The Lamp Dec - Jan 2024 by NSW Nurses and Midwives' Association

NORTHERN AGED CARE BEACHES HOSPITAL

Help us make Expired MOU poses providers obey the new risks. law. page 12

page 14

ANNUAL CONFERENCE

Your rightful place at the centre of primary care. page 16

REGULARS Your letters Professional Perspectives Health & Wellbeing Crossword

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION VOLUME 80 NO. 6 DECEMBER JANUARY 2024

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CONTENTS

Contacts NSW Nurses and Midwives’ Association For all membership enquiries and assistance, including The 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 Hunter Office 8–14 Telford Street, Newcastle East NSW 2300

VOLUME 80 NO. 5 DECEMBER / JANUARY 2024

NSWNMA Communications Manager Gia Hayne T 02 8595 1234 (metro) T 1300 367 962 (regional) For all editorial enquiries, letters and diary dates T 8595 1234 E lamp@nswnma.asn.au 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 0414 550 376 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au

COVER STORY Lifeblood goes to a national vote Months of organising by members will culminate in a national vote as The Lamp goes to press.

Editorial Committee Shaye Candish, NSWNMA General Secretary Michael Whaites, NSWNMA Assistant General Secretary O’Bray Smith, NSWNMA President Michelle Cashman, Long Jetty Continuing Care Richard Noort, Justice Health Liz McCall, Byron Central Hospital Diane Lang, South East Regional Hospital, Bega Valley Rachel Hughes, John Hunter Hospital Karen Hart, Wagga Wagga Base Hospital Printed by Printed by IVE Group Sydney Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information & Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Adrian Hayward, 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. Authorised by S. Candish, General Secretary, NSW Nurses and Midwives’ Association, 50 O’Dea Avenue Waterloo NSW 2017 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 2023 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30. Individuals $84, Institutions $140, Overseas $150.

AGED CARE

ANNUAL CONFERENCE

Help us make providers obey the law Mandatory care minutes for aged care residents are now law, but some employers are dodging their responsibilities. Aged care workers can help to make sure providers obey the rules. Nurses and midwives’ rightful place is at the centre of primary health care We need to challenge the prejudice against nurses and midwives using the full extent of their knowledge and abilities, Mary Chiarella told the NSWNMA Annual Conference.

REGULARS

5 Editorial 6 Your letters 28 Branch Beat 30 What’s on 32 Ask Shaye 35 Competition 36 News in brief 40 Professional Perspectives 41 Nursing Research 44 Your Health & Wellbeing 46 Crossword

‘Collectivism and solidarity are so critically important’ Watching the Matildas’ performance in this year’s FIFA Women’s World Cup™ was “one of the best months of my life”, Craig Foster told delegates to the recent NSWNMA Annual Conference.

GAZA

‘Nowhere and no-one is safe’ Hospitals under military attack, nurses dying under military fire, a child killed every 10 minutes, a critical disease risk: life in Gaza, where health and safety no longer exist. COVER: Kayla Wipiti, Helen Gardiner, Stella Lin Photographed by Sharon Hickey

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THE LAMP DECEMBER / JANUARY 2024 | 3

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Simply visit your local Mitsubishi Motors Dealership, provide your membership details to confirm eligibility and reference BP #3008852. They will then provide you the National Fleet Drive Away price for your chosen vehicle. *Information is current as at July 2023 and is subject to change. Offer valid on orders placed prior to 31 March 2024. National Fleet with Mitsubishi Diamond Advantage pricing varies from vehicle to vehicle and will be quoted at time of enquiry. The offer is available to current members of the NSW Nurses and Midwives’ Association. This offer is not valid with any other offer and cannot be substituted for any other form of benefit such as a cash equivalent. BP #3008852 is specifically for NSW Nurses and Midwives‘ Association and must be quoted to Dealership at time of quote request. Terms and Conditions for Mitsubishi Diamond Advantage can be found on our website: https://www.mitsubishi-motors.com.au We reserve the right to withdraw, extend or modify this offer without notice.

EDITORIAL

SHAYE

Candish GENERAL SECRETARY

Serious health reform is not negotiable We must ensure the State government delivers the funding necessary to fulfill its promises on ratios. In its September budget the new Minns government made a solid start by allocating almost $1 billion for nursing and midwifery positions to help deliver ratios in public health. The government made an election promise to the people of NSW to deliver safe staffing in emergency departments, intensive care units, postnatal maternity and multipurpose services. It also promised to convert current nursing hours wards to shift by shift ratios. The good news from the budget is that there is funding for the 1112 nurses that the previous government had failed to deliver on. These positions are now safe. On top of that there is funding for 1200 more nursing and midwifery positions that is new. However that level of funding in the budget will not be enough to roll out ratios in every hospital, ward and unit within the five designated specialties over the next four years. So there is progress but also a new challenge before us. Going forward we must ensure that there is sufficient future funding to fulfill the promise to implement ratios across the state.

“Properly funding health services provides a golden opportunity for the government to invest in communities, people and relationships.”

I would encourage you to have a chat with your local MP about the importance of funding ratios. CLARITY NEEDED AROUND PAY

WHERE TO FROM HERE

The government’s intentions around pay remain unclear. In the budget they also announced $3.6 billion for wages to essential workers over the next four years. How that money is distributed and what will be allocated to nurses and midwives has not been announced. Our message to the government is clear: Serious health reform is not negotiable and nurses and m idw ive s de ser ve cer t a i nt y around the resourcing of ratios and significant improvements to their take home pay. This is a fight we will take right up to the next budget in June. We will have to campaign strongly for Labor to do more in their 2024/25 budget There were other positive signs in the budget for health. There was fee relief for student nurses and midwives of $4000 per annum if you commit to working in the public health system, but again, not enough positions are being funded and we question how this will be targeted. There is also extra funding for women’s health and for more sexual assault examiners. There is mixed budget news for infrastructure, with further funding for the new Rouse Hill hospital, but existing hospitals like Albury Wodonga being underfunded, leaving communities and staff uncertain about the direction for their services.

