell, my only concern has to be looking after her health needs, no matter what her financial status.

But for my family and me Medicare also has a very personal meaning. When my sons were aged three and six months, I returned to work early after maternity leave because money was scarce. On the morning of my second shift I found a small lump, which turned out to be malignant. What followed was months of surgery and hospitalisation. During that very stressful time we had plenty of things to worry about, but the one thing we didn’t have to worry about was a medical bill.

I was never asked if I could afford to pay, because Medicare covered everything. Had it not been for Medicare I may not be alive today, because without early diagnosis and treatment, which I could not have afforded to pay for, my chances of survival would have been very slim.

I implore all nurses and midwives to continue to fight for our universal health care system so that we, our families and our patients, can access the medical treatment we need, when we need it, without worrying about whether we can afford to pay for it.

Annette Alldrick RM, Nowra

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6 | THE LAMP APRIL 2015

A true role model Thank you for publishing the well deserved acknowledgment of Jan Stow’s nursing career (The Lamp February 2015). I worked with Jan Stow while she was Director of Nursing at Westmead Hospital. It was an absolute pleasure to work with her. She was an inspiring person and Director of Nursing. I will always have the utmost admiration for her: a true role model.

Fiona Stewart CNC, Baulkham Hills Caring for community nurses Nurses work hard in the community setting. At Mount Druitt, Doonside and Blacktown Community Health Centres we are endeavouring to nurture the nurses and all health staff who care for our community clients.

We have established a Health and Wellbeing working party, which is looking at providing Janis Paterson GP Liaison creative and fun activities to not Nurse Chronic Aged and only look after the physical Complex Care (left) and health of nurses, but also the Kathy Coller GP Liaison emotional health. We will be Nurse Child and Family having a team challenge to Health. “walk around Australia� (via a pedometer challenge).

As well we will be offering staff low cost relaxation massages and trying to secure Weight Watchers at Work. We have lots of ideas.

Kathy Coller RM, Glenhaven

We are being betrayed I attended the March 4 rally because of its great importance to me and my family that people understand exactly how this government is betraying us.

Please continue to stand up as nurses to help make Australia a better place to live and bring our families up in.

Colleen Shirley EEN, Grose Vale

DVD comp smooths out kinks I can only encourage you to enter the DVD competitions. I have just won the Upper Middle Bogan series, which is absolutely hilarious.

And I received an exercise DVD to get the kinks out. Thank you!

Sharon Emerson CNC, Jindera Stand up for country nurses and midwives Just wanted to send a great big thank you to all the nurses, friends and family that represented the country nurses on March 4. I am a midwife at Lismore Base.Thank you all for your hard work and effort on organising the day. Not only is there a struggle to keep our pay rates but we are currently fighting to keep three fulltime midwife positions.

Sharon Coombs RM, Keith Hall

YOUR LETTERS

Losing rights – it could happen to you For those who think this will never happen, talk to your local posties about the recent announcement regarding abolition of overtime.

This is a hot topic in many industries fuelled by open demands from our employer organisations who are putting extreme pressure on governments to scrap penalty rates, disband overtime, increase workers’ output, increase retirement age and reduce the minimum wage in the name of productivity and global competitiveness.

Can we first start questioning boardroom salaries and politicians’ perks in the name of profit!

Mark Quealy RN, Botany

We must speak out against mandatory detention The vilification of the head of the Human Rights Commission Gillian Triggs by our federal government is just the latest chapter in shameful conduct on asylum seekers, since the start of mandatory detention of asylum seekers in 1993. Gillian Triggs was pointing out the obvious damage being done to the most vulnerable of the 5000 detainees, the 261 asylum seekers who are children.

I urge that our Association take a strong stand against the damaging and cruel indefinite mandatory detention of asylum seekers. We should also oppose the “turn back the boats” policy the Abbott government brought in. Perhaps we will have to wait for a future Royal Commission to find out the casualties of that policy, as well as the Abbott policy of handing Sri Lankan Tamils back to the Sri Lankan regime.

When on holiday my wife and I read in the Bangkok Post of asylum seekers sewing their lips together. Is this the image of Australia we want the world to have – a rich country that drives asylum seekers to absolute desperation?

Incredibly, we are still signatories to the 1951 UN Refugee Convention, which disallows discrimination against refugees on the grounds of how they got here. Australia violates that at every turn. And we have been doing that since 1993 – mandatorily detaining those arriving by sea.

Our governments have not been alone in the world in using asylum seekers as political footballs, trying to win racist votes by being “tough on refugees”. But we are surely one of the richest countries receiving the fewest asylum seekers to be treating them so cruelly.

I appeal to delegates reading this letter to present a strong resolution speaking out against the terrible human toll being taken by the policy of indefinite mandatory detention.

Stephen Langford EEN, Paddington NSWNMA RESPONDS Dear Stephen,The Association shares your concerns about Australia’s treatment of refugees and your disgust at the recent attacks on the President of the Humans Rights Commission by the Abbott government.

NSWNMA has long been active on this matter, including through our early work with ChilOut and more recently through our participation in Unions for Refugees.We also encourage all members to discuss this issue at their branches.

HAVE YOUR SAY Send your letters to: Editorial Enquiries email lamp@nswnma.asn.au fax 9662 1414 mail 50 O’Dea Avenue, Waterloo NSW 2017.

Please include a high resolution photo along with your name, address, phone and membership number.

Letters may be edited for clarity and space.

Anonymous letters will not be published.

ADVERTISE IN THE LAMP. REACH OVER 60,000 NURSES AND MIDWIVES. To advertise please contact Patricia Purcell on 02 8595 2139 or 0416 259 845 or email ppurcell@nswnma.asn.au

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NEWS IN BRIEF

AUSTRALIAN MEN NOW EARN $298.10 MORE EACH WEEK THAN AUSTRALIAN WOMEN

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Gender pay gap hits new high

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Exclusive to

New figures from the Australian Bureau of Statistics (ABS) show that the gender pay gap has blown out to 18.8 per cent: Australian men now earn $298.10 more each week than Australian women.

Despite this trend the Abbott government has watered down rules for workplace reporting on gender equity, a move ACTU President Ged Kearney calls “deeply disappointing”.

“If the Coalition government is serious about addressing gender inequality it needs to strengthen workplace gender equality reporting,” she said. “Without meaningful data employers cannot identify where gender pay gaps exist and take action to address the discrimination and barriers many women face.”

Ged Kearney says the government should stop paying lip service to increasing female participation in the workforce and start tackling inequality.

“The time for talk is over – Australian women need action.”

The ACTU says there are a number of measures the government can take including: • Expand the existing paid parental leave scheme to 26 weeks (at the minimum wage) and include superannuation.

• Increase childcare funding.

• Target funding to ensure social, community and care workers, who are mostly women, receive decent wages and conditions.

• Revoke the Fair Work Amendment Bill which proposes to allow employers to ask parents to trade wages and conditions in return for family friendly hours.

• Boost, rather than water down, workplace gender equality reporting legislation.

NEWS IN BRIEF

Australia

Call to end pregnancy discrimination The ACTU has lodged a claim with the Fair Work Commission to give workers the right to return to work, part-time or on reduced hours, following parental leave.

ACTU President Ged Kearney says the claim will increase female participation in the workforce, help end pregnancy discrimination and boost economic growth.

“Having more women in paid employment increases government revenue through income tax, increases economic demand through higher household wealth and spending and improves economic independence for women with less reliance on welfare,” she said.

Increasing women’s participation in the workforce in Australia by six per cent from current levels could increase GDP by as much as $25 billion, according to a G20 report by the OECD, International Labour Organisation, International Monetary Fund and World Bank.

The ACTU’s claim for family friendly work arrangements includes: • That an employee returning to work after parental leave be entitled to return to the position they held prior, on part-time or reduced hours.

• That if there are substantial business grounds, or where the position no longer exists, the employer must accommodate the employee’s return to work on reduced hours in a position that is equivalent in status and pay.

• That an employer can only refuse to do so on substantial business grounds.

• That an employee who has changed their work arrangements has the right to revert to the position and work arrangements they held prior to taking parental leave, two years from the birth or adoption of their child or later by agreement with their employer.

• That employees be allowed two days paid leave to attend appointments associated with pregnancy, adoption or permanent care orders.

Britain

Low pay leads to sex work

North Korea

Ebola fears close borders North Korea has officially reopened its borders to foreign tourists and business nearly five months after shutting them for fear of the Ebola virus, reported Reuters.

North Korea is thousands of miles from the epicenter of the Ebola outbreak in West Africa and has had no reported cases of the virus, which has killed more than 9000 people.

However its borders were closed to foreign tourists last year for fear the virus might spread and the government imposed a strict 21-day quarantine for foreign aid workers and diplomats who were ordered to stay in embassy compounds. According to Reuters, the quarantine remains in place for several African countries.

More than 70 per cent of British sex workers have previously worked in healthcare, education or charity, while more than a third hold university degrees, according to one of the largest surveys of the sex industry to be undertaken.

The academic research, carried out by Leeds University and funded by the Wellcome Trust, highlighted the pressures that lead people to enter the sex industry.

One respondent said she could not keep up her mortgage repayments while earning £50 a day as an NHS care assistant.

The sex worker, who was in her early 50s, told the Guardian she had worked for many years as a hospital care assistant before deciding to become a sex worker.

“I was doing six, 13-hour shifts a week in a hospital just so that I could keep up my mortgage payments. Even working such long hours I failed to keep up the repayments and lost my home. In the NHS I was earning £50 a day, now I earn £100 an hour and work on average just 163 days a year.

“I worked in the care sector for 20 years. A lot of empathy is required for that work and the same is true of sex work.

Eight out of 10 of the men I see don’t actually want to have sex with me, some just want affection and someone to talk to.”

THE LAMP APRIL 2015 | 9

EDUCATION@NSWNMA

What's On April 2015

Practical, Positive Leadership Series – 4 Days 13 April, 11 May, 10 June, 6 July NSWNMA, Waterloo A 4 day workshop specifically designed to meet the leadership needs of nurses and midwives.

Members $340

Non-members $600

Practical Positive Leadership for the Aged Care Team Series – 4 Days 29 April, 27 May, 24 June, 22 July NSWNMA, Waterloo A 4 day workshop specifically designed to meet the leadership needs of nurses working in aged care.

Members $320

Non-members $540

Legal and Professional Issues for Nurses and Midwives – ½ Day 30 April, Gymea 4 June, Armidale Topics covered include the Health Practitioner Regulation National Law, potential liability, importance of documentation, role of disciplinary tribunals and writing statements.

Members $40

Non-members $85

Are you meeting your CPD requirements? – ½ Day 6 May, NSWNMA, Waterloo 3 June, Armidale Seminar is suitable for all nurses and midwives to learn about CPD requirements and what’s involved in the process.

Members $40

Non-members $85

REGISTER ONLINE www.nswnma.asn.au/education/education-calendar For enquiries: Metro: 8595 1234 | Rural: 1300 367 962

NSWNMA MEMBER NEGOTIATION & ADVOCACY PROGRAM 2015 Negotiation and Advocacy Part 1 for Delegates/ Activists’/Members 20 May, 16 September, 18 November NSWNMA, Waterloo Negotiation and Advocacy Part 2 ‘The IRC, FWC, AHPRA and You’ 20 May, 16 September, 18 November NSWNMA, Waterloo

FOR MORE INFORMATION: Lyn Stevens on 8595 1234 (metro) 1300 367 962 (regional)

NEWS IN BRIEF

Australia

Anger can trigger heart attack University of Sydney research reveals that the risk of a heart attack is 8.5 times higher in the two hours following a burst of intense anger.

It is the first Australian study to investigate the link between acute emotional triggers and high risk of severe cardiac episodes.

“Our findings confirm what has been suggested in prior studies and anecdotal evidence – even in films – that episodes of intense anger can act as a trigger for a heart attack,” said lead author Dr Thomas Buckley, Sydney Nursing School, University of Sydney and researcher at Royal North Shore Hospital.

“The data shows that the higher risk of a heart attack isn’t necessarily just while you’re angry – it lasts for two hours after the outburst.”

In the study “anger” was qualified as five and above on a one-to-seven scale, from “very angry, body tense, clenching fists or teeth, ready to burst” up to “enraged, out of control, throwing objects”. Anger below this level was not associated with increased risk.

“The triggers for these bursts of intense anger were associated with arguments with family members (29%), arguments with others (42%), work anger (14%) and driving anger (14%),” said Dr Buckley.

“The data also revealed that episodes of anxiety can make you more likely to have a heart attack.

“High levels of anxiety were associated with a 9.5 fold increased risk of triggering a heart attack in the two hours after the anxiety episode.

“Increased risk following intense anger or anxiety is most likely due to increased heart rate, blood pressure, tightening of blood vessels and increased clotting, all associated with triggering heart attacks,” he said.

South Korea

Clean your arteries with coffee Drinking a few cups of coffee a day may help people avoid clogged arteries according to Korean researchers. They studied more than 25,000 male and female employees who underwent routine health checks at their workplace.

Employees who drank a moderate amount of coffee – three to five cups a day – were less likely to have early signs of heart disease on their medical scans reported the BBC. Researchers scanned the study subjects for tiny deposits of calcium in the walls of their coronary arteries to provide an early clue that the heart disease process may be occurring.