We will continue working with the Ministry of Health to facilitate the implementation of ratios through the Safe Staffing Taskforce. The 2480 positions funded in the budget gives us something to start with. But we know it’s not enough. We need to engage the government and convince them to provide more funding. We need to approach our local MPs and convince them that more needs to be done. They need to understand that nurses and midwives will not stop advocating until ratios are implemented in every hospital, community health setting, and multi-purpose service in NSW. Already some branches have started this process (see pp 28-29). There is a role for everyone in this campaign. I would encourage you to have a chat with your local MP about the importance of funding ratios properly. Many MPs are convinced that ratios are essential in every specialty and in every hospital if we are to attract and keep the nurses and midwives that the Public Health System so desperately needs. We also need them to understand that the funding of healthcare should not be seen as inherently bad or burdensome. Properly funding hea lth ser vices provides a golden opportunity for the government to invest in communities, people and relationships. n

THE LAMP DECEMBER / JANUARY 2024 | 5

YOUR LETTERS

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FEATURED LETTER

A mental health system in crisis

To advertise contact Danielle Nicholson 02 8595 2139 / 0429 269 750 dnicholson@nswnma.asn.au

No excuses In 2017, I was a fresh-faced new grad, ready to take on the nursing world. That was until an email didn’t appear in my inbox and my world came crashing down. Or so I thought. The reality was I hadn’t received a new grad position. At first I was crushed. But after the initial rejection, I picked myself up. Despite my initial setbacks I started my nursing career in nursing homes and general practices. My passion for acute care remained strong. I began applying for registered nurse positions with NSW Health. To my delight, I successfully secured a position at Westmead Hospital. I began working in mixed medicine, neurology, and the gastroenterology ward, where I was well supported by the CNE and NUM. In 2020, I was initially apprehensive and scared about working on COVID-19 wards. However, after some consideration I was determined to continue serving the community. In 2021, four years after being rejected for a new grad position, I was successful in becoming an acting NUM in Neurology. Reflecting on my nursing career to date, I am reminded of a quote by Florence Nightingale: “I attribute my success to this – I never gave or took any excuses.” To any new grads who are facing similar obstacles, don’t let any initial setbacks deter you from pursuing your nursing career dream. Remember: not getting a new grad is not the end of the world. I am living proof of that. Ashwina Beeharry, acting NUM

Recently, I spoke before a parliamentary inquiry into the ‘Equity, accessibility and appropriate delivery of outpatient and community mental health care in New South Wales’, on behalf of the NSWNMA. As a mental health nurse, it was a privilege to be given a voice in what is a very important inquiry. I arrived at the inquiry hoping to shed light on the inequity of access experienced by mental health consumers in the community and outpatient settings. This is something I witness in my everyday working life. I used this opportunity to speak about burnout for frontline mental health workers, and the support required for nursing staff in this field. I stressed the reality that this is often traumatising work. There was also discussion about the Mental Health Telephone Access Line, which has been privatised in some LHDs. We also examined the

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opportunities, including financial support, for mental health nurses to further their studies and gain higher grade positions by accessing postgraduate study. While I was initially nervous about the prospect of speaking before a parliamentary inquiry, I found the overall experience to be not quite as intimidating or as unfriendly as I expected. I sincerely hope the panel members listened to my evidence and take action to address the dire state of our mental health system. Victoria Norris, RN

Unite for a brighter aged care future After my mother passed away, I turned my full attention towards aged care, becoming an assistant in nursing. I wanted to help older Australians, and by help, I meant all the way. I knew there had to be a way to make a difference not just to individual people’s lives, but also to fix things and make the latter stage of life more dignified and supportive. Fast forward 10 years and wow … what a difference we truly have made. In 2017, I was asked to join other union members to stand up and fight for our rights, and the rights of all affected by the appalling conditions in aged care. We were in crisis. We were a small handful of very passionate and very angry nurses who truly wanted to make a difference. Our targets were in line with what the Royal Commission handed down, and make a difference we did! So far aged care nurses have won: • labour agreements • an RN 24/7 • pay increases

If there’s something on your mind, send us a letter and have your say. You could WIN scrubs to the value of $50 thanks to eNurse.

EMAIL YOUR LETTERS TO: Editorial Enquiries at lamp@nswnma.asn.au 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.

• care minutes and a voice for workers. These are incredible wins and will make a real difference in the lives of aged care nurses and the residents we care for! But there is so much more that still needs to change. We all need to stand together and fight for our basic human rights and for the rights of those we care for: the residents – people whose voice is often forgotten, neglected and overlooked. Janine Quinn, AiN

Pill testing saves lives

to the findings of our very own coroner’s inquest into the six deaths at NSW music festivals in 2019, which supported pilltesting measures. For many of those who use pilltesting services, it represents the first time they have had a frank and honest discussion with a healthcare professional about safer drug use, and the risks and side effects of taking said drug. This is a conversation that would never happen without pilltesting services. As nurses and midwives, we proudly work in an evidence-based health system. It’s time the NSW Government put evidence into practice and implement pill testing as a priority. Annie Smoker, RN

As a drug and alcohol nurse with more than 10 years’ experience in the field, it baffles me that we still have to debate the evidence that pill testing saves lives, and minimises the harm associated with drug use. With another hot summer forecast, young people are inevitably going to head out to festivals and, yes, they will take illicit substances. Notre Dame’s postgraduate programs I cannot for the life of are flexible, so your study works for you. me understand why Upskill with the University of Notre Dame’s the NSW Government postgraduate nursing and midwifery is not implementing programs including: measures we know • Graduate Diploma of Midwifery minimise harm. • Graduate Certificate in You could listen to Contemporary Midwifery me, a nurse for two • Graduate Certificate in decades, including Contemporary Nursing. 10 years working in drug and alcohol, or you could listen to the numerous experts in the field. There are also international examples of successful Kimberley Midwifery student implementation of pill testing. If that’s not enough, you can listen

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notredame.edu.au/postgraduate THE LAMP DECEMBER / JANUARY 2024 | 7

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COVER STORY

Lifeblood goes to a national vote Months of organising by members will culminate in a national vote as The Lamp goes to press.

SW nu r sing st a f f at Aust ra lia n Red Cros s Li febloo d a long w it h other state and territories are considering voting no for a new national agreement over the coming weeks. They want “respect” in the form of better pay, improved conditions, and protection of existing entitlements that Lifeblood management is seeking to erode. A national meeting of members of the Australian Nursing and Midwifery Federation (ANMF) authorised the ANMF to lodge a dispute application with the Fair Work Commission if negotiations with Lifeblood fail to achieve a satisfactory result. The online meeting of almost 200 registered nurses, enrolled nurses and assistants in nursing voted to start consultations across the nation about the types of protected industrial action they might take. Protected action refers to industrial action that can legally be taken when bargaining for a new enterprise agreement is unsuccessful.

MAJORITY VOTE OF 99 PER CENT A motion carried with a 99 per cent majority stated: “We call on Lifeblood to meaningfully address our concerns and resolve to continue to campaign for improved pay and conditions, and consider all means available in order to advance our claims.” With negotiations stalling, the ANMF were compelled at the start of November to list the matter in the Fair Work Commission, with 8 | THE LAMP DECEMBER / JANUARY 2024

HELEN GARDINER, STELLA LIN AND KAYLA WIPITI the case being heard by Deputy President Coleman. The ANMF were able to secure and claw back some improvements to pay and conditions right across the country. But for NSW members all of the cuts were not taken off the table. Lifeblood staff collect blood, plasma, platelet and breast-milk donations for distribution to hospitals. ANMF branches, including the NSWNMA in New South Wales, have been negotiating with Lifeblood management to replace state and territory-based agreements that expired years ago. However, Lifeblood changed tack and now wants a first-ever national enterprise agreement to cover ANMF members in all states and territories. Negotiations started in early 2023. The motion carried by the second national members’ meeting in October rejected Lifeblood’s proposal to compress pay increments and prevent staff from progressing

between sub-levels. “This will create inequity among workers and does not recognise current employees’ experience and knowledge,” the motion said. NSWNMA General Secretary Shaye Candish said Lifeblood’s proposed national agreement included an inadequate pay offer and cuts to conditions that would leave NSW nurses worse off. For example, Lifeblood wants to slash public holiday entitlements for part time employees.

INADEQUATE PAY OFFER, CUTS TO CONDITIONS It also wants to cut the part-time public holiday benefit, which is provided in recognition that some part-time employees work a set pattern of days while others rotate, but enjoyment of the public holiday payments should be shared equally. Cutting the benefit would cost a parttime RN as much as $3,478 in one year and $10,434 over three years.

COVER STORY

Shaye said there should be no reductions to existing conditions and no employee should be worse off with a new national agreement. “If Lifeblood wants to retain and attract skilled clinicians in its workforce, it must listen to and respect staff concerns, and do better.” She said management had “consistently ignored and rebuffed” the NSWNMA in its many attempts to negotiate a new agreement since it expired in June 2021. Management apparently was distracted by a wage theft scandal in which the Red Cross’s Humanitarian Services Division and Lifeblood Division were found to have

underpaid more than 11,000 current and former employees. Individual underpayments ranged from less than $100 to more than $20,000. The Red Cross entered into ‘enforceable undertakings’ with the Fair Work Ombudsman to backpay employees over $25 million in stolen wages. Between 2010 and 2021, up to 1,160 Lifeblood employees were underpaid various leave entitlements, shiftwork loadings, public holiday loadings, overtime, redundancy entitlements, superannuation and minimum rates of pay totalling over $3.5 million, the Fair Work Ombudsman said.n

‘If Lifeblood wants to retain and attract skilled clinicians in its workforce, it must listen to and respect staff concerns, and do better.’ — Shaye Candish

‘An amazing sense of solidarity and unity’ Member leaders take grassroots views to national bargaining table. The NSWNMA Lifeblood branch has grown rapidly during 2023 to cover 24 donor sites in NSW. The branch has elected new officials and recruited 34 member leaders, who represent staff at donor sites and other work units.

‘If you’re sitting at the bargaining table as I am, you know what’s happening in the negotiations and what Lifeblood is seeking.’ – Helen Gardiner, Clinical nurse educator and NSWNMA member leader

Sixteen Lifeblood member leaders attended a customised campaign training day at NSWNMA Sydney headquarters in September. It was the first time many had met in person, as campaigning is done mainly through WhatsApp Groups and Zoom meetings. Clinical nurse educator Helen Gardiner is one of 10 NSWNMA member leaders who are also part of the union’s national bargaining team that meets with Lifeblood management. “If you’re sitting at the bargaining table as I am, you know what’s happening in the negotiations and what Lifeblood is seeking,” she said. “We have had 10 bargaining meetings so far. In the initial meetings, we (member leaders) mainly listened to what was being said. “We’ve taken a much bigger part in the last few meetings, speaking up about our work at the donor centres and how the staff are feeling.” Helen said the October national Zoom meeting had “an amazing sense of solidarity and unity. It

showed how strongly we want to fight this fight. “It was a really great meeting. There were a lot of questions; members felt very open to be able to ask honest questions and give honest answers.” She said it was valuable to hear at the national meeting about working conditions and campaign developments from Lifeblood members in other states. The Lifeblood NSW branch is running a successful campaign to get nursing staff interested and involved in union activity. “We’ve got union member leaders dotted through all the donor centres, which means we can talk to the staff and explain what we as a union are doing and what we are fighting for,” Helen said. “Every donor centre has its own union-led WhatsApp or Facebook Messenger group chat, so we can quickly communicate everything from our branch meetings into those groups.” n

THE LAMP DECEMBER / JANUARY 2024 | 9

COVER STORY

Ramsay’s ‘slap in the face’ to NSW nurses NSWNMA challenges global health giant over safe staffing and pay.

and midwives need an increase that closes the gap with higher paid Ramsay staff in Queensland and keeps up with inflation.

amsay Health Care staff in NSW have strongly supported a petition in support of adequate pay increases and safe staffing ratios for nurses and midwives.

She added that the company’s current approach also “runs counter to the industry-wide trend towards minimum staffing ratios, which are being adopted by major employers in the public, aged care and not-forprofit healthcare sectors”.

“We call on Ramsay to commit to cost-of-living pay increases and safe nurse/midwife-to-patient ratios,” stated the NSWNMA petition, signed by over 3000 nurses and midwives along with additional hundreds from doctors and other employees. Ramsay is one of the world’s biggest private healthcare companies, with 33 private health facilities in NSW alone. The company has rejected costof-living pay increases and ratios in current bargaining for a new enterprise agreement. This is despite reporting a net profit of $298.1 million for the year to June 2023, in which earnings before

‘As the leading private hospital operator in NSW, Ramsay should put patients first and lead the way on staffing conditions and pay.’ — Shaye Candish 10 | THE LAMP DECEMBER / JANUARY 2024

interest and tax increased by 13 per cent to $1 billion. The NSWNMA is campaigning for a new agreement, including a pay increase, to be backdated to 1 July 2023. Ramsay initially offered a pay rise of just 8.5 per cent over three years – 3 per cent from 1 July 2023, 3 per cent from 1 July 2024, and 2.5 per cent from 1 July 2025. It later upped the offer by a meagre 0.25 per cent, with 3.25 per cent to be paid from 1 July 2023. The NSWNMA bargaining team, which includes 1 2 workplace leaders, countered with a claim for a 6-per-cent-per-annum increase over three years.

RAMSAY DEFIES INDUSTRY TREND NSWNMA General Secretary Shaye Candish said Ramsay NSW nurses

“As the leading private hospital operator in NSW, Ramsay should put patients first and lead the way on staffing conditions and pay. “If it does not do so, it will fail to attract and keep the necessary nu mb er s of sk i l le d nu r se s and midwives.” Shaye said Ramsay had taken a constructive step by abandoning some of its proposed cuts to existing conditions – especially on annual leave accrual for shift workers. “Nurses and midwives expect management to also genuinely negotiate on wages and staffing,” she added.

MEMBER LEADERS JOIN BARGAINING TABLE NSWNMA rank-and-file bargaining representatives from a cross-section of facilities around the state have attended all sessions. RN Lyn Whitlam, a member of the bargaining team from Sydney’s North Shore Private Hospital, said

COVER STORY

“Ramsay is employing more people in senior management on big wages and rewarding shareholders, but not paying anything like a decent wage to the people who allow it to make its KPIs. “We pointed out to the Ramsay team that if it doesn’t substantially improve our conditions, it won’t be able to recruit enough staff and it definitely will lose a lot of existing staff.