None of the employees included in the study had outward signs of heart disease, but more than one in 10 were found to have visible calcium deposits on their scans.

The researchers then compared the scan results with the employees’ self-reported daily coffee consumption, while taking into account other potential heart risk factors such as smoking, exercise and family history of heart problems.

People who drank a few cups of coffee a day were less likely to have calcium deposits in their coronary arteries than people who drank more than this or no coffee at all.

The study authors say more research is needed to confirm and explain the link.

Australia

Trading our health away A new report that examines potential impacts of the proposed Trans-Pacific Partnership (TPP) on our health sector has found the new free trade agreement will have numerous adverse impacts on health.

The report found that the TPP, currently being developed between 12 negotiating parties across the Asia-Pacific region, will likely lead to increases in the cost of medicines – not only for individuals but also for hospitals. It also found it will make disease prevention measures, such as stemming the negative impacts of nicotine and alcohol, more difficult to implement. The TPP is also likely to make it harder for people to choose healthier options when buying food.

The NSWNMA has repeated its call to the federal government to release the text of the trade agreement and allow a fully informed debate on the matter, or to withdraw Australia from the negotiations.

“The public’s healthcare should not be negotiated away in secrecy,” said NSWNMA Assistant General Secretary Judith Kiejda. “This is a perfect opportunity for our government to say that our world-class healthcare system is off limits when it comes to free trade deals.”

A copy of the report Negotiating Healthy Trade in Australia can be found at http://hiaconnect.edu.au/research-and-publications/tpp_hia/.

Canada

Puppy to sniff out superbug Vancouver’s largest hospital is training a sniffer dog to seek out the superbug C. difficile.

C. difficile attacks people whose immune systems have been weakened by antibiotics.

It’s an infectious disease that inflames the large intestine and can cause fever, diarrhea and sometimes death. Normally hospitals decontaminate rooms using ultraviolet machines to blast light radiation on walls and surfaces that may contain the bug.

But when a hospital is large it’s more efficient to know which rooms need cleaning.

This will be the job of Angus, a nine-month-old English Springer-Spaniel.

“If something has a scent, a dog can be trained to find it,” Teresa Zurberg, his trainer, told the Vancouver Globe and Mail.

Elizabeth Bryce and Diane Roscoe, researchers at Vancouver General Hospital, are working with Teresa Zurberg to train the puppy. They provide cotton swabs impregnated with the scent of C. difficile, which has been isolated from the infectious bug. The next step involves Angus searching the hospital for the scented swabs.

“This program is quite innovative. We haven’t found a similar approach,” Dr Bryce said.

Dogs are being increasingly used to search out a variety of scents. Among other things they can find bedbugs, improvised explosive devices and some forms of cancer. In a 2014 study conducted in Italy, cancer-sniffing dogs were able to detect prostate cancer in urine samples with 98 per cent accuracy.

In other studies they have been able to discover lung and breast cancers, although research is still in the early stages THE LAMP APRIL 2015 | 11

COVER STORY

10,000 rally to protect penalty rates

12 | THE LAMP APRIL 2015

More than 800 nurses took to the streets of Sydney and Newcastle on March 4 to show their opposition to the federal government’s attack on penalty rates and workers’ rights.

NURSES AND MIDWIVES IN SYDNEY WERE part of A throng of more than 10,000 people who rallied in front of Parliament House on a day of action to protest the federal government’s attack on workers’ rights.

Twenty-two NSWNMA workplace branches across the state voted to endorse coordinated stop work action on the day.

NSWNMA General Secretary Brett Holmes said nurses and midwives were responding to the Productivity Commission’s latest inquiry into workplace conditions. He says the inquiry, commissioned by the federal government, poses a serious risk to penalty rates, the minimum wage and a return of unfair individual contracts.

“Our members firmly believe in the need to protect the rights of workers who are required to be on shift during unsociable hours and to ensure they are paid fairly,” Brett said. “Working afternoons, nights and weekends puts enormous physical and social strains on shift workers and not everyone is capable of these demands – the idea that nurses and midwives will continue to work these shifts with no compensation is ludicrous.

“Attacks like these on penalty rates are a direct attack on the rights of nurses and midwives to work for fair pay and conditions, regardless of where they are employed in the health and aged care sectors.

“Cuts to penalty rates could mean a cut in take home pay of up to 30 per cent for nurses and midwives working shifts.

“What the Productivity Commission inquiry and the federal government is considering, which could deliver cuts to penalty rates, is an outrageous act to punish high-skilled nursing and midwifery staff by removing their incentive to work and contribute to society.”

The ACTU said rallies were held throughout the country including in Sydney, Newcastle, Broken Hill, Lismore, Melbourne, Mildura, Adelaide, Canberra, Perth, Brisbane, Gold Coast, Townsville, Mackay, Hobart, Launceston, Darwin and Tennant Creek.

National accounts released on the same day showed that labour productivity growth was solid in 2014, with GDP per hour worked rising by 1.6 per cent.

Labour productivity grew by an average

of 1.5 per cent per year during the period covered by the Fair Work Act – introduced by the previous federal Labor government – compared to 1.1 per cent a year under Work Choices, under the Howard government.

ACTU Secretary Dave Oliver said the Abbott government’s “destructive agenda of savage cuts” should be abandoned in favour of support for incomes, wages growth and investment in jobs and skills.

“The national accounts show that our economy is weak, which is putting Australians out of work,” he said. “Living standards are taking a hit under this government and the figures show real net national disposable income per person down by 0.9 per cent over the year.

“Productivity growth is strong and workers continue to do their bit so why has the government asked the Productivity Commission to conduct an inquiry into IR laws?

“The figures show this government is totally off track and their deep budget cuts are hurting our economy and putting pressure on households.”

THE LAMP APRIL 2015 | 13

COVER STORY

A stalking horse to lower wages and conditions The Productivity Commission inquiry into Australia’s industrial relations system is unnecessary and changes to current laws around penalty rates, the minimum wage and collective bargaining would be detrimental to nurses and midwives, says the ANMF.

“The increasing gap between male and female wages is at a 20-year high and acute in the health and social services sectors.”

THE AUSTRALIAN NURSING AND MIDWIFERY Federation (ANMF), in its submission to the Productivity Commission inquiry says there have already “been many such inquiries with copious submissions and data being provided”.

These enquiries always come up with the same thing, the ANMF says: “Policy tensions that manifest in a push on the one part to reduce unit labour costs, reduce regulation and diminish collective bargaining strength and on the other hand to raise and improve the safety net of wages and conditions and place collectivism at the centre of the bargaining unit”.

The ANMF says the Productivity Commission’s discussion papers emphasise “productivity” and “flexibility” yet fail to address one of the key issues affecting work in Australia, which is of particular relevance to the nursing and midwifery workforce.

“That is the continuing gender division of labour and the increasing gap between male and female wages. That gap is at a 20-year high and is acute in the health and social services sectors,” it says.

In its submission the ANMF advocates strongly for a livable minimum wage, the retention of penalty rates and the right to collective bargaining.

NURSE AND MIDWIFE WAGES LINKED TO THE MINIMUM WAGE The ANMF says the minimum wage and National Employment Standards are the principal mechanism by which the wages and conditions of nurses and midwives are determined. A reduction in the minimum wage would have an impact on pay in the health sector.

“A reduction in the minimum wage will affect women, especially low-paid

14 | THE LAMP APRIL 2015

women and especially those in the caring professions such as nurses and midwives and especially AiNs in the aged care sector.”

The ANMF refutes the claim of employers that an increase in the minimum wage will have a negative impact on employment levels.

“The Fair Work Commission has repeatedly pointed out that in a growing economy modest increases in the living wage have little or no impact on employment levels.

“The right to a minimum wage remains vitally important to large numbers of working Australians. And despite the media hype most of them do not fit the low wage stereotype of a teenager with casual employment in their local supermarket. Many are adults with dependent children who work full-time.”

REMOVING PENALTY RATES A DISASTER The ANMF says it is disappointed the Productivity Commission appears to have embraced the myth that penalty rates have “aroused a special degree of controversy”.

It says employer groups invariably blame the Fair Work Act and the creation of modern awards “as devilish instruments that reduce workplace flexibility, push up labour costs and force employers to close their cafes and shops on weekends”.

It says that a reduction in penalty rates would have a “deleterious impact” on nurses and midwives and the provision of health care in Australia.

Even a marginal reduction in penalty rates could cost a nurse or midwife $180 per week in income. A complete removal of penalty rates could cost as much as $470 a week.

It ain’t broke but Abbott aims to smash it

Commission focuses on employer complaints When Tony Abbott announced a “root and branch” inquiry into workplace laws by the Productivity Commission his strategy was to get the changes for which the Coalition sought justification, according to David Peetz, Professor of Employment at Griffith University.

A report by the Fair Work Commission, released in January, shows labour productivity is high under the workplace laws that were implemented by the previous federal Labor government. This raises questions about why there is need for an allencompassing review of workplace laws.

The Australian Workplace Relations Study (AWRS) was one of the most significant studies of Australian workplace relations in 20 years, involving 3000 businesses and 8000 employees.

Claims by employers and the Abbot government that wages are too high and productivity too low are not borne out by the study.

The study found that labour productivity remained steady or had increased in the previous year for 85 per cent of these enterprises.

It also found that wages and salaries account for only a minor proportion of sales and services revenue for almost 90 per cent of enterprises that operate for profit.

“The government needs an ‘independent’ rationale for radical IR change,” he said.

“The Productivity Commission could be relied upon to make bold recommendations, as it is seen as a body of overwhelmingly liberal market economists.”

The scope of the Productivity Commission inquiry The federal government announced the terms of reference for the Productivity Commission inquiry in December last year.

In January, 5 wide ranging issues papers were released that invited submissions by a hasty deadline of March 13.

The government has said it will take the Productivity Commission’s recommendations to the next federal election, due towards the end of next year. Current safety measures that are up for grabs in the inquiry include: the minimum wage safety net of “national employment standards” penalty rates the modern award safety net system Other protections for workers that are under threat include: collective bargaining what is “permitted matter” in agreements (such as ratios) unfair dismissal anti-bullying laws restrictions of individual contracts

• • • • • • • • •

“History tells us the results, if implemented, would include lower real wages, especially for low-paid workers…”

— Professor David Peetz

Professor Peetz says the IR issues paper released by the Productivity Commission revealed a very broad-ranging approach to industrial relations, consistent with ultimately making “once in a generation” recommendations.

In particular, the Productivity Commission is challenging the concept that underpins industrial relations law: of achieving a balance of power in the workplace.

“The focus of the review is revealed by its use of language. It is a review for employer issues of productivity and flexibility, not employee issues of equity and justice. In the issues papers there are 40 mentions of “flexibility” and 50 of “productivity” but only three of “equity”, while “justice” is only mentioned in others’ titles. ‘Penalty rates’, ‘dismissal’, ‘minimum wages’ and ‘awards’ – all sources of employer complaint – get 45, 50, 142 and 123 mentions respectively; ‘women’ get three (mostly historical), ‘gender’ another three, ‘inequality’ two and ‘poverty’ one.

Professor Peetz says there are differences between the Abbott strategy and WorkChoices – the last great Liberal Party attack on workers’ rights – but the desired outcomes are the same.

“History tells us the results, if implemented, would include lower real wages, especially for low-paid workers, and probably increased insecurity for them.

“Any new approach would likely place relatively more emphasis than WorkChoices did on attacking unions and collective bargaining power, and less on overtly cutting individuals’ pay.”

THE LAMP APRIL 2015 | 15

COVER STORY

Cutting penalty rates is cutting pay Meg Pendrick RN highlighted the importance of penalty rates to the nursing and midwifery professions when she addressed a rally of 10,000 people in Sydney in March.

Following is a transcript of her speech.

16 | THE LAMP APRIL 2015

I am here today because I am sick of being taken for granted and I want this federal government to actually listen to those of us who work in industries that provide a 24-hour service. Industries that provide a service during the unsociable hours when everyone else is enjoying their family, their after work life or they are asleep.

Nursing is not a Monday to Friday job – it’s not a nine to five job – it’s a physically demanding job, an emotionally challenging job and at times an unrewarding job. It requires empathy, professionalism, discipline and composure – constant problem solving and reasoning.

You are on your feet for long periods of time and this is not the once off – this is within the normal practice of a nurse, morning, afternoon and night.

Shiftwork is a part of our job. We have no say in this, as healthcare is 24 hours a day, seven days a week.

Penalty rates are recognition of our contribution to the care of the sick and dying. They acknowledge that while I missed my son’s soccer game, my daughter’s netball practice, my sister’s birthday or my parents’ anniversary dinner, I have been a valuable and necessary asset in the provision of a service.

A service people expect.

For many nurses and midwives, particularly working mums and dads, these penalty rates help pay mortgages, pay for childcare, put petrol in the car, feed our families and allow us to afford our own healthcare.

This federal government has requested the Productivity Commission to conduct an enquiry into the workplace relations’ framework and one of the issues they have highlighted for review is penalty rates.

They have already attacked the health sector. Any Medicare co-payment will push more people into our emergency departments and increase nurse workloads and privatising our public hospitals will increase all our personal health costs.

If employers and this government succeed in cutting penalty rates to retail, hospitality and other industries it is only a matter of time for healthcare.

Cutting penalty rates is a pay cut. For some of us it means 25 to 30 per cent less in our take home pay.