THE RAMSAY BARGAINING TEAM team members come from “big and small workplaces, city and country areas, midwifery, rehab, and mental health”. “Each of us has presented the bargaining meetings with accounts of unsustainable workloads leading to staff exhaustion and sometimes misadventures,” she said.

CLOSING THE GAP WITH QUEENSLAND “Our counter-offer of 6 per cent per annum would only almost bridge the gap between NSW and Queensland Ramsay nurses and midwives. Only in limited cases would it bring nurses and midwives above Queensland's rates.

“We have also described the unacceptable working conditions, such as missed meal breaks and unpaid overtime, which we are expected to put up with. “Ramsay has listened to our arguments for safe minimum staffing but has not moved from its long-standing position that the current system works best for its business. “This is despite evidence from reputable, peer-reviewed publications that ratios would benefit patient outcomes – and the fact that other operators have implemented or are in the process of implementing ratios.” Lyn described the company’s pay offer as “a slap in the face” that would leave NSW nurses well behind their Queensland colleagues and NSW public sector nurses. “The NSW public sector got 4 per cent from 1 July 2023 and will probably get another 4 per cent next year, so 3.25 per cent would put us behind from the word go.

“As a bargaining group we have put across to Ramsay how let down nurses and midwives feel. You almost feel humiliated by the way management has persisted with its inadequate offers and ignored our arguments for staffing ratios.” Lyn detects a greater willingness among nurses and midwives to take industrial action compared to the bargaining period for the previous enterprise agreement. “This time we are not struggling to deal with the onset of the pandemic; we have big cost-of-living increases, and we have seen our colleagues in other healthcare organisations receive bigger wage rises and COVID bonus payments, which Ramsay also refused to pay.” By late October, more than half the nursing workforce at North Shore Private and some doctors had already signed the NSWNMA petition. Bargaining representatives expect further discussions with Ramsay before Christmas, and will continue to push for a fair pay increase and safe ratios. n

‘We have put across to Ramsay how let down nurses feel’ — Lyn Whitlam, RN “Despite this, Ramsay’s CEO has claimed that its wage offer compares well with equivalent positions in the public and private sectors.

THE LAMP DECEMBER / JANUARY 2024 | 11

COVER STORY

Healthscope erodes staffing levels at privatised hospital Patients, nurses and midwives at Sydney’s Northern Beaches Hospital continue to be disadvantaged by the privatisation of public healthcare services a decade ago.

orthern Beaches Hospital (NBH) at Frenchs Forest is a unique 4 86 -bed facility run as a publicprivate partnership created by a former NSW Liberal/National coalition government. Despite community outrage at the privatisation, NBH opened in 2018 to replace public health services provided at Manly and Mona Vale public hospitals. The coalition government closed Manly Hospital and kept Mona Vale Hospital open with residual services only. Healthscope operates all NBH beds – private and public – and employs all nursing and midwifery staff. The NSW government effectively buys clinical services for public patients from Healthscope. All patients in ED are treated as public patients. They can choose to be admitted to the hospital as either a public or a private patient. Around 80 per cent of patients remain public across the hospital – including maternity services.

AWARD DOES NOT APPLY Nurses and midwives at NBH were initially employed on a 'Copied State Award', which was a copy of the Public Health System Nurses’ and Midwives (State) Award 2018. This agreement protected Nursing Hours Per Patient Day (NHPPD) at NBH for up to five years OR until a new enterprise agreement was negotiated. During 12 | THE LAMP DECEMBER / JANUARY 2024

‘We feel the public are being shortchanged by the staffing arrangements at Northern Beaches Hospital.’ — Branch President Robyne Brown

enterprise bargaining negotiations in 2020, Healthscope attempted to push through an agreement which would have removed NHPPD early, this was subsequently voted down. In November 2021, negotiations concluded with a Yes vote, protecting NHPPD on public wards in a Memorandum of Understanding (MOU). After the MOU expired in October this year, Healthscope moved to f ur t her undermine t hese staffing levels, which were already below those applying at other public hospitals. He a lt h s c op e a n nou nc e d i n November it would replace the NHPPD measurement with Labour Hours per Patient Day (LHPPD) in the public wards from 3 January 2024 – bringing them into line with staffing levels in private wards. Healthscope said the LHPPD measurement would include “all

positions directly or indirectly supporting patient care in the ward/ unit environment. At NBH this includes the NUM, CNE, CNC and ward clerks.”

FEARS FOR PATIENT SAFETY NSWNMA General Secretary Shaye Candish said that under the expired MOU, NHPPD were calculated solely on the basis of nurses and midwives providing direct clinical care. The MOU excluded clinica l nurse educators, specia lists, and consultants, along with nurse unit managers, from the NHPPD calculation. “They were entitled to be rostered as supernumerary (in addition to minimum staffing levels) and free to attend to their clinical leadership, education, and supervisory duties,” Shaye said. “Failure to renew the MOU staffing arrangements represents a risk for

COVER STORY

‘Failure to renew the MOU would represent a risk for nurses, midwives, other hospital staff, and members of the public who rely on NBH as their local public hospital.’ — General Secretary Shaye Candish nurses, midwives, other hospital staff and members of the public who rely on NBH as their local public hospital. “NBH should be in public hands. The Northern Beaches community deserves a hospital that is run solely in the interests of the public – not those of a private operator.”

The NSWNMA NBH branch called on Healthscope to maintain the MOU arrangements shortly before it expired in October. A branch resolution said it had already raised multiple staffing concerns with Healthscope and “fears for what will happen to staffing, patient safety and quality of patient care once these protections (under the MOU) are removed.” “The community of Northern Beaches deserve a public hospital with the same level of staffing as other similar public hospitals,” the branch said. NBH nurse and NSWNMA branch president, Robyne Brown, said, “We feel the public are being short-changed by the staffing arrangements at NBH.” “It may be a flash, relatively new hospital but feedback from members suggests it is certainly not staffed adequately across all areas. “Members are worried that NBH staffing in public wards and units will fall further behind NSW

public hospitals now that the MOU has expired.”

ED POSITIONS SLASHED Robyne said that even before the MOU expired, Healthscope cut four 12-hour day shifts from the emergency department despite the fact that the acuity of ED presentations had increased. “There was no prior consultation with the NSWNMA and affected nurses,” she said. The ED job cuts are at the centre of a long dispute between the NSWNMA and the NBH executive over ED staffing and safety including excessive workloads and inadequate breaks, and how this impacts patients. Shaye Candish said the NSWNMA used work health and safety legislation to access the ED and consult with and survey affected nurses. “The survey revealed serious and imminent risks to the health and safety of nurses in ED,” she said.n

Campaign led by NSWNMA defeated five privatisations The former NSW Liberal/National Coalition government intended NBH to be one of many public hospitals to be handed to private operators as public– private partnerships. However, the Coalition did not count on the strength of public opposition to privatisation. Led by the NSWNMA, public protests blocked hospital privatisations at Maitland, Goulburn, Wyong, Shellharbour and Bowral. In 2017, The People’s Inquiry into Privatisation produced a scathing report, which found that health privatisations had resulted in: • reductions in care hours for patients • a lack of government accountability • reductions in nurse staffing numbers and appropriate skill mix • profit motives outweighing the delivery of quality care

THE WYONG COMMUNITY JOINS NURSES AND MIDWIVES TO SAVE THEIR HOSPITAL FROM PRIVATISATION.