What would it mean to you to take a 30 per cent pay cut?

To me it is a major attack on my income and livelihood. It denies my current provision for my family and sends a message of disregard about my skills, my training, my experience, my commitment – and my profession.

I am here today because I am against cuts to penalty rates and any other anti-worker recommendations. I am part of the workforce that works the hours and does the work that many others admit they don’t want to do – because I love my job.

But we are not invisible and don’t take us for granted.

We will stand up to protect our rights from interference by the Productivity Commission and the federal Liberal government.”

“I am part of the workforce that works the hours and does the work that many others admit they don’t want to do – because I love my job. But we are not invisible and don’t take us for granted. We will stand up to protect our rights from interference by the Productivity Commission and the federal Liberal government.”

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COVER STORY

“WE CAN STOP NEGATIVE CHANGES IF ENOUGH PEOPLE TAKE A STAND.” — Joanna Zhang RN

Joanna Zhang RN, second from left.

Andrew Sipowicz RN

Martin Gray CNE 18 | THE LAMP APRIL 2015

Threats to penalty rates and the vital role of registered nurses in New South Wales aged care facilities were the two main issues that led RN Joanna Zhang to attend the National Day of Action.

Under current laws NSW nursing homes must have a registered nurse on duty at all times.

But changes to the wording of the federal Aged Care Act have prompted a flow on affect to the definition of what is a nursing home in the NSW Public Health Act, potentially removing the requirement for an RN 24/7.

The NSWNMA and community groups are lobbying the government to legislate to make the 24/7 requirement permanent.

As a registered nurse at an aged care facility in Sydney’s western suburbs Joanna is particularly worried that the state government will allow the requirement to be removed.

“It’s a ridiculous and crazy idea to reduce the role of trained nurses in aged care,” she told The Lamp. “Australian society is ageing and there are more and more elderly people with complex needs – often associated with dementia – who need to be taken care of.

“However if they take RNs out of nursing homes the remaining staff will not be qualified to assess and treat such patients. More patients will have to be taken to hospital for assessment, which will put unnecessary stress on the elderly and their families and overload the ambulance service and the emergency departments.”

Joanna went to the Sydney rally with two other nurses from her facility.

“It felt good to take part with nurses from other hospitals and facilities. It made me feel we can stop negative changes if enough people take a stand,” she said.

She says she believes protests by the health sector played a role in forcing the government to back away from the proposed Medicare co-payment.

“That case proves it is possible to change the government’s mind.”

“WE NEED TO GET OUR MESSAGE ACROSS TO POLITICIANS.” — Andrew Sipowicz RN Last month’s National Day of Action was another strong signal to the federal government not to tamper with workplace laws and working conditions, says Westmead Hospital delegate and registered nurse Andrew Sipowicz.

Andrew said the high turnout at rallies around Australia on March 4 followed the Victorian and Queensland elections, which saw Liberal state governments lose office to Labor.

“The pretty clear message to the Liberals federally is that people are angry and worried about these sorts of changes and will vote accordingly,” he said.

“The government’s decision to drop their plan for a Medicare co-payment is a good sign. It shows we can stop these attacks on people’s living standards.”

Andrew went to the rally with two busloads of nurses from Westmead Hospital. He says he took part because he wants “to support fair pay and fair working conditions for all Australian workers.

“I thought it was important for nurses to be involved in a common cause with other unions because everyone’s working conditions, including penalty rates, are potentially at risk.

“We know the Productivity Commission is looking at our working conditions and Prime Minister Abbott and the Business Council are looking at them too.

“A lot of nurses are really angry that the government is even considering trying to reduce penalty rates.”

Andrew says the nationwide rallies were an important “show of strength” to influence government decision-making.

“It may not be such a pressing issue now but I don’t think we can be complacent. We are 18 months away from the next federal election and we need to get our message across to politicians now.

“When Abbott went to the last election he told us he wasn’t going to touch Medicare and education.

How can you can trust someone with a record like that?”

“IT IS IMPORTANT TO KEEP THE ISSUE AT THE FRONT OF PEOPLE’S MINDS.” — Martin Gray CNE The NSWNMA should continue to highlight potential threats to working conditions despite the National Day of Action succeeding in “putting the federal government on notice,” nurse Martin Gray, vice president of the Association’s Prince of Wales branch, told The Lamp.

“The business lobby is making plenty of noise about getting rid of penalty rates and other working conditions. The government will give them what they want if we don’t put up a strong counter-argument,” Martin said.

“The National Day of Action was a ‘pre-emptive strike’ to say to the government: ‘we are putting you on notice – don’t even think about touching penalty rates’.

“The government has not yet made a decision but we still got thousands of people onto the streets of Sydney. If it decides to go ahead and reduce penalty rates there will be tens, even hundreds of thousands on the streets.

“It is important to keep the issue at the front of people’s minds.

“I think a lot of members take the attitude that, until it’s official, they will carry on with business as usual.

“While the government hasn’t come out and said they are definitely going to cut penalty rates, we know that’s what they’d like to do.

“The danger is, if we wait for the government to announce a change it will be harder to roll it back. They will not want to be seen to be giving into pressure.

“Like all shift workers, nurses feel very strongly that they deserve penalty rates.

“Penalty rates are essential to bring our basic salary up to a living wage – particularly in Sydney where rents and house prices are just ridiculous.”

Martin says he experienced the abolition of penalty rates in Britain in the early nineties.

“We had penalty rates when I started my nurse training but by the time I became a registered nurse my hospital had scrapped them. They gave everyone a small pay rise instead.

“The result was that the people who wanted to work permanent nights and weekends stopped working those hours because there was no longer any incentive.

“And people like me who did not want to work excessive nights and weekend shifts were suddenly required to do so.

“As a young man just starting out in my nursing career, I found I had no real life outside of work and became disillusioned with nursing. What 21year-old wants to be at work all the time, when his friends are out having fun?

“They eventually had to bring back penalty rates, though in a watered down form.”

Branches vote for strike action More than 20 NSWNMA branches voted to strike so they could participate in the national day of action. The branches included: • Bankstown Hospital • Blacktown Hospital • Canterbury Hospital • Bulli District Hospital • Cessnock Correctional Centre Justice Health • Coledale District Hospital • Concord Hospital • Concord Centre for Mental Health • Gosford Hospital • Liverpool Hospital • Liverpool Mental Health • Manning Base Hospital • Mount Druitt Hospital • Nepean Hospital • Port Kembla Hospital • Prince of Wales Hospital • Prince of Wales Mental Health • Royal North Shore Hospital • Royal Prince Alfred Hospital • Stockton Centre • Westmead Hospital • Wollongong Hospital.

THE LAMP APRIL 2015 | 19

PUBLIC HEALTH

Our 2015 Public Health System award campaign is underway After months of research and consultation with members the public health system Log of Claims Committee has finalised a claim that will go to a vote of branches in April.

Up for the fight: NSWNMA councillors Gil Wilson and Kerry Rodgers with Assistant Secretary Judith Kiejda, President Coral Levett, General Secretary Brett Holmes and councillors Lyn Hopper, Gary Clark and Lorna Scott.

GENERAL SECRETARY BRETT HOLMES SAYS THE NSWNMA remains committed to improving and extending ratios throughout the public health system.

“The battle to improve ratios continues. The 2015 claim includes exactly the same ratios claims that were included in the 2014 campaign,” he said.

“The strong show of support for last year’s ratios claim means the campaign for ratios in EDs, paediatrics, and neonatal intensive care units will continue in 2015, with some additional claims recommended by your elected Log of Claims Committee.The claim also seeks to improve ratios in all NSW hospitals to the same level as Group A city hospitals.

20 | THE LAMP APRIL 2015

“It’s time for the state government to build on the legally enforceable ratios system that we have already won to improve and fund nurse ratios that are fair for all hospitals and extend the current system to more nursing specialties.”

Brett says there is a wealth of international evidence to back up the case for ratios.

“International nursing research continues to be published that shows increasing nursing numbers and RN skill mix delivers better patient outcomes and avoids adverse events.

“The government can afford to do this – it’s a priority for our society, for the health system and our profession.”

Features of the claim A reasonable pay rise

Your next pay rise is due in July 2015.

Your elected committee recommends that NSWNMA again claim a 2.5 per cent pay increase, the same amount as last year.

Inflation is currently 1.7 per cent per annum.

Your feedback tells us that what you want is a balance between improved nurse-to-patient-ratios, workloads and a fair pay rise.

Building on our current ratios system

The ratios campaign that nurses and midwives backed so strongly over the past few years will continue:

• Improve ratios in all NSW hospitals to the same level as Group A city hospitals.

• Introduce ratios in paediatric and neonatal intensive care units.

• Introduce ratios in EDs, EMUs and MAUs. • Introduce ratios in intensive and critical care units.

• Introduce a ratios-equivalent system in community and community mental health.

The full details of these ratios claims for all the relevant specialties will be outlined in a kit to be sent to branches in April prior to a vote by members.

ALP pledges to enshrine ratios in law NSW Labor party has pledged to enshrine nurse-to-patient ratios in law – for the first time in NSW – so future governments and health officials will have to ensure that nurse numbers are protected and not traded away.

NSW Labor leader Luke Foley said he had listened to the voices of nurses.

“Labor has a strong record of supporting nurses and we understand that nurses are best placed to know what level of staffing is needed to provide safe and efficient care.”

Labor promised an extra new 735 nurses in emergency departments and an extra 105 nurses in paediatric wards.

This would benefit 75 emergency departments and paediatric wards across Australia.

“These additional staff will take pressure off staff and patients in over-stretched emergency departments, and provide more care for children in our paediatric wards across NSW.” NSWNMA General Secretary Brett Holmes says this is a significant step forward.

“This is a great testimonial to the ongoing efforts of nurses and midwives who have been campaigning tirelessly for many years now to put patient safety first,” he said.

“We understand that nurses are best placed to know what level of staffing is needed to provide safe and efficient care.”

– NSW Labor leader Luke Foley

Vote on the claim Branches will be sent kits outlining the details of the claim, in mid-April. Your branch is asked to vote on the 2015 claim by no later than Thursday April 30. All members are encouraged to join the branch discussion about the claim and plan how you can join activities to push for improved and extended ratios this year.

The NSWNMA strongly recommends that your branch gets behind the campaign effort to put patient safety first.

To continue campaigning for ratios go to www.backyournurses.org

WHAT’S NEW IN THE CLAIM? Your elected Log of Claims Committee recommends that in addition to the existing claims for improved and extended ratios the following five claims be included.

There are new ratio claims for: • Short-stay wards • Drug and Alcohol units, and • Non- Birthrate Plus maternity services.

In addition there is a claim for: • Increasing the minimum notice for rosters • Three ADOs accrual and nonforfeiture of accumulated days off for DoNs and Area Managers, Nurse Education.

Liberals promise more nurses but not ratios During the election campaign Mike Baird pledged to increase frontline nursing and midwifery staff by 2100 FTE positions.

The announcement was welcomed by the NSWNMA but General Secretary Brett Holmes warned that these numbers were not backed up with a commitment to ratios.

“Any effort to boost overall nurse numbers in our state’s public health system must be matched with a commitment to improve nurse-to-patient ratios using the ‘nursing hours per patient day’ model and mandated statewide through the introduction of legislation,” he said.

“We challenge the LiberalNationals Coalition to match or better the election pledge by NSW Labor in providing mandated nurse-to-patient ratios and enshrining them in law.”

THE LAMP APRIL 2015 | 21

PUBLIC HEALTH

“We have to keep the issue in the minds of the public.”

— Annette Alldrick The NSWNMA must maintain pressure on the government to introduce equal nurse-to-patient ratios across the health service “for the safety of patients and the sanity of nurses” says Annette Alldrick, NSWNMA delegate and branch secretary at Shoalhaven Hospital.

Annette, who is also a member of the Association’s council, believes there is strong community support for the ratios campaign.

“We had three rallies for ratios in the centre of Nowra – the last one got hundreds of signatures on a petition,” she said. “But we have to keep the issue in the minds of the public.”

Annette says Shoalhaven nurses are most concerned about inadequate staffing in the medical ward and emergency department.

“As a category B hospital our medical ward only has a ratio of one nurse to five patients on afternoon shifts and we desperately need one to four.

“The medical and surgical wards are very busy and desperately need parity with Sydney.

“In the emergency department there is no nurse in the paediatric bay from 2200.

The nurse allocated to the resuscitation bay has to cover the paediatric bay and if a resuscitation comes in, staff from other areas of the unit have to cover the paediatric bay.”

Annette welcomes the commitment by NSW Labor to provide sufficient staff to deliver a 1:3 ratio in EDs and paediatric wards in Peer Group A, B and C hospitals.

“Let’s hope that Labor’s adoption of ratios as a policy puts pressure on the Liberals to follow suit.

“The evidence is overwhelming that ratios result in improved clinical outcomes, less readmissions to hospital and better long-term health outcomes for patients.”

“The health system is bursting at the seams.”

— Michelle Nicholson A nurse-to-patient ratio of 1:3 is needed in emergency departments to ensure all patients receive safe and timely care, says nurse Michelle Nicholson, a NSWNMA councillor.

“A busy metropolitan emergency department sees 200 to 250 patients per day. A 1:3 ratio would ensure that they are all seen within the four-hour target,” she said.

Michelle adds that the Association is currently campaigning for a 1:1 ratio for emergency resuscitation units.

“At my hospital – a major trauma centre – we have one nurse looking after three of the sickest patients in the hospital. A 1:1 ratio would ensure those patients could be moved out of the resus bay quicker.

“The health system is bursting at the seams and is just not coping at the moment.”

She says outpatients departments also need ratios.

“Outpatients departments sometimes have only two nurses who have to see a couple of hundred patients a day – and they do admin work as well.”

22 | THE LAMP APRIL 2015

Michelle says the Association must also campaign for ratios in community nursing.

“There is a real benefit in having more nurses out in the community. We are trying to discharge patients earlier but we are hampered because there are just not enough community nurses to provide the services that patients need.

Many patients are referred to clinics post-discharge for ongoing care.”

Michelle is concerned that C Group hospitals – often small, rural facilities – have missed out on some of the gains won in the Association’s ratios campaign.

“Their patients are just as sick as ours, so why are they are supposed to manage with less staff?

“We need to keep fighting to help them out.

“During our previous campaigns the union put a lot of information including TV ads out to the community and it got the public talking about the issue. We need to keep doing that.”

“Safe patient care – we are not in this for any other reason.”

— Sue Brazil Unequal workloads between big and small hospitals are obvious in Hunter New England Local Health District. It includes John Hunter Hospital, a major trauma and teaching centre, and small Peer Group C facilities like Scone and Cessnock hospitals.

Nurses at the smaller facilities often struggle to cope with lower staffing ratios and less non-nursing support, says NSWNMA councillor Sue Brazil.

“Staff at the smaller hospitals often raise with me the issue that they haven’t been given the same workload ratios as their counterparts in the bigger hospitals,” she said.

“As far as workloads are concerned you still have inequality across the board.

“NHPPD in medical, surgical, rehab and palliative care wards can be 5, 5.5 or 6 depending on the size of the hospital.

“Nurses at the small facilities also don’t have any after-hours support from doctors and clinical support officers, for example.

“Why should a very sick patient in a medical ward at Muswellbrook, for instance, get less care than a patient in a similar condition at John Hunter?”

Sue says the Association needs to maintain its campaign to extend ratios to paediatric wards and emergency departments.

These are major issues at John Hunter, which has the busiest emergency department in the state, and the 114-bed John Hunter Children’s Hospital, one of only three children’s hospitals in the state.

“I hear from nurses in these areas that they are working harder and still do not have enough time to provide the level of care they believe is required.

“All the international research shows that ratios have a dramatic impact on patient outcomes.

“Ratios are worth fighting for if they result in safe patient care and patients can get better outcomes from the care we give.

“We are not in this campaign for any other reason.”

“The goal of 1:3 in paediatrics would be welcome.”

— Peg Hibbert A big increase in paediatric patient numbers has created a pressing need for more nursing staff, highlighting the importance of the Association’s ratios campaign says Hornsby nurse and NSWNMA councillor Peg Hibbert.

“Paediatrics has been very busy over the past few weeks. They have found it hard to get more staff, which has caused a lot of angst,” she said.

“The paediatrics ward is currently staffed at 1:5 which is clearly inadequate. The union’s goal of 1:3 staffing in paediatrics would be most welcome.”

Peg says Hornsby Hospital serves a fastgrowing population. The state government has nominated the area as a growth region and according to Hornsby Council there has been a big jump in the proportion of overseas-born residents and young families.

Peg says another staffing issue may arise with the hospital about to open a new surgical wing with eight operating theatres.

There are five at present; three general, one orthopaedic and one set up for C sections.

“Management says they have done the sums and we can cope with existing staff levels.

“The branch expects there will be a significant workload increase and we will have to keep a close eye on it.”

Peg says it is an encouraging sign that the state Labor opposition has adopted nurseto-patient ratios as policy.

“Hopefully it will help our campaign. We have got to keep at it because if we take one step back the department will take two steps forward and walk all over us.”

THE LAMP APRIL 2015 | 23

MEDICARE

Medicare records heading offshore?

The Medicare payment system is the latest public asset to be lined up for sale.

AFTER TRYING AND FAILING TO introduce a Medicare co-payment for visiting your doctor, the federal government now wants to privatise the Medicare payment processing system.

The move would destroy the jobs of thousands of public sector workers, mostly women, including many in rural and regional areas with high unemployment.

At least some of these jobs are likely to go to overseas call centres and data processing agencies.

“The government has not made a public case for this sell-off plan or debated it in parliament. It’s privatisation by the back door,” said Nadine Flood, national secretary of the Community and Public Sector Union.

She said the Abbott government had so far eliminated almost 8000 public service jobs with another 8500 slated to go – even without the privatisation of Medicare payments.

The government has asked companies to express interest in providing claims and payment services for the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS).

The new provider would have to process $29 billion of claims from 600 million transactions a year conducted for the Department of Health, and nearly $2.5 billion in claims from 33 million transactions for the Department of Veteran’s Affairs.

As the Australian Financial Review noted, few Australian companies would be capable of such a big job. But running a for-profit Medicare payments system “could provide an

extremely lucrative and stable revenue stream for successful candidates,” the newspaper said.

Large outsourcing firms from the US, Germany, Japan and Britain, as well as Australia Post, are poised to bid for the Medicare payments business, according to media reports.

Federal Labor’s Shadow Minister for Human Services, Doug Cameron, warned that privatising Medicare payments could lead to public sector jobs being shipped offshore.

“If you look at the history of banks in this country, then it’s clear that jobs will very quickly end up in India or the Philippines,” he said.

“People shouldn’t have to spend longer standing in line at Australia Post, at some private company’s shopfront or spend hours on hold to some international call centre, just to lodge a claim or hand in a form.”

Nadine Flood said privatisation also posed a threat to people’s privacy.

“Medicare’s database contains sensitive and detailed medical, personal and financial records of all Australians.This information should not be outsourced to for-profit companies,” she said.

Already, the government has closed filing warehouses in Adelaide and Darwin and handed the files of millions of Australians to a US company, Iron Mountain.

The warehouses held decades worth of Medicare, Centrelink and Child Support Agency files.

The Department of Human Services says Iron Mountain’s role in managing the records will grow as more warehouses are closed.

The Community and Public Sector Union is asking people to sign its “Stop the Medicare Sell-Off” petition at: www.stopmedicareselloff.com.au

“Jobs will very quickly end up in India or the Philippines.”

— Doug Cameron Federal Shadow Minister for Human Services 26 | THE LAMP APRIL 2015

INDUSTRIAL

In-charge allowance test case won The NSWNMA has won an important test case involving payment of in-charge of shift allowances in the public health system.

“It is so much easier to go and speak to nursing administration if you have someone to back you up.”

— Cathy Pink RN

Cathy Pink RN and Bernadette White RN

THE NSW INDUSTRIAL RELATIONS Commission has ruled that a nurse or midwife designated to fulfill the clinical management role in a ward or unit during a shift must be paid an in-charge of shift (ICS) allowance, even when the Nursing/Midwifery Unit Manager is rostered on duty.

The NSWNMA took a case to the commission on behalf of two members working as registered nurses in the Haematology Ambulatory Care Unit (HACU) at Concord Repatriation Hospital in Sydney, where they were regularly designated to undertake the role of team leader.

The Association claimed the members were entitled to be paid the ICS allowance, prescribed by clause 12 (v) of the Public Health System Nurses’ and Midwives’ (State) Award 2011, when they worked as team leaders in the HACU between 2007 and 2014.

The NSWNMA has found it difficult to enforce that award provision since its insertion in 2002.

Local Health Districts have usually argued that the day-to-day clinical management role is not defined in the award and, in their view, the NUM undertakes

the clinical management role even when the NUM is absent from the floor performing other duties.

Even when LHDs have accepted that nurses/midwives are undertaking the clinical management role, they have argued the ICS allowance is not payable unless the clinical management role is formally delegated.

In a decision that will affect many other nurses, Justice Roger Boland ordered Sydney Local Health District to pay the full amount claimed by our members.

He found they were entitled to be paid (and back paid) the ICS allowance because the duties of team leaders constituted a day-to-day clinical management role for the purposes of the award.

He also found that the act of designating our members to perform the clinical management role when the NUM Level 3 was rostered on duty also fulfilled the requirement to delegate. The delegation did not have to be in writing.

One of the nurses represented by the Association, Cathy Pink, said the NSWNMA had advised the nurses they were eligible for the allowance.

“After management rejected our claim

the union represented us in negotiations and when these failed, the union offered to run the case in the commission.”

She said management rejected their claim “mainly on the basis that the NUM was on duty, on site and always contactable and was fulfilling the clinical management role.

“In reality it was the team leader who was running the unit; the NUM was there as a resource person while doing other duties.

“We were designated as team leaders on the roster but after we started asking about the allowance management removed the team leader description from the roster.”

In April 2012 the NSWNMA lodged a claim in Cathy’s case covering six years back payment of the allowance.

Cathy said preparing for the case involved a lot of work going back over past rosters to try to calculate the amounts involved and helping to prepare the evidence.

“At times I thought, I’ve had it with this and just wanted it over. But we persevered and eventually got the win.

“It had been such a long battle and when the judge ruled in our favour, we were ecstatic.

“It showed me the value of joining the union. It is so much easier to go and speak to nursing administration if you have someone to back you up.

“If you really believe you have a case you have to be prepared to keep pushing because management will put it off as long as possible and hope you go away.”

THE LAMP APRIL 2015 | 27

ENVIRONMENTAL HEALTH

Hunter health at risk from coal In one of Australia’s once most fertile river valleys, the Hunter Valley, coal mining is expanding at a rapid rate with devastating effect on community health, social cohesion and traditional industries.

A NEW REPORT ON THE HUNTER VALLEY from the Climate and Health Alliance (CAHA) reveals serious harm to human health from all stages of coal production – including mine development, mining activities, and coal transportation and combustion.

CAHA, an alliance of 28 health and climate organisations, including the NSWNMA, also exposes an alarming refusal by successive state governments to acknowledge the risks or heed their own health department officials.

Of all the air pollutants produced by coal mining activities particulate matter is the most significant. Fine particles, known as PM2.5 and PM10, are associated with significant health impacts.

In 2013, the World Health Organisation reported: “There is no evidence of a safe level of exposure [to PM10 or PM2.5].”

PM2.5 particles travel deep into the lungs and pass into the blood stream, posing a risk of stroke and heart attack. European 28 | THE LAMP APRIL 2015

studies suggest particulate matter in ambient air pollution contributes to the development of lung cancer even at levels below current European air quality standards.

Particulate matter is also thought to be the most important component of diesel engine exhaust, which was recently classified as a human carcinogen by the International Agency for Research on Cancer.

Emissions from diesel, used extensively in mining, are particularly toxic as they emit PM2.5 containing polycyclic aromatic hydrocarbons (PAHs), known carcinogens.

They also include volatile organic compounds that can, in the presence of sunlight, combine to form ground level ozone that is harmful to respiratory and cardiovascular systems, according to the CAHA report.

“The current approach is to regulate to certain air quality targets as the standard, when in fact exposure to air pollution at the standard itself is not safe.

“The most recent NSW Air Emissions

Inventory (published in 2012 using 2008 data) indicates emissions of PM10 in the Sydney Greater Metropolitan Region (GMR) increased 20 per cent from 1992 to 2008, an increase largely attributed to increased coal mining in the Hunter Valley.

SOCIAL COHESION SHATTERED The residents of Bulga (population 360) won two court cases in five years to prevent a Rio Tinto mine going ahead.

The Land and Environment Court ruled that the benefits of the mine did not outweigh the impacts of noise and dust on residents and the destruction of rare forests containing endangered plant and animal species. This was upheld on appeal but it was a short-lived victory.

Subsequently, the NSW government removed the right of communities to take such “third party merits” actions in court.

Instead, power was given to the Planning Assessment Commission (PAC).

In recommending conditions to reduce

SOURCE: Climate and Health Alliance’s report, Coal and Health in the Hunter

the impact of Rio Tinto’s Mount Thorley |Warkworth mine project, PAC suggested relocating the entire village of Bulga.

In the village of Camberwell,Yancoal, owned by the Chinese government, solved the issue of troublesome villagers by buying 49 of the 56 houses and renting them back, sometimes to vendors, at nominal rents.

Camberwell is surrounded on three sides by mines, with a fourth side held by property owner, Wendy Bowman, who refuses to sell her cattle farm that would extend an existing mine onto grazing land on Glennies Creek – an important tributary that contributes to the health of the Hunter River and irrigation of the nearby Pokolbin and Broke-Fordwich wine regions. The mine is small in comparison to others in the Hunter and will only operate for seven years.

“Why dig up and destroy all the creek flats that will feed people for hundreds of years?” Mrs Bowman says.

The New South Wales Office of Water

initially opposed the new mine and then reversed its opposition, without explanation, in 2012.This led to its approval despite opposition from NSW Health.

CAHA reports that an economic assessment of the project found the cost benefit analysis (submitted by the mine owners to the planning approval process as part of an Environmental Assessment) overstated the value of the project to New South Wales by $378 million. There was no value assigned to ecological impacts and no consideration of health impacts “I don’t blame the mining companies, I blame governments and I don’t think there’s any difference between Liberal and Labor on this,” says Camberwell resident Deirdre Olofsson, who has fought for years to access state planning documents surrounding mine approvals.