• erosion of pay and working conditions for staff • cost blow-outs • a decline in quality of services accessible to the public. The operator of NBH, Healthscope, is owned by giant Canadian company Brookfield Asset Management, which manages over US$850 billion in global assets. Brookfield Asset Management has received international media attention over allegations of tax avoidance via the use of offshore tax havens. n THE LAMP DECEMBER / JANUARY 2024 | 13

AGED CARE

“Nothing has changed at my workplace. It is even worse than before. Not sure where all the budget is going. Past few weeks have been very difficult due to the workload, understaffing, and absolutely no support from the management team.”

o wrote a registered nurse (RN) at an aged care f a c i l it y in S yd ne y ’s southwest recently.

The RN added, “We are getting more residents with very difficult behaviours; more incidents to report; new admissions with no paperwork; the pressure to complete assessments and care plans while minding all residents, resident/ family complaints, medication administration, doctors’ rounds; it 14 | THE LAMP DECEMBER / JANUARY 2024

just goes on and on. I’ve never felt so burnt out.” The nurse is one of dozens of aged care workers who have told similar stories in answer to an NSWNMA written survey. The stories show that some facilities are failing to meet new mandatory care minutes for residents, despite receiving extra government funding for that purpose. Since 1 October 2023, residents must receive, on average, 200 minutes of care each day – including at least 40 minutes from an RN. From 1 October 2024, this will be boosted to 215 minutes of care, including 44 minutes delivered by an RN. Under the new law, the government sets quarterly care-minute targets for

‘It is essential members speak up and let us know if they suspect their employer is failing to meet their obligations.’ — NSWNMA, General Secretary Shaye Candish every aged care facility, based on the needs of residents living in the home over the previous three months. Staff, residents and their families are able to track the requirements via the federal Department of Health and Aged Care website.

AGED CARE

Aged Care Watch website

SWNMA General Secretary, Shaye Candish, urged members to help the NSWNMA make providers stick to the new legal standards. “Aged care workers now have an opportunity to help monitor and enforce the new care standards,” she said. “An updated ‘Aged Care Watch’ website will allow staff, residents and families to publish their stories about the state of care in their facilities, while remaining anonymous. “By telling us their experiences, members can help us to put pressure on providers to do the right thing.”

The website was set up by the NSWNMA in partnership with the Queensland Nurses’ and Midwives' Union and the United Workers Union. The site was about to be launched when The Lamp went to press. “It is essential members speak up and let us know if they suspect their employer is failing to meet their obligations,” Shaye said. She pointed out that mandatory care minutes and other important changes, such as requiring RNs to be employed in facilities 24/7, came about as a result of a long campaign by NSWNMA members and others.

the Royal Commission into Aged Care Quality and Safety, which recommended every aged care facility follow care-time targets that reflect the needs of their residents. “The NSWNMA will continue to campaign for greater transparency and accountability measures to ensure care minutes are delivered as intended,” Shaye said. “We will also continue to push for aged care workers to have greater power in enforcing the delivery of these reforms.” n

https://www.agedcarewatch.org.au/

The campaign forced the former federal government to establish

Stories of understaffing and neglect Staff doing unpaid work and missing their breaks. Residents left soiled for long periods because workers are too busy to answer the bell. Staff required to perform tasks outside the scope of their role. Residents not receiving adequate care, and medication incidents. These are just some of the consequences of understaffing reported to the NSWNMA in response to a written survey. “We are constantly short of AiNs, as there is a limited staff pool to pull from to fill shifts,” wrote an RN at a NSW North Coast nursing home. “ENs are doing care staff tasks and duties, RNs are doing routine medication rounds, and often there is no functional in-charge nurse role. “Even RNs sometimes are doing personal care due to lack of staffing. There is minimal use of agency staff for AiNs, when there is a high demand for it.”

In a typical response, an assistant in nursing at a facility in Sydney’s northwest wrote, “We always have to work understaffed. We have to attend double-assist by one staff only. No replacement for first sick call. No kitchen staff, and staff have to handle medication, residents and kitchen when we are understaffed.” An RN at a nursing home southwest of Sydney reported that some RNs were being replaced with Certificate IV-qualified staff, leaving the remaining RNs covering their floor to cope the best they could. “We RNs have to administer medications. If there is any incident during the round, we have to leave the meds trolley to attend it. Meds rounds are interrupted and many times we don’t finish it on time. “We are understaffed. We need more staff for difficult residents, behaviourally unstable residents, for high falls-risk residents,

for full-care/high-care residents. Call bells are still not answered on time due to staff being busy with other residents.” An endorsed enrolled nurse (EEN) reported that a facility southwest of Sydney was even more understaffed than before the introduction of mandatory care minutes. “A ratio of 32-to-1 RN/EEN is bonkers. I don’t get a break and if I do, it is interrupted by phone calls or management,” the EEN wrote. An RN at a Blue Mountains facility reported their workload had increased as a result of a cut in hours for night-shift carers. “I continue to work through my unpaid meal break. Meanwhile, management emails us about unacceptably high call-bell response times,” the member noted. n

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ANNUAL CONFERENCE

Nurses and midwives’ rightful place is at the centre of primary health care We need to challenge the prejudice against nurses and midwives using the full extent of their knowledge and abilities, Mary Chiarella told the NSWNMA Annual Conference.

fficient and effective primary health care “is the only way our health system in the future is going to be sustainable,” said Chiarella, a former chief nursing and midwifery officer in the New South Wales Department of Health, and a professor emeritus at University of Sydney’s Faculty of Medicine and Health. Expanding nurses and midwives’ scope of practice can deliver an accessible and responsive primary healthcare system that reduces “health inequity and improves quality of life”, Chiarella said. “We have to remember that only 17 per cent of the primary healthcare workforce are actually GPs, and the other 83 per cent are made up of nurses, midwives, nurse practitioners, Aboriginal and Torres Strait Islander health practitioners, and allied health practitioners. And these experienced clinicians are delivering excellent integrated care, often to disadvantaged groups, which augments, rather than fragments, the patient’s healthcare management.” Unfortunately, vested interests are opposed to expanding the role of nurses and midwives in primary health care, she said. “In Australia, the politics of primary health care are tied up with the 16 | THE LAMP DECEMBER / JANUARY 2024

‘My view is we are Amazons, not victims. You are going to have to become stronger, more passionate, more persuasive, and persevere more.’ — Mary Chiarella, former chief nursing and midwifery officer, NSW Department of Health and professor emeritus at University of Sydney’s Faculty of Medicine and Health funding of primary health care. The medical professional groups – the AMA and the RACGP, in particular – oppose any moves on behalf of nurses and midwives to move legitimately into primary health care in their own right.