“Government knows the health impacts and they are just laughing at us.”

CAHA agrees: “The views of health experts and community members have lit-

tle impact on policy and approvals and projects are failing to account for greenhouse emissions, human health and broader environmental impacts,” the report states.

CAHA estimates that health damage caused by exposure to fine particles (PM2.5) emitted from coal mines and coal fired power stations costs $47 million a year in the Hunter town of Singleton and $18.3 million in Muswellbrook.These particles travel deep into the lungs and pass into the blood stream, posing a risk of stroke and heart attack.

In Newcastle, annual health costs associated with air pollution from PM10 particles are an estimated $13 million a year and will more than double with the opening of a projected fourth coal terminal. Annual externalised cost of associated health damages from the five coal-fired power stations in the Hunter Valley is estimated at around $600 million per annum*. *Details of how this estimate is reached are available online in the report at caha.org.au/projects/hunter-coal/

THE LAMP APRIL 2015 | 29

ENVIRONMENTAL HEALTH

Holiday in the Hunter: a guide for the cautious traveller The impacts of a massive increase in coal mining are threatening to destroy not just human health but the thoroughbred, wine, tourism and agricultural industries that are major contributors to the Hunter Valley’s economy and employment.

IF YOU INTEND TO VISIT THE Hunter Valley, just two hours from Sydney, first grab a copy of the NSW Health fact sheet titled “Mine Blast Plumes and You”.

In February last year a plume turned the sky over Muswellbrook deep orange when a blast at the Mount Arthur mine detonated an explosive mixture of ammonium nitrate and fuel oil.

The resulting plume, containing nitrogen dioxide, spread several kilometres from the site. At high levels, nitrogen dioxide can cause pulmonary oedema (inflammation of the lungs), which can be fatal.

If despite your best efforts you find yourself in or near a plume NSW Health advice is “do not enter it (this includes driving through it) and move out of the plume’s path if possible. If at home, head indoors, close all doors and windows. If you are in a car, wind up windows and close vents until the plume passes. If you find yourself in a plume, try to move out of it as quickly as possible. If you have been exposed, use water to thoroughly wash eyes, and to clear your 30 | THE LAMP APRIL 2015

nose and throat. If you experience respiratory symptoms you should seek immediate medical attention and inform the doctor of possible NO2 (Nitrogen dioxide) exposure.

Be alert for possible delayed breathing problems. If you are an asthmatic, use your reliever medicine.”

Before you leave home you could also download a map from the Climate and Health Alliance’s report, Coal and Health in the Hunter (caha.org.au).This will help you avoid the great swathes of mining land that dwarf delightful vineyards, thoroughbred studs and farms that have traditionally, until recent state governments’ obsession with more and more coal mining, co-existed with mining.

If you’re asthmatic pack a puffer or two along with your tourist brochures. The NSW Asthma Foundation warns the Hunter Valley is a “hot spot” because of its coal industry.

In 2010 a strategic directions report by Muswellbrook Shire Council found that Hunter Valley viticulture and tourism industries contributed $1.8 billion dollars annually into the economy of New South Wales.

“Coal mining activities are fundamentally incompatible with viticulture and wine tourism activities, which should not exist in close proximity to one another,” it said.

In a 2014 report, Seeing through the Dust, the Australia Institute agreed with NSW Minerals Council claims to employ around 12,653 people, but said this was only about five per cent of the workforce. It disputed industry claims to creating another 59,0084 indirect jobs.

“Estimates from industry bodies such as this overlook an important fact – all industries contribute to the creation of indirect jobs.When nurses and teachers spend

their wages, when hospitals and schools buy supplies and construct new facilities, they are all affecting other industries and could claim to be creating indirect jobs.

“Industries that do employ lots of people, like health care and education, generally do not to need to estimate their indirect jobs to demonstrate their importance. Only relatively small employers like mining employ economists to make these estimates.”

The report says mining contributes two to three per cent of NSW Gross State Product (GSP), 2 per cent of annual revenue through royalties and 1.4 per cent of the state’s jobs.

The Hunter Thoroughbred Breeders Association, which says it is not inherently anti-mining, has enlisted high profile racing industry types, including Gai Waterhouse, to join their campaign for some control of the rapidly burgeoning mining industry.

“We are seriously concerned about the increasing encroachment of coal and coal seam gas mining and the cumulative impact these industries will have on our water quality, our land management, our air quality and the health of our people and our livestock,” Dr Cameron Collins, president of Hunter Thoroughbred Breeders said.

Beauty bows to the ugly Muswellbrook Hospital Emergency nurse and NSWNMA delegate Adrian King is familiar with the health issues confronting Hunter Valley residents.

He said Muswellbrook Hospital Emergency treats a standard number of asthma and croup cases.

“It is the chronic conditions that are of concern. You see people who’ve worked in the coal fired power station for 20 years being diagnosed with asthma for the first time.”

Adrian noticed a friend, a miner, had a condition known as clubbing, when the nail bed curves. It is a sign of chronic oxygen depletion.

He advised him to see a doctor.

“There was so much stuff at the bottom of his lungs the doctor told him to stop smoking. He’s never smoked in his life.”

Like many residents Adrian knows farmers who see themselves running out of options to keep on farming, looking at moving, considering the production of different crops.

Some have already moved to the Upper Hunter, where more mining has just been approved despite a long fight by residents of Bulga to stop it.

“Bulga has fantastic river flood plains.

To dig up beautiful productive soil like this just doesn’t make sense,” Adrian said.

“The grim economic reality is that many people don’t want coal mining, but they do want jobs,” he said. “If there were other options they’d ditch it in a minute.”

THE LAMP APRIL 2015 | 31

GALLIPOLI 100 YEARS

Nurses confronted full horror of modern war On the 100th anniversary of the Gallipoli landing The Lamp reproduces an account by journalist Steve Waldon of the experiences of nurses among the carnage, first printed

by The Age in 2005 to commemorate the 90th anniversary.

Australian Army nurses attached to the Egyptian Government Hospital Suez 1918 PHOTOGRAPH COURTESY JUDITH DOIG

“LIKE THE WHOLE WAR EXPERIENCE, Gallipoli would have produced great shock for young Australians. I mean if you are badly wounded and taken off the field, you realise that bullets kill, bombs maim, and this is no longer ‘the great adventure’, yet they were expected to be stoic.”

Richard Reid is talking about the Anzac experience of young and middle aged men, from the April landing through 32 | THE LAMP APRIL 2015

the terrors of the August offensive to the withdrawal from the Gallipoli Peninsula.

But Dr Reid, senior historian at the Veterans Affairs department commemorations branch, knows all too well that the frontline troops were not the only Australians to experience war’s pitiful humanity.

Trauma of a different type, but no less real, was experienced by Australian nurses,

most of who had never been exposed to the carnage of modern war, he says.

Apart from the lack of facilities and equipment, awful weather and unhygienic conditions, the nurses were confronted daily with death, dying and wounds so appalling, it is only reasonable to assume that nurses too must have come home with a sense of horror that marked the rest of their lives.

Australian nurses served on hospital

ships off Anzac Cove, in military hospitals in Egypt and in field hospitals including the Australian General Hospital on Lemnos, a small island 100 kilometres from the battle zone.

Dr Reid told The Age that the nurses’ dedication and compassion in the most difficult circumstances was officially recognised but has remained largely unappreciated.

“When it was decided that all who had been directly involved in the campaign would be entitled to wear the brass ‘A’ on their uniforms, this right was extended to the nurses of the Australian Army Nursing service,” he said.

Put simply all reliable reports of the Dardanelles campaign, including those of Age reporter Philip Schuler, conclude that the medical treatment of wounded diggers was, at best, adequate and, at worst, a fiasco.

The report attributes this not to the doctors and nurses so much as to British planners’ almost incomprehensible under-calculation of likely casualties.

Once the wounded and dying started piling up in the wards and on the decks of hospital ships – that is immediately – Australian nurses saw what happens when the shockwaves and metal shards of high explosives ordnance do their evil work.

In her 1992 book Guns and brooches: Australian Army Nursing from the Boer war to the Gulf war, the late Jan Bassett assembled anecdotes and historical accounts of the situation Australian nurses endured during the Gallipoli campaign.

Apart from hierarchical difficulties the daily realities produced great strain. Bassett writes of “notably the lack of matron-in-chief, the ill defined role of matrons, and the ineffective leadership of both Australian and British medical services in Egypt”.

Bassett’s book records the recollections of Sister Ilma Lovell, who was on the hospital ship Formosa when it approached Suvla Bay on August 7: “We were receiving wounded all night, and terrible wounds they were. The majority of them were 10 days old, flyblown and septic.

Limbs, had they been able to be treated before and would have been saved, had to be amputated.”

When she led her nurses on to Lemnos to staff the 3rd Australian General Hospital, the matron, Sister Grace Wilson, wrote on August 9 that they found “150 patients lying on the ground – no equipment whatever – did best we could – have tents but no beds, no water to drink or wash”.

Two days later she wrote: “Convoy arrived, about 400.

Just laid the men on the ground and gave them a drink.

Very many badly shattered, nearly all stretcher cases. Tents were erected over them as quickly as possible.

“All we can do is feed them and dress their wounds. A good many died. It is just too awful – one could never describe the sense – could only wish all I know to be killed outright.”

Dr Reid said Wilson’s belief that some soldiers were so badly wounded, physically and mentally, they would be better off dead, was an early indicator of what we know now as post-traumatic stress disorder.

“Limbs, had they been able to be treated before and would have been saved, had to be amputated.”

– Sister Ilma Lovell, aboard hospital ship Formosa August 7, 1915 Reproduced with permission of “The Age / Fairfax Syndication”

Bernice Collopy (back row fourth from left) was trained at Sydney Hospital. Nursing provided a major opportunity for Australian women to participate actively in the war. Around 3000 Australian nurses served as part of the Australian Army Nursing Service in places as diverse as Egypt, England, France, Gallipoli, Italy, Burma, Salonica and India.

Many worked in British hospitals or in British army nursing units, and later with Australian units, as well as on hospital ships and in Australian hospitals for the wounded. Overseas, it was not practicable for Australian nurses to treat only Australians: they treated and nursed the wounded of many nations — Margaret Whitton.

among fifteen wounded men Under another cloudy sky my grandmother stands amongst fifteen wounded men.

I wanted them to be young, and strapping, and larrikin.

But, as they look into the camera they whisper things to me that flash and burn my memory.

The fog of the day settles.

They are chilled as they gather close their ill-fitting clothes.

Their neatly parted hair shows a control they crave.

But, the confusions, the smell, the noise and the terror are all there in clenched half smiles, in darting eyes.

My grandmother’s hands rest with priority on the gloved man’s wheelchair.

He holds his side protecting the broken rib, the torn abdomen.

His eyes do not focus on the camera.

They dwell in an anger, a madness of pain.

In a destiny reshaped by brutality.

Sister Collopy and Patients the photo is titled.

My grandmother seems impish and full-fleshed, not the way I ever knew her.

For a few fleeting, nightmarish weeks these people were thrown together, entwined in a mistake of history.

To be repeated.

To be continued.

I smell the slow burn of the 1918 flash, And see the men move stiffly to pick up their hats.

They help each other across the road to the hospital As Bernice wheels her man Each bump echoing pain.

— Margaret A Whitton, Royal Prince Alfred Hospital THE LAMP APRIL 2015 | 33

GALLIPOLI 100 YEARS

Reminiscences from a bloody imperial war What did Gran do during the war?

“WHEN MY SISTER ASKED ‘WHAT DID Gran do during the war?’, I didn’t know the answer and decided to find out. Since then I have completed a doctorate trying to answer that question, not just for Gran but for all Australian Army nurses, and have published a book called More than Bombs and Bandages:Australian Army nurses at work in World War I (Big Sky Publishing, 2011).

My book examines Australian nursing schools and the training that nurses received, then compares this baseline of learning against what nurses did during the war as members of the Australian Army Nursing Service (AANS) working overseas.

Just what did Australian Army nurses do? It seems logical to reply that ‘they nursed’, they looked after sick people, they provided care — but war environments, such as those created in World War I, threw up unpredictable situations and created diverse opportunities. No member of the AANS would have dreamed on embarkation from Australia that they might end up running a hospital kitchen for a year or managing a ‘hotel’ for 200 nurses.

What theatre nurse would have thought of running more than one table at a time in an operating theatre or giving anaesthetics? And who could have predicted the advent of Spanish flu when doctors were largely helpless and recovery rested on the nursing skills of those present?

These diverse and non-nursing roles go to the heart of More than Bombs and Bandages — and the important words here are ‘More than…’ Other World War I nursing histories feature Australian nurses who received the Military Medal for their bravery under fire when their hospitals in France were bombed and those awarded Royal Red Crosses for professional work and achievement.They frequently mention bandaging wounded soldiers. But military nursing work in World War I was so much more.

I think it is important that contemporary nurses in Australia understand the breadth of the nurses’ collective effort.

To me, military nursing practice is so important that the absence of discussion about it lessens any World War I military history.”

— Kirsty Harris is an Honorary Fellow in the School of Historical Studies at Melbourne University.

34 | THE LAMP APRIL 2015

Mothers what are you doing?