“But this would suggest that GPs are everywhere, doing everything in primary health care, which is demonstrably not the case.” Chiarella cited Ross Gittins, economics editor of the Sydney Morning Herald, who recently

ANNUAL CONFERENCE

pointed out that other countries with good health care “make sure that GPs can’t insist on doing things that could be done by other health workers, nurses, nurse practitioners, pharmacists and physios”. In Australia, however, “the existing funding system brings considerable financial rewards to the medical profession, in terms of controls and or monopolies on certain practices, such as prescribing treatments and referrals.” Chiarella urged the audience to resist the current system where “the nurse or the nurse practitioner or a midwife is earning money for and on behalf of a GP.” While organised medicine has previously sanctioned nurses and midwives carrying out many tasks that were not of themselves revenue raising, such as dialysis, “it has actively resisted the transference of others that are income related”. Chiarella noted: “There is still a belief that doctors are in charge of the healthcare system and the patients. All other staff are subordinate to them and controlled by them.”

NURSES NEED TO BUILD COALITIONS Chiarella observed that many nurses and midwives are highly skilled and qualified, often more so than junior doctors. L eg islat ion to approve t he introduction of nurse practitioners was introduced in New South Wales in 1998, and as of December 2022, there were 2492 endorsed nurse practitioners in Australia. But Chiarella said that while the role is now recognised and protected, more work is needed to persuade interest groups and the wider public of the legitimate role of nurse practitioners, as well as nurses and midwives more broadly. Particularly in the face of opposition from groups such as the AMA and RACGP, who want to restrict the role of nurse practitioners and limit the MBS services they can deliver. A f ter much lobby i n g a nd consultation, the 2023–2024 federal

budget at first appeared to offer some hope when the federal government announced Medicare rebates for care provided by nurse practitioners would increase by 30 per cent. Budget papers a lso a llowed for nur se prac t it ioner s “to participate in Medicare-subsidised mult idisciplina r y tea m ca se conferences, offering better support to people with chronic conditions”, Chiarella said. A new $50-million scholarship program to encourage nurses and midwives to undertake postgraduate study and support registered nurses to become nurse practitioners was also announced. But hidden in the fine print was the news that these changes would not commence until July 2024, she said. Chia rella ca lled for st rong, disciplined coa lition-building between nursing professional g r o up s , s t r a t e g ic p ol it ic a l lobbying, and campaigns to raise public awareness.

Citing the number of former nurses and midwives in powerful leadership roles today – including Ged Kearney and Helen Haines in federal parliament; Trish Davidson, Vice-Chancellor at the University of Wollongong; and Susan Pearce, Secretary, New South Wales Ministry for Health – Chiarella said now is the moment to fight for nurses and midwives’ rightful place at the centre of primary health care. “My view is we are Amazons, not victims. You are going to have to become stronger, more passionate, more persuasive, and persevere more, if necessary, because the evidence is already out there that we do make a difference. “We cannot allow archaic systems to continue. We need to continue to speak up and lobby for best practices in health care. And we need to provide evidence that nursing and midwifery primary health care is the answer to the overcrowding in our hospitals.”n THE LAMP DECEMBER / JANUARY 2024 | 17

ANNUAL CONFERENCE

t was thrilling seeing these “powerful and strong” Australian women inspiring young girls and boys, said Foster, a former Socceroo captain and this year’s NSW Australian of the Year. “There’s a great story about a young boy who went and said to his little compatriot when they were going to have a kick: ‘How about I’ll be Sam Kerr and you be Steph Catley?’” But perhaps even more inspiring, for Foster, is the way the Matildas have led the world in the fight for equal pay. “In this Women’s World Cup™, we wanted to watch Matildas play, but much, much, more than that, we wanted to have a conversation about gender equality.” Seven years ago, Foster was appointed the interim chair of the footballers’ union, Professional Footballers Australia. “The first thing that was obvious when I came in was that women didn’t have full membership of the organisation,” he said. “There were no women on the Board or on the executive. And for the first time, we brought the Matildas onto the Board.”

18 | THE LAMP DECEMBER / JANUARY 2024

CRAIG FOSTER, NSW AUSTRALIAN OF THE YEAR 2023

Having the Matildas as “part of decision-making at that table” changed the conversation and the organisation’s culture, Foster said. Now, the Matildas have won equal pay to the Socceroos through a deal negotiated with their union. This includes sharing the revenue from broadcast and ticket sales of all football games by both teams. Since 2019, the Matildas have also led a global campaign to pressure FIFA for prize money equal to the Men’s

World Cup™, but success there has been harder to achieve. “The Matildas came out with their own campaign, and most of the female teams and their own global players’ union, which is called FEPRO, [initially] didn’t support them,” explained Foster. He said they showed “why collectivism and solidarity are so critically important”.

ANNUAL CONFERENCE

‘Often, we don’t really recognise or realise how much of a voice we have.’ — Craig Foster

MATILDAS NOT AFRAID TO TAKE A STAND Foster says he was not surprised when the Matildas were among the first to support the campaign he led in support of Hakeem al-Araibi, a refugee footballer from Bahrain. Hakeen was incarcerated, along with 150 athletes who took part in a peaceful pro-democracy demonstration during the Arab Spring. The authorities “came in the middle of the night, put him in prison. They strapped him into a chair and smashed his legs with an iron bar,” Foster said. When he was released, he fled to Australia. But he was arrested after pressure from Bahrain when he visited Thailand for his honeymoon. In his advocacy for Hakeem’s release, Foster organised a coalition of organisations and people. “The first port of call for me was to go to [the player’s union] that stands up for all our players. And that body immediately came on board. And the

first people, not surprisingly to me, to step forward and hold a sign to say ‘Save Hakeem’ were the Matildas. “ Wit h i n t he hu ma n r ig ht s environment it is predominantly women who have the incredible courage and strength to step forward. Many of our human rights organisations are run by women, and they are motivated by not so much the extraneous politics and other things, but just by doing what is right.” Foster visited Hakeem in prison in Thailand and he came up with a plan to visit FIFA headquarters in Switzerland to seek their support, even though one of the organisation’s vice-presidents was a member of the Bahraini royal family. “I sent them a tweet publicly and said, ‘I’ll be there in 48 hours from now and we’ll have a meeting at 1 pm at your offices. Otherwise, I’ll hold a press conference on your doorstep to tell everyone what's going on.’”