“My father Leslie Dalkin (1911-1991) rescued this poster during an office clean up at the head office of Rheem Australia at Rydlamere in the mid 1970s and it has been hanging in my home since then. A digital copy has recently been provided to the Australian War Memorial. It is not known how the poster came to be at Rheem and the general manager at the time allowed my father to keep it.

The poster can be dated to the presidency of the Australian Nurses’ Gift Fund of Mrs W.A. Holman (Ada, nee Kidgell, wife of the 19th Premier of NSW, William Holman) from approximately November 1915 to April 1916.”

— Margaret Dalkin, retired NSWNMA member

WAR STORIES Written using diaries and letters written

by WWI nurses, author Peter Rees takes us into the hospital camps, wards and tent surgeries on the edge of some of the most horrific battlefronts modern war has seen.

ANZAC GIRLS shines a light on the contribution of women to the ANZAC legend, nurses who were trailblazers for their gender and their profession.

Kitty McNaughton, front, second from left.

Kitty’s war “AS NEWS OF THE GALLIPOLI WOUNDED arrived in Australia in 1915, Kitty McNaughton enlisted in the Australian Army Nursing Service. She embarked on the Orsova for Egypt in July 1915, nearly missing the boat; it was the beginning of a four-year odyssey that would change forever the way she thought about herself and her world.

Kitty McNaughton and I grew up in the same quiet district of dry stone walls and wheat fields, bluestone schools and meandering creeks near the You Yang ranges in Victoria, though we were generations apart.

I found her name and that of her cousin Sadie McIntosh on our local Memorial Gates.The nurses were out of alphabetical order and under the names of the soldiers, who were themselves the grandfathers of my school friends.

As I stood before the monument that day, the idea of this unknown woman setting out on a journey, which would take her away from the familiarity of neighbourhood and family, across the world and into war, took hold of me and would not let me go.

The book Kitty’sWar follows Kit’s journey through war, from Egypt, where she cared for the Gallipoli sick and wounded, to the

25 April, 1915 was the start of an eightmonth stalemate in which thousands lost their lives. Living in the trenches among dysentery, flies and mud, innocent 17-year-old Tolly Johnson fears that he and his brother Bevan will be killed, while commander of the campaign General Sir Ian Hamilton clings to the belief he can take the peninsula.

The eight-hour series GALLIPOLI was inspired-by Les Carlyon’s best-selling book of the same name.

harsh conditions of Lemnos Island, off the coast of the Dardanelles, and thence to France and the Somme.

Here she nursed severely wounded German soldiers for the British:‘my Huns’, as she called them. During Passchendaele, a year later, she ran the operating theatre of a clearing station near the front line.

Kit finished the war as Australia’s first plastic surgery nurse, assisting the discipline’s pioneers as they repaired the shattered faces of Australian soldiers.

On her return home she married the man she had dreamt about on the way to war – Joe Ryan, a Little River farmer.”

— Janet Butler is an Honorary Associate in the History Program at La Trobe University, Melbourne.

MEMBER GIVEAWAY Email The Lamp by the 15th of the month to go into the draw to win a copy of the book ANZAC GIRLS thanks to Allen and Unwin or a threedisc DVD pack of GALLIPOLI thanks to Roadshow Entertainment.

Email your name, membership number, address and telephone number to lamp@nswnma.asn.au and note your preference for book or DVD! THE LAMP APRIL 2015 | 35

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ask judith

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

Risk control requires careful assessment At our public hospital emergency department the current configuration requires the clinical initiative RN to be stationed in the waiting room in an open desk area and we are concerned their safety could be compromised by presenting patients who are aggressive or intoxicated.

We are seeking some type of perspex/acrylic fabricated window to be installed to provide a physical barrier in the waiting room. How can this be progressed?

Before any risk control strategies are finalised a risk assessment should be carried out to identify all contributing risk factors, examine a range of risk control strategies and determine any associated residual risks.

Ideally the risk assessment will take a broader view and include risks to workers, patients and the organisation and also incorporate clinical and non-clinical aspects.

It is often the case that a number of strategies need to be used in combination to achieve the best result.

Taking the proposed perspex barrier as an example, the clinical initiatives RN must periodically circulate among patients in the waiting room to monitor their condition.

This is difficult to do from behind a perspex barrier, which in turn won’t provide protection when the nurse is not behind it.

It will also make communication with patients more difficult and could aggravate the situation. If the barrier partly encloses the desk in the waiting room, it may also create an entrapment point and increase the risk to the nurse.

It is often best to have a range of strategies.

NSWNMA suggests considering the following range of alternatives, which should be implemented simultaneously: — Nurse to carry a personal duress alarm connected to the ED and the facility duress response team.

— Nurse to be in full view of other staff at all times, e.g. in full view of reception staff.

— Waiting room to be monitored by CCTV. This will allow remote monitoring by others and provide evidence in the event that an incident does occur.

— Security officer to be called to provide a security presence and back-up if there are any high-risk patients or visitors in the waiting room.

— Training to be provided to ED nurses, and security staff, in violence prevention and management (including de-escalation) in accordance with Ministry of Health policies.

— Additional risk control measures may be required after-hours, e.g. locking the door to the ED and access only after persons

presenting have been screened. However, if patient numbers are low and beds aren’t full, the clinical initiatives nurse may not be required in the waiting room.

— Determine escape routes (e.g. doors into treatment area, doors to the outside, and corridors leading from the ED waiting room) and whether there are any entrapment points that should be avoided by the nurse.

NSWNMA suggests that you follow local procedures for resolving Work Health and Saftey (WHS) issues. The employer is required by law to identify and eliminate or control risks, and must consult with workers about identifying and controlling risks prior to making any changes to premises or systems of work that may impact on your health or safety.

You can raise concerns with: — Management in the first instance, in writing, requesting that a risk assessment be carried out in consultation with workers.

— Your local NSWNMA branch. The branch can pass a resolution requesting action be taken to assess and resolve risks.

— The Health and Safety Committee or your Health and Safety Representative.

— Your LHD risk management consultant.

All LHDs have a number of professional WHS officers whose job it is to assist with resolving identified risks.

— WHS officers at the NSWNMA who can provide advice and advocate on your behalf if required.

— If all other avenues have been exhausted, lodge a request for service with WorkCover NSW asking that an inspector investigate the matter.

Nearly time to re-register I am an RN and it’s coming up to that time of the year when I have to re-register with AHPRA (the Australian Health Practitioner Regulation Agency). Would you please provide information about my obligations in relation to Continuing Professional Development (CPD)?

All nurses need to re-register with AHPRA before 31 May each year and the Association has produced a resource to assist with this process entitled Guide to Continuing Professional Development: A resource guide to assist NSWNMA members in meeting their CPD requirements for ongoing national registration. This document can be found in the Members Only section on the NSWNMA website under the heading Continuing Professional Development (http://members.nswnma.asn.au/members_ only/pdf/Continuing_Professional_Develop ment_resource_guide_2014.pdf)

Another useful document is AHPRA’s Frequently Asked Questions located on their website (www.nursingmidwiferyboard .gov.au/Codes-Guidelines-Statements /FAQ/CPD-FAQ-for-nurses-andmidwives.aspx)

Can I jump puddles?

As a community nurse I am required to be outside a lot and I am concerned about being caught in wet weather while visiting clients. Using an umbrella is impossible because of the equipment we carry and is especially difficult if it is windy. Am I entitled to ask for proper waterproof clothing to enable me to remain reasonably dry in such conditions?

Yes you can request to have proper wet weather gear to take with you when doing your home visits. The Public Health System Nurses’ and Midwives’ (State) Award 2011, clause 23, Uniform and Laundry Allowances, sub clause (vi) states: “Each employee whose duties regularly require them to work out of doors Shall be supplied with a suitable waterproof coat, hat and overboots. Sufficient waterproof clothing shall be made available for use by other employees who in the course of their duties are exposed to wet weather.”

If your employer is not providing such clothing you need to put a written request to your line manager and, if necessary, refer them to the above award provisions. If you continue having problems call the Association.

Holiday I didn’t ask for I am an EN working in a public hospital and have been rostered a day of annual leave on the next roster that I did not request. Is this allowed?

No.You cannot be directed to take annual leave unless you have been given a minimum of 28 days notice. The Public Health System Nurses’ and Midwives’ (State) Award 2011 at sub clause (vii) (c) of clause 30, Annual Leave, states: “The employer shall give each employee, where practicable, three months notice of the date upon which he or she will enter upon leave and in any event, such notice shall not be less than 28 days.”

THE LAMP APRIL 2015 | 37

social media | nurse uncut

WHAT’S

HOT

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

Send us your ideas at nurseuncut@nswnma.asn.au

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

A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES

THIS MONTH

Penalty rates: 13,000 nurses and midwives respond www.nurseuncut.com.au/penalty-rates-13000-nurses-and-midwives-respond

An overwhelming response to an ANMF survey shows how highly nurses and midwives value their penalty rates.

My year as a new grad in Alice Springs www.nurseuncut.com.au/reflecting-on-my-year-as-a-new-graduate-nurse-in-alice-springs

An unusual new nurse (she is over 50) did her new grad year in an extraordinary place and found it was one of the best years of her life.

Work health and safety essentials www.nurseuncut.com.au/work-health-and-safety-essentials-for-nurses-and-midwivesbooklet-and-videos

Three informative videos cover health and safety issues for nurses and midwives, supervisors and WHS officers.

Musings of a mental health nurse www.nurseuncut.com.au/musings-of-a-mental-health-nurse

Why would anyone choose to be a mental health nurse? Leah wonders that herself sometimes, but she loves her job.

How can I move from aged care to anaesthetics? www.nurseuncut.com.au/how-can-i-move-from-aged-care-to-anaesthetics

It’s a Catch-22 – University anaesthetics courses require clinical experience. So how can RN Mary make the change?

Why the government would have us pay more for poorer health www.nurseuncut.com.au/why-the-government-would-have-us-pay-more-for-poorer-health

Coalition plans for the health system reflect the belief that user-pays health systems are better – despite evidence to the contrary.

New on SupportNurses YouTube channel National day of action speeches and march RN Meg Pendrick delivers a powerful speech saying hands off our penalty rates! >>youtu.be/A-BJ346gSqc Aged care RNs 24/7!

Palliative care nurse practitioner Debbie on the importance of RNs in aged care. >>youtu.be/164M6Mhd6o4

NSWNMA on Instagram!

Yes, we’re on Instagram, so share your local photos with us @nswnma and #NSWNMAforce4change.

Follow us on Twitter NSWNurses & Midwives @nswnma Watch us on YouTube SupportNurses Connect with us on Facebook

New South Wales Nurses and Midwives’ Association >> www.facebook.com/nswnma Look for your local Ratios put patient safety first >> www.facebook.com/safepatientcare Branch page on Aged Care Nurses >> www.facebook.com/agedcarenurses our website.

THE LAMP APRIL 2015 | 39

BOB FENW WICK MEMORIAAL MENTORING GRANTS PROGRAM M APPLICAATTIONS OPEN 30 MARCH 2015 CLOSE 30 APRIL 20115 Applications are now open to reegistered nurses who want a unique opportunity to further their mental health nursing career by participating in this innovative Program.

What iss it?

Who caan appply?

What will w eaach mentor nt ring grant innclude?

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40 | THE LAMP MARCH 2015

social media | facebook

WHAT NURSES & MIDWIVES SAID & LIKED on facebook www.facebook.com/nswnma

Liberals oppose ratios Goulburn MP Pru Goward spoke against ratios at a local forum: “...this government will remain opposed to ratios...”

Cannabis campaigner dies Medicinal cannabis campaigner Dan Haslam died from bowel cancer at the age of 25.

Labour supports ratios NSW Labor vowed to employ hundreds of nurses for EDs and paediatrics and legislate for present and future ratios if elected.

Penalty rates survey We asked you to take an ANMF penalty rates survey (and 13,000 nurses and midwives did!) Lots of passionate comments spilled out.

They foolishly think this is not an issue for them, because most politicians have private health cover. The nurse:patient ratio is worse in private!

Hope you end up in a 30-bed ward with only three staff. Then you’ll see why ratios matter to patient care and staff stress levels!

Condolences to the family. A real inspirational young man, thank you for the voice of reason for the cause, we still have a long way to go, but we won’t give up.

Thank you for standing up and having a voice for what you believe helped you and others.

You helped create an awareness of the unnecessary pain being suffered by many.

Heart breaking. May the suffering and bravery and the openness of Dan and his family not be in vain.

I truly hope this happens for ED. But how many wards are not maintaining the minimum safe staffing as set out by clause 53? You know it’s bad when branch reps are advocating for safe patient care by trying to make their local health areas provide at least the minimum safe staffing on the wards.

There needs to be mandated ratios across all areas of nursing, including rural hospital wards. It’s not only important for patient safety but also for the safety of our nurses, who work far and beyond what should be expected of them.

I think I’ll go work at McDonalds.

It’s naive to talk about not being in the job for the money, when we all have needs and bills to pay – we are not nuns after all. That attitude goes along with society thinking all nurses are women, therefore have a man to support them. Penalty rates make up 30 per cent of my wage, because I work nights and I deserve every cent!

Dedication doesn’t pay the rent.

Penalty rates go a very small way to compensating for the damage done to family and social relationships. Nurse and midwife pay rates do not reflect the arduousness of the job, physically and emotionally.

Penalty rates = being able to pay the mortgage.

I worked more afternoons and nights over the years than I want to remember and penalty rates made up somewhat for missing some of my child’s life (divorced dad) – only just.

Penalty rates are not a luxury but a right we deserve for the time we don’t see our families and the many outings or events we miss. The time we miss our children’s weekend sport games. The music/dance lessons you have to say no to because you can’t guarantee you can take them every week. Rotational shifts play havoc for one’s health, sacrifices that nurses make, these need to be compensated!

I find not being able to guarantee my kids their sport activities so hard, all because I love a job that is 24/7.

PHOTO GALLERY

These Sydney aged care nurses always want an RN on duty.

Student nurses jump for joy as the new academic year comes around!

Aged care nurses are especially vulnerable when it comes to penalty rates.

Moruya nurses drove home their message with this banner.

THE LAMP APRIL 2015 | 41

It’s time

The NSWNMA campaign uniform range endorses a modern appearance and offers both comfort and durable features, while still embracing NSWNMA image.

The range consists of a Unisex Scrub Top and Unisex Classic Pant. Both made from 65% polyester, 35% cotton. This fabric blend is durable and of superior quality. The scrub campaign uniform also has number of functional features, including jet pockets, pen partition, drawstring front on pants and brushed fabric coating for added comfort.

Sizes range from XS-4XL to ensure various body shapes and sizes are catered. Most importantly, the range has been designed to ensure a comfortable fit every time.

Scrub top and pant are $20 each incl GST.

to scrub up for 2015

ORDER FORM

Order your NSWNMA campaign scrub uniforms for conference and rally times, and make an impression!

NSWNMA Scrub top $20. Quantity: Size: XS S M L XL 2XL 3XL 4XL

NSWNMA Scrub pant $20. Quantity: Size: XS S M L XL 2XL 3XL 4XL

Total cost of order $

Please include postage & handling of $5 per order. Bulk orders will be charged accordingly.

NAME ADDRESS POSTCODE PHONE (H)

(W)

Method of payment:

Cheque

(MOB)

Mastercard

Visa

NAME OF CARD HOLDER CARD NUMBER

/

EXPIRY DATE

SIGNATURE

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

SCRUB TOP

Merchandise order forms also available on www.nswnma.asn.au

SCRUB PANTS

Bankcard

Size (cm)

XS

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Half Chest Circumference

53

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General Guide for Female

8/10

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29

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54.5

Half Waist (Stretched)

47

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58.5

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68.5

72.5

Half Hip

55

59

63

66

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72

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80

Out Seam Length

103

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Money Order

test your knowledge

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Across 1. Fracture at two or more places in a bone (8.8) 9. Permitted by law; legal (5) 10. A double knot consisting of two asymmetric half hitches, which tends to slip under tension (6.4) 11. Measured or expressed in numbers (7) 12. An anatomic depression or recess (3) 13. To obtain a return or reward (4) 14. Small toothlike processes (9) 16. Containing nitrogen in one of its higher valences (6) 17. Rapid heart rates over 140 per minute caused by electronic circuit instability in an implanted pulse generator (7.9)

22. A sensation that may precede an attack of migraine or an epileptic seizure (4) 24. Relative value unit (1.1.1) 25. Rope, cord, etc, used for binding or securing (7) 26. A rounded elevation (4) 27. Major lips; mounds of tissue forming the lateral boundaries of the vulva (5.6) 31. An alkylating agent used topically to manage transitional cell cancer of the urinary bladder (8) 32. The brown color that sun rays impart to the skin (3) 33. Surgical reopening of a uterine tube clubbed because of fimbrial adhesions (16)

Down 1. Excessive deposit of melanin in an area of dermatitis (16) 2. A practitioner who temporarily takes the place of another (5) 3. Interpersonal meeting or consultation for the purpose of obtaining information (9) 4. According to reasoning, in a clear and consistent manner (9) 5. Yaws (9) 6. A cause of irritation; a nuisance (9) 7. The inner and larger bone of the forearm (5) 8. Development of the embryo outside the uterine cavity (7.9) 13. Networks of nerves or blood vessels; plexus (5)

15. Of little importance; not decisive (10) 18. A volatile, highly toxic liquid, formed by the destructive distillation of glycerin and during the burning of fat (8) 19. Graphite (8) 20. A condition of extreme prostration (8) 21. Acts, omissions or error in judgements (8) 23. Symbol for americium (2) 28. Anteroposterior (1.1) 29. A disease characterized by an inward bulging of the acetabulum into the pelvic cavity (4) 30. Symbol for radium (2)

THE LAMP APRIL 2015 | 43

NURSES & MIDWIVES: There are many benefits of being a financial member of the NSWNMA — did you know that

Authorised by B.Holmes, General Secretary, NSWNMA

YOUR MEMBERSHIP FEES COVER YOU FOR TRAVEL TO AND FROM WORK? If you are involved in an accident while travelling to or from work, NSWNMA’s Journey Accident Insurance provides you with peace of mind.

In recent years this insurance has been a financial safety net for many members who have met unfortunate circumstances travelling to or from work.

As a financial member of the NSWNMA you are automatically covered by this policy. It’s important to remember however, that it can only be accessed if you are a financial member at the time of the accident.

So make sure your membership remains financial at all times by paying your fees by Direct Debit or Credit.

Watch Alexis talk about Journey Accident Insurance

JOURNEY ACCIDENT INSURANCE Your journey injury safety net

UNSURE IF YOU ARE FINANCIAL? IT’S EASY! Ring and check today on 8595 1234 (metro) or 1300 367 962 (rural).

Change your payment information online at

www.nswnma.asn.au

nursing research online

The Australian Journal of Advanced Nursing (ajan.com.au) is a free online journal of original research and scholarly papers about all areas of nursing.

Public health nurses experiences of their role as part of a primary care team Martina Giltenane, MHSc, PGD (Public Health Nursing), BSc (General Nursing), Public Health Nurse, Limerick Local Health Office, Limerick, Ireland; Marcella Kelly, MSc (Education), BSc (Community Health), RNT, PHN, RM, RGN, Lecturer, National University of Ireland, Galway, Ireland; Maura Dowling, PhD, MSc, RNT, BNS, RGN, Lecturer, National University of Ireland, Galway, Ireland This study aimed to understand public health nurses (PHNs) views and experiences of their role as part of a primary care team (PCT) and developments within primary care.

Public health nurses in Ireland play a key role in PCTs due to their generic role and function. However, they are faced with many opportunities and challenges as part of PCTs. A major challenge is particularly evident, with 44 per cent of the population in Ireland being over the age of 65 and living in rural areas. This group is supported mainly by PHNs. Moreover, unlike community-based nurses internationally, PHNs in Ireland are seen as “all-purpose” generalist nurses caring for people of all ages, across the lifespan, in a geographical area, within a PCT. PHNs have traditionally provided the core nursing and midwifery care in the community, with community registered general nurses in more recent years supporting and contributing to community services.

article describes the development of part of the overall NP role within the Department of Neurosurgery focusing on the NP led Carpal Tunnel Syndrome (CTS) clinic, and benefits to date.

www.ajan.com.au/Vol32/Issue3/1Giltenane.pdf

www.ajan.com.au/Vol32/Issue3/5Scanlon.pdf

A nurses’ guide to qualitative research

Patient satisfaction with their pain management and comfort level after open heart surgery

Rebecca (Becky) Ingham-Broomfield, RN, Cert.Ed, Dip.Nurs, BSc, MSc, Lecturer, University of New England, Armidale, NSW, Australia This article provides a breakdown of the components of qualitative research methodology. Its intention is to simplify the terminology and process of qualitative research to enable novice readers of research to better understand the concepts involved.

An expectation of nurses graduating is that they will become critical consumers of research (Wright-St Clair et al 2014). Liamputtong (2013, p. 5) and Wright-St Clair et al (2014, pp.4-5) agree Evidence Based Practice (EBP) can be defined as the conscientious integration of best research evidence with clinical expertise, patient values and needs in the delivery of high-quality, cost effective health care.

Assessment tools are used on a regular basis by clinicians in clinical practice, and during research (Imms and Greaves 2013) to ultimately improve patient care. In this paper main components of qualitative research are discussed as one paradigm for researching health-related problems and issues. www.ajan.com.au/Vol32/Issue3/4Broomfield.pdf

Development of a nurse practitioner-led carpal tunnel syndrome clinic Andrew Scanlon, DNP, MNS, NP (Australia), ANP (USA), FACN, FACNP, Department of Neurosurgery, Austin Health, Heidelberg, Victoria, Australia; Chandrashan Perera, BMedSci, MBBS, Royal Perth Hospital, Perth, Western Australia, Australia; Gus Gonzalvo, Director of Neurosurgery, MBBS, FRACS, Department of Neurosurgery, Austin Health, Heidelberg, Victoria, Australia; Gavin Fabinyi, Neurosurgeon, MBBS (Melb), FRACS, Department of Neurosurgery, Austin Health, Heidelberg, Victoria, Australia To meet the changing needs of health care, nurse practitioner (NP) models of care have been introduced in practice in Australia since 2000 (Australian College of Nurse Practitioners 2014). These roles have been many and varied and practiced within both the public and private health care system. In late 2007, with increasing pressure for access to specialised care within the neurosurgical outpatient clinics, the Department of Neurosurgery at Austin Health, a public health service in Victoria Australia, choose to pursue a NP role to tackle this problem. The following

Neziha Karabulut, PhD, RN, Associate Professor, Department of Surgical Nursing, Ataturk University, Erzurum, Turkey; Yesim Yaman Aktas, PhD, RN, Assistant Professor, Faculty of Health Sciences, Giresun University, Giresun, Turkey; Dilek, Gurcayir, MSc, RN, Research Assistant, Faculty of Health Sciences,, Ataturk University, Erzurum, Turkey; Durdane Yilmaz, MSc, RN, Graduate Student, Faculty of Health Sciences,, Ataturk University, Erzurum, Turkey; Volkan Gokmen, RN, Graduate Student, Faculty of Health Sciences,, Ataturk University, Erzurum, Turkey The results of this study may help nurses anticipate and address patient pain more effectively in the early post-operative period following open-heart surgery. Pain after cardiac surgery is often severe (Mueller et al 2000). Pain after surgery decreases the quality of life of the patients and affects their comfort level. Although pain is a predictable part of the postoperative experience, inadequate management of pain is common and may result in clinical and psychological changes that increase morbidity, mortality, and costs and decrease the quality of life (Tse et al 2005; Apfelbaum et al 2003; Walker and Wagner 2003). There are many different causes of post-operative pain after cardiac surgery. Numerous sources of pain have been identified, such as incisions, trauma, immobility, chest tubes left in after surgery, invasive equipment, and nursing and medical interventions (Gélinas 2007; Kwekkeboom and Herr 2001; Hamill-Ruth and Marohn 1999). The impact of inadequate pain relief is well known and can result in delayed mobilisation and related complications as well as psychological distress and anxiety (Taylor and Stanbury 2009). www.ajan.com.au/Vol32/Issue3/2Karabulut.pdf

THE LAMP APRIL 2015 | 45

book me The NSWNMA library catalogue is online! Visit www.nswnma.asn.au/library-services-online-library-catalogue/ Essentials of Correctional Nursing Lorry Schoenly and Catherine Knox Springer Publishing Company via Footprint Books www.footprint.com.au RRP $89 ISBN 9780826109514 Essentials of Correctional Nursing regards the patients in criminal justice settings as a disenfranchised population and argues that nurses strive to deliver care that reduces suffering and improves the quality of life for not only incarcerated individuals, but also their families and the community at large. Chapters examine specific themes, starting with an overview of concerns for ethical principles, legal considerations and safety. Common inmate-patient health care concerns and diseases, such as chronic and infectious diseases, mental illness and drug withdrawals, are addressed before moving on to the nursing care processes of health screening, nursing sick call and emergency care delivery. Attention is given to management and leadership concerns (including increasing union activity among nurses), the need for research participation and evidence-based practice. The book uses a structured problem-solving approach, with a more clinical, authoritative tone that creates some distance between the care giver and patient. This book would be a valuable resource not just for Justice Health nurses but all who encounter patients that currently are, or have previously been, incarcerated.

Evidence-Based Rehabilitation: A Guide to Practice, 3rd Edition Mary Law and Joy MacDermid SLACK Inc www.healio.com/books RRP $44.72 ISBN 9781617110214 Evidence-Based Rehabilitation outlines the concepts, methods and strategies common to broader evidence-based practice as they apply to the rehabilitation sphere, with the goal of integrating research findings with clinical wisdom and clients’ preferences and values. Several chapters assess the role of reflection in supporting evidence-based practice, methods for finding evidence, then how to critically and systematically evaluate the results of research. The book also discusses strategies to build evidence into practice, use tools like guidelines and clinical pathways and communicate with clients, managers, funders and practitioners. A range of forms, guidelines and worksheets are also provided at the end.

SPECIAL INTEREST Mosby’s Pocketbook of Mental Health, 2nd Edition Eimear Muir-Cochrane, Patricia Barkway, and Debra Nizette Elsevier www.elsevier.com RRP $54.50 ISBN 9780729541909 This handy, readable text aims to provide immediate advice for a range of health professionals who encounter people with mental health problems in their daily work. Suggestions for what to do in typical situations are provided in each chapter. Themes covered include cultural issues common to Australia and New Zealand, managing medications, co-occurring medical problems, loss and grief, law and ethics, talking therapies, managing challenging behaviours and surviving clinical placements. Emphasis is placed on the core elements of engaging with people with mental health problems, which can then inform practical skills, and approaches suitable to a range of settings for care.