He travelled to FIFA offices with friend Brendon Schwab, head of the World Players Association, the global athletes’ union, where they sat in the lobby and refused to leave until they had a media release from FIFA supporting Hakeem. When Hakeem had his final court case, diplomats from 14 countries turned up to the courtroom in Bangkok to show solidarity. “It was a huge statement to Thailand, and it was one of the reasons why, in the end, we were able to get Hakeem out,” Foster said. Foster urged the audience to think about “how we can lend our power to other people, both within your industry, and also in broader society. We all have a range of power, or social and political capital. Often, we don’t really recognise or realise how much of a voice we have.” n

THE LAMP DECEMBER / JANUARY 2024 | 19

ANNUAL CONFERENCE

Understanding AI is an ‘ethical imperative’ Like it or not, the use of artificial intelligence (AI) in nursing and midwifery is “here to stay” said Saba Akbar, a researcher into how AI can help nursing assessments.

het her it is a medication-infusion pump detecting hyperglycaemia, or a blood pressure monitor, most nurses and midwives are already using AI to help make decisions about patient care, she says. And as the integration of AI tools into healthcare settings grows, “there is almost an ethical imperative for nurses to have a minimum basic understanding of AI”, Akbar told delegates to this year’s NSWNMA Annual Conference. “As nurses and midwives we are the group who collect the most data from the moment we start our work with the patient. We’re doing an initial assessment at the time of admission, then we’re doing repeated, continuous assessments while the patient is in our care.”

‘AI is only as useful as its users.’ — Saba Akbar, PhD candidate and AI researcher As part of her research, Akbar has designed a program to see if AI can help nurses to assess patients. The automated program “starts with identifying patient condition, looking at all the medical records and recommending what assessments to do, but also filling out the forms for us. So, kind of making our lives easier”. 20 | THE LAMP DECEMBER / JANUARY 2024

Called SNA P (smar t nursing assessment program), it is currently being tested as a prototype. Akbar, who worked as a surgical nurse and in general wards and special care units before embarking on her PhD research, said she became interested in looking at how AI and machine learning can improve nursing practice and make nurses’ lives easier. She gave the example of a wound care app that now helps nurses with decision making. The app collects a picture of a patient’s wound and uses AI to analyse the wound size and the cells involved, and then gives a recommendation about treatment. In aged care, an app called PainChek is being used for patients who cannot communicate with their caregivers. A caregiver can record a video of three seconds, and the app uses AI and facial recognition features to tell you if the patient is in pain. Akbar described it as “an AI-powered early warning system” that is reducing mortality and length of

stay. Another AI-powered technology used in aged care is to monitor falls and it can detect “whether [a patient has] a fall or looks like they’re dizzy, or if they have been alone for a while”. AI is only as useful as its users, Akbar warned. “The data that we input has to be good quality, because as in all of these things, it’s always garbage in, garbage out.” Akbar emphasised that it is imperative that nurses and midwives are not just the target users of AI in health: it is also vital they are involved in the development and implementation stages of AI applications. n

Learn more: To take part in the SNAP study to research whether AI can help improve patient assessments and save nurses time, go to: study.snap-ai.org

OBITUARY

Vale Lynne Ridge – A union trailblazer Lynne was born in Camperdown on 10 January 1949. She had a few years living with her two siblings and parents in Chippendale and Newtown. Unfortunately her parents separated and at the age of four Lynne was placed into the care of a church minister in Wollongong on the steps of Bidjura Childrens Court, however there is no official record. She lived with several families through her young years before commencing her nursing training at Wollongong Hospital in 1967 where she made lifelong friends. She married in 1969 and became a mother soon after. These were happy days. They continued their married life in Papua New Guinea for several years and returned to Sydney in 1986. Lynne started as an Information Officer at the NSWNMA in May 1986 before becoming the Recruitment and Membership Officer. It was a dream job for her, assisting members and branch executives with recruitment in their workplaces. She then became the Marketing Officer liaising with external organisations and raising awareness about nurses. During her time the membership of the NSWNA increased, against a general decline in union membership. In 1996 the Commonwea lth Government approved a National Nurses Memorial on Anzac Parade in Canberra that had to be self-funded. Lynne drove the plan, engaged external agencies and $2 million was raised. It can be seen today commemorating nurses from all wars.

In 1999, Lynne developed and coordinated a plan of action across the NSW Public Health System to assist Timor Leste with urgent medical supplies. Her significant leadership – and passion - enabled $500,000 to be raised along with medical and pharmaceutical goods which were shipped to the Timor Leste Health Ministry. In 2000 Lynne was instrumental in the “What’s A Nurse Worth” wages campaign developing a plan and activating the membership along with her colleagues. It was a huge success with pay increases for our public sector membership at around 9 per cent. The State Government under Bob Carr told the NSWNMA that we would completely blow the budget! As if Lynne cared! Nurses deserved these pay increases! In 2005 and for three years after Lynne spent three months a year on the road during the Your Rights at Work campaign. Again Lynne created a plan for our members to become active in marginal electoral seats across NSW to protect their conditions of employment. It too was hugely successful. Some of Lynne’s other creative achievements include: • The Short film festival • May Day rallies she loved • International Nurses Day that always had a theme • The Bernie Banton Foundation for asbestos victims • Unions for Transfusions • The Waterfront Dispute alongside the MUA.

Alice Cashin campaign was close to Lynne’s heart after she had seen an article in the Sydney Morning Herald in 2016 about a WW1 nurse who had received Royal Red Cross medal and she was in a derelict grave at Woronora cemetery. Lynne found Alice’s family and lobbied for Commonwealth and State grants in partnership with St Vincent’s Hospital where Alice had trained. She raised $25,000 and a bronze statue of a nurse in uniform now stands next to Alice’s grave. Lynne was a trailblazer. She was so passionate in her beliefs. She was an amazing mentor to all of those who worked with her. Her contribution to the union movement will continue to touch the lives of members for many years into the future. However, her family were her rock: her children, Kathryn and Richard, their partners, Tony and Cindy, along with her grandchildren, Ella, Logan, Nicholas, Hayley, Sam and Marcus who were the love of her life. There were many great lunches and the odd champagne in her retirement years. She became an expert at ceramics. Art was another great love in her life. Lynne received an OAM for her services to her Union and Industrial Relations in April this year. She is missed by all her friends.

Linda Griffiths, Susan Pearcen

THE LAMP DECEMBER / JANUARY 2024 | 21

GAZA

“

he world cannot stand silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation, and despair.” This was the appeal of Tedros Adhanom Ghebreyesus, DirectorGeneral of the World Health Organization (WHO), to the United Nations Security Council on 10 November, as he outlined the situation on the ground in Gaza. Tedros said the situation “is impossible to describe, with hospital corridors crammed with the injured, the sick and the dying, morgues overflowing, and surgical procedures conducted without anaesthesia”. “Thousands of displaced people are sheltering at hospitals, with 70 per cent of the more than 11,000 people so far killed being women and children. “On average, a child is killed every 10 minutes in Gaza,” he said. Some 1.5 million people now are displaced and looking for shelter any where, but “nowhere and no-one is safe”, and overcrowding is increasing the risk of diarrheal and respiratory diseases and skin infections, the WHO chief told the Security Council. He told world leaders there had been more than 250 attacks on health centres in Gaza and 25 in Israel since the start of the conflict on 7 October. A month later, more than 100 UN staff had been killed.