Nursing in criminal justice services Elizabeth Walsh and Ann Norman M&K Publishing www.mkupdate.co.uk RRP £25 (approx $49) ISBN 9781905539857 Nursing in Criminal Justice Services aims to present through storytelling a holistic and human-centered view of the lived experience of both patients and nurses involved in the criminal justice system. It begins with the story of one person’s experience of receiving care in the criminal justice system. Several chapters take the reader along the British health and justice pathway, from initial patient contact with nurses in police stations, to nursing care in courts, through prison nursing services and finally into the world of multi-disciplinary community health teams, where nurses work alongside the Probation Service. The second half of the book touches on some broader issues facing nurses working in criminal justice settings, including governance, legal issues and professional development. Between the two parts sits a meditative essay by Professor Freshwater of the Universities of Leeds and Western Australia, on the nature of caring in custodial settings. The concluding chapter argues for actively engaging in reflection while nursing in order to maintain high quality care for a vulnerable group of people.

news for members Access to CINAHL Plus with Full Text Members can now access the CINAHL Plus with Full Text research database directly! Simply log in to the Association’s member-only page then click on the CINAHL link. CINAHL Plus with Full Text is the definitive research tool for nursing and allied health literature, providing full text for more than 750 journals and thousands of articles dating back to 1937. It also includes searchable cited references, legal cases, clinical innovations, critical paths, drug records, research instruments and clinical trials. For further information or assistance please contact the NSWNMA Library.

All books can be ordered through the publisher or your local bookshop. NSWNMA members can borrow the books featured here via the Library’s online catalogue www.nswnma.asn.au/library-services-online-library-catalogue/. Call 8595 1234 or 1300 367 962 or email gensec@nswnma.asn.au for assistance with loans or research. Some books are reviewed using information supplied and have not been independently reviewed.

THE LAMP APRIL 2015 | 47

movies of the month

DVD SPECIAL OFFER The Great Barrier Reef is our greatest natural wonder, but how long can it hold back the forces of humankind that threaten its survival? Shot over 12 months Life on the Reef follows park rangers, traditional owners, coast guards, scientists, fishermen and residents living and working in the largest World Heritage area on earth. The series takes the audience along as seasons change, animal behaviours adapts and a cast of characters within the marine park swings into action to respond to each new challenge. Featuring epic visuals this three-part natural history series shows us the reef in ways weâ&#x20AC;&#x2122;ve never seen before.

RURALMEMBERGIVEAWAY Email The Lamp by the 15th of this month to be in the draw to win a dvd of Life on the Reef thanks to Roadshow Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

48 | THE LAMP APRIL 2015

movies of the month

Black Sea is a superbly shot men-on-a-mission thriller with chest-tightening tension, writes Stephanie Di Nallo.

This film by Kevin MacDonald, director of The Last King of Scotland and Touching The Void centres on rogue submariner Captain Robinson (Jude Law), who together with a misfit crew is seeking sunken treasure – lost Nazi gold from WWII – in the depths of the Black Sea. Robinson has dedicated his life to the sea at the expense of his marriage, so there is no disguising the lust that clouds his eyes when he hears of the potential $40 million bounty lying at the bottom of the Black Sea. In it he sees freedom, the chance to support and perhaps win back his estranged wife and child, the chance to escape from under the burdens of his professional life – a chance to strike a blow for the working man.

But the Russians have also heard of this great treasure and it is a race to see who gets to it first.

Greed and desperation soon take hold on board their claustrophobic vessel. Australian Ben Mendelsohn plays Fraser, a knife-wielding psychopath who adds to the already mounting tension.

A shocking betrayal, a startling discovery and escalating uncertainty about the mission cause the men to turn on each other.

As the situation reaches breaking point the crew must make an uneasy truce if they hope to make it back to the surface alive.

Though this film lives in the shadow of sub-genre masterpieces, Black Sea is a gripping and suspenseful thriller.

Stephanie Di Nallo is an RN with the Australian Red Cross Blood Services IN CINEMAS APRIL 9

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

DVD SPECIAL OFFER From the red earth of the outback comes a look at one of Australia’s most extraordinary emergency departments, the Broken Hill Hospital ED. Experience just how different a life-threatening crisis can be when you work in one of the most isolated locations on earth. Over eight episodes Outback ER follows doctors and nurses as they deal with the daily emergencies that come through their doors. With each emergency they must tackle the dual challenges of isolation and location: situated on the border between New South Wales and South Australia, Broken Hill ED is part of one state’s public health system yet geographically nearer to the metropolitan services of another. Viewers meet patients, their families and friends and watch as the medical team deals with emu-motorbike collisions, cardiac arrests and circular saw mishaps.

RURALMEMBERGIVEAWAY Email The Lamp by the 15th of this month to be in the draw to win a dvd of Outback ER thanks to Roadshow Entertainment. email your name, membership number, address and telephone number to lamp@nswnma.asn.au for a chance to win!

THE LAMP APRIL 2015 | 49

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

Send your event details to: lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space.

NSW

ACT

INTERNATIONAL

Nurses Christian Fellowship – Professional Breakfast 18 April Wentworth Falls www.ncfansw.org Continence Foundation of Australia NSW state conference 1 May Darling Harbour www.continencensw.org.au/events.php/12/cfansw-state-conference Empower Nurse Education – Professional Development Workshop 1 May Newcastle www.empowernurseeducation.com.au Empower Nurse Education – Aspects of Aged Care Conference 22-23 May 2 Newcastle www.empowernurseeducation.com.au Medical Imaging Nurses Association National Conference 19-21 June Sydney www.trybooking.com/Booking/BookingEvent Summary.aspx?eid=110777 Nurses Christian Fellowship – Is Longevity becoming an ethical dilemma?

23 June Sydney www.ncfansw.org Empower Nurse Education – Acute Care Nursing Conference 1 August Newcastle www.empowernurseeducation.com.au Nurses Christian Fellowship – Workshop and AGM 15 August Sydney www.ncfansw.org DANA Many Faces of Addiction Forum 13-14 August Sydney www.danaconference.com.au Australian Wound Management Association (NSW) 14-15 August Terrigal info.nsw@awma.com.au Empower Nurse Education – Anaesthetics and PARU Conference 4-5 September 2 Newcastle www.empowernurseeducation.com.au 26th PANDDA 2015 Conference 15 - 16 September Parramatta www.pandda.net 2015 Australian Nursing and Midwifery Conference 15-16 October Newcastle www.nursingmidwiferyconference.com.au/ Australian and New Zealand Orthopaedic Nurses’ Association Conference Climbing to the Summit 11-13 November Sydney www.anzonaconference.net/

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

Asia Pacific Hospice Conference: Transforming Palliative Care 30 Apri - 3 May 2015 Taipen, Taiwan www.2015aphc.org/ Pacific Rim International Conference on Disability and Diversity 18-19 May Waikiki, Hawaii www.pacrim.hawaii.edu/ Patient Safety Congress 6-7 July Birmingham, United Kingdom http://info.patientsafetycongress.co.uk/ 9th European Congress on Violence in Clinical Psychiatry 22-24 October Copenhagen, Denmark www.oudconsultancy.nl/Copenhagen2015 4th World Congress of Clinical Safety (4WCCS) 28-30 September Vienna, Austria www.iarmm.org/4WCCS/

50 | THE LAMP APRIL 2015

INTERSTATE Alzheimer’s Disease International 2015 15-18 April Perth www.australianageingagenda.com.au/event/al zheimers-disease-international-2015/ Gerontic Trauma Nursing Conference 30 April-1 May Melbourne www.australianageingagenda.com.au/event/g erontic-trauma-nursing-conference/ APNA Continuing Education Workshops for Nurses in Primary Care 2015 1-2 May Perth www.apna.asn.au/educationworkshops APNA National Conference 2015 14-16 May Gold Coast http://apnaconference.asn.au/best-practiceawards/ Eating Disorders and Obesity Conference 18-19 May Surfers Paradise www.eatingdisordersaustralia.org.au/ Australian and New Zealand Addiction Conference 2015 20-22 May Surfers Paradise www.addictionaustralia.org.au The person centred approach to healthy weight management. If not dieting, then what?® 2015 22-23 MayHobart 5-6 June WA 19-20 June SA www.apna.asn.au/ifnotdieting Parkinson’s Australia National Conference 27-29 May Adelaide www.aomevents.com/ParkinsonsAustraliaNati onalConference APNA Continuing Education Workshops for Nurses in Primary Care 2015 29-30 May SA www.apna.asn.au/educationworkshops Cancer Nurses Society of Australia 18th Winter Congress 14- 16 June Perth www.cnsawintercongress.com.au No 2 Bullying Conference 29-30 June Gold Coast www.no2bullying.org.au 16th International Mental Health Conference 12-14 August Gold Coast www.anzmh.asn.au/conference/ 2015 CRANAplus Conference 15-17 October Alice Springs www. crana.org.au

NCFI Quadrennial International Conference Healthy Lives in a Broken World – A Christian response to nursing 6-10 June 2016 Tagaytay City, Philippines www.ncfi.org

REUNIONS Lewisham Hospital 40-year reunion Class of April 1975 11 April Julie Macqueen nee Conlan: juliemacqueen@yahoo.com Wendy Jarick wendyjarick1@hotmail.com.au NEC Prince Henry/Prince of Wales 40-year reunion October 1972 – 1975 PTS 24-25 October Margret Brignall (nee Samuel) 0418 646 959 Margaret.Samuel@sswahs.nsw.gov.au Sonia Keeling (nee Graf) 0407 221 407 mskeeling@bigpond.com Gill Gillon (nee Horton) 0401 048 205 gillgill@optusnet.com.au

diary dates is a free service for members.

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Clinician Fact Sheet:

Acute Coronary Syndromes The goal of the Acute Coronary Syn y dromes Clinical Care Standa d rd is to improve the early, accurate diagnosis and managemen e to of an acute coronary syndrome to maximise a patient’s chances of recovery, and rreduc u e their risk of a future cardiac event.

Clinicians and health services can use thi h s Clinical Care Standard to suppor o t the delivery of high quality care.

UNDER THIS CLINICAL CARE STA AN NDAR RD A patie nt p re se nting with acute che st pain or othe r symptoms sugge stive of a n acute c orona r y syndrome re c eive s c a re guide d by a docume nte d che st pain a s se s sme nt pathway.

A patie nt with acute che st pain or othe r symptoms sugge stive of a n acute c orona r y sy ndrome re c eive s a 12-le ad ele c troc a rdiogra m ( ECG ) a nd the re sults a re a nalyse d by a clinicia n expe r ie nc e d in inte r p reting a n ECG within 10 minute s of the fir st e me rge ncy clinic al c ontac t.

A patie nt with a n acute ST-se gme nt- elevation myoc a rdial infa rc tion ( STEMI ) , for whom e me rge ncy re pe r fusion is clinic ally app rop r iate, is of fe re d timely pe rcuta ne ous c orona r y inte r ve ntion ( PCI ) or fib r inolysis in ac c orda nc e with the time fra me s re c omme nde d in the cur re nt National He a r t Foundation of Australia / Ca rdiac Societ y of Australia a nd New Ze ala nd G uid e lin e s fo r th e Ma nag e me nt of Acute Co r o na r y Syndr o me s.

In ge ne ral, p r ima r y PCI is re c omme nde d if the time from fir st me dic al c ontac t to balloon inflation is a nticipate d to be le s s tha n 9 0 minute s, othe r wise the patie nt is of fe re d fib r inolysis.

A patie nt with a non - ST-se gme nt- elevation acute c orona r y syndrome ( NSTE ACS ) is ma nage d b a s e d o n a d o c u m e n te d , e v i d e n c e - b a s e d a s s e s s m e n t o f t h e i r r i s k o f a n a d ve r s e e ve n t .

The role of coronar y angiography, with a view to timely and appropriate coronar y revascularisation, is discus se d with a patie nt with a non - ST-se gme nt- elevation acute c orona r y syndrome ( NSTE ACS ) who is a s se s se d to be at inte r me diate or high r isk of a n adve r se c a rdiac eve nt.

Before a patie nt with a n acute c orona r y syndrome le ave s the hospital, they a re involve d in the developme nt of a n individualise d c a re pla n. T his pla n ide nttifie s the life st yle modific ations a nd me dicine s ne e de d to ma nage their r isk fac tor s, addre s se s their psychosocial ne e ds a nd include s a refe r ral to a n app rop r iate c a rdiac re habilitation or a nothe r se c onda r y p reve ntion p rogra m.

T his pla n is p rovide d to the patie nt a nd their ge ne ral p rac titione r or ongoing clinic al p rovide r w i th i n 4 8 h o u r s of di s c h a r g e.

More infor mation on the Clinic al Ca re Sta nda rds p rogra m is available from the Australia n Commis sion on Safet y a nd Q ualit y in He alth Ca re we bsite at w w w. s a fe t ya n dqua l i t y.g ov. a u /c c s.

Acute Coronar y Syndromes Clinical Care Standard d Clinician Fact Sheet, 2014