22 | THE LAMP DECEMBER / JANUARY 2024

Credit: Anadolu Agency via Getty Images

“The world cannot stand silent while hospitals, which should be safe havens, are transformed into scenes of death, devastation, and despair.” — Tedros Adhanom Ghebreyesus, Director-General, WHO NURSES KILLED IN THE BOMBARDMENT On 12 November, the UN relief agency in Gaza reported that three nurses had been killed at Al-Shifa Hospital amid Israeli bombardment and clashes near the hospital. Dr Khaled Abú Hamra told the Spanish daily El País how a family of

four carrying a white flag tried to flee from Al-Shifa Hospital, besieged by the Israeli army, when it came under fire. After stepping a few metres onto the street, several shots killed the mother and one of the two children, and wounded the father and the other child.

GAZA

70 per cent of the more than 11,000 people so far killed are women and children.

Credit: Anadolu Agency via Getty Images

“We need to evacuate the hospital now, but they shoot everyone who tries to escape,” he said, describing the situation as “complete chaos, without internet, electricity, food or water, and with many victims on the ground.” Patients, refugees and staff could not leave the hospital due to the constant shelling and shooting, Abu Hamra said. International health agencies have confirmed the lethal environment around the Gazan hospitals. Médecins Sans Frontières described the situation at the Al-Shifa Hospital as “catastrophic”. The International Committee of the Red Cross warned that “thousands of wounded, displaced and medical personnel are at risk”. The Palestine Red Crescent Society said Israeli forces had opened fire on the intensive care unit at Al-Quds Hospital in Gaza City.

GAZA’S HEALTH SYSTEM IS ON ITS KNEES W HO said “women, children a nd newborns in Ga za a re disproportionately bearing the burden of the escalation of hostilities in the occupied Pa lestinian territory, both as casualties and in reduced access to health services”. It says “there are an estimated

50,000 pregnant women in Gaza, with more than 180 giving birth every day. Fifteen per cent of them are likely to experience pregnancy or birth-related complications and need additional medical care”.

“In addition to caring for the 28,000 people who are wounded, many of them with life-threatening injuries, they are trying to manage the regular health needs of more than two million people.

“More than half of the Gaza Strip’s 36 hospitals and two-thirds of its primary healthcare centres are not functioning at all. Those that are functioning are operating way beyond their capacities,” it said.

“There are 2000 patients on cancer therapy; and there are more than 350,000 patients with diabetes, heart disease and hypertension.

WHO said health workers “are physically and mentally exhausted and are doing their best in unimaginable conditions”.

“Supporting Gaza’s health workers is at the heart of WHO’s operational response plan,” it said.n

COD resolution calls for ceasefire The NSWNMA Committee of Delegates passed the following motion at its meeting on the 21 November: “As nurses and midwives we defend the human right to healthcare. We cannot stay silent as healthcare workers and patients are seen as acceptable collateral damage. As nurses and midwives we call for peace over war.

The Australian Government must through all means possible, in the strongest terms possible, demand that the international community enact an immediate ceasefire in Gaza and Israel, for the provision of humanitarian aid, and for the release of the hostages.” The resolution passed with 137 votes for, 12 votes against and 13 abstentions. n THE LAMP DECEMBER / JANUARY 2024 | 23

COMPETITION

Wishing our members a holiday season full of peace, joy, and happiness. We invite you to be part of this year's giveaway.

Stars, glittering city lights and a dinner on the water to remember

Lunch with 360° harbour views

This premium dining experience embodies everything that makes our city so special. Quality Australian food, live entertainment and a premium, yet relaxed setting. All set against the spectacular backdrop of Sydney’s skyline by night.

The Captain Cook Cruises Harbour View Long Lunch cruise offers an exceptional restaurant experience for up to 3 hours. Featuring a 3-course à la carte dining menu and ever-changing Sydney Harbour views, this is one waterfront restaurant you won't want to miss.

We have partnered with Captain Cook Cruises, you could win a Starlight Dinner for two (valued at $278)*.

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WISH eGift Card Thanks to Member Advantage, you could win a $100 WISH eGift card. We have three to give away! Shop at a wide range of stores including Woolworths, BIG W, BWS, Dan Murphy’s and participating Caltex Woolworth petrol stations. With no expiry date, you can shop at any time. *Conditions apply. Scan the QR code for full t&c’s and to enter.

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Nurse Blake Shock Advised Tour

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Seasons Greetings from the home of gifts with meaning www.kohliving.com.au

Splash into summer at Raging Waters Sydney

Ascent Footwear’s comfort for hard working feet

Hailed as a “genuine phenomenon” by The New York Times, Blake worked in US trauma centres before his career in comedy. As a way to cope with the stress of nursing job, Blake started posting original comedy videos which connected with nurses, nursing students, and healthcare workers around the world gaining Nurse Blake 3.5M followers on social media and over 300M views.

Raging Waters Sydney is the best place to spend time with your friends and family this summer.

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Win one of 2 x double passes (Any Day Ticket) to Raging Waters Sydney*.

Win one of 2 x double passes to see Nurse Blake at the Sydney Opera House on Thursday 29 February.*

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Welcome to The new online CPD portal

for NSWNMA members

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2024 2024 NSW NSW Nurses Nurses and and Midwives’ Midwives’ Association Association Election of Delegates and Alternate Election of Delegates and Alternate Delegates Delegates

Pursuant to the Industrial Relations Act 1996, Ms Peta Kava

Pursuant to Independent the IndustrialReturning Relations Officer Act 1996, Ms PetabyKava will be the appointed the will be the Independent Returning Officer appointed by and the Industrial Registrar for the election of branch delegates Industrial election of branch delegates alternate Registrar delegatesfortothethe Annual Conference and and the alternate delegates to the Annual Conference and and the Committee of Delegates of the New South Wales Nurses Committee of Delegates of the New South Wales Nurses and Midwives’ Association. Midwives’ Association.

Nominations Nominations

Nominations in writing are invited on and from 1 January 2024 Nominations in writing are invited on and from 1 January 2024 for the following positions: for the following positions: Branch delegates and alternate delegates to the Annual B alm teirtn lele ga s st.o the Annual Corannfech rendceeleagnadtetsheanCdom teaeteofdDee gatete Conference and the Committee of Delegates. Each branch shall be entitled to elect such delegates Each branch be entitled to elect such as delegates according to theshall number of financial members at 31 according to the number of financial members as at 31 December 2023, as follows: December 2023, as follows: 50 financial members or less 50 financial members or less 51-130 (inclusive) financial members 51-130 (inclusive) financial members 131-300 (inclusive) financial members 131-300 (inclusive) financial members 301-500 (inclusive) financial members 301-500 (inclusive) financial members 501-750 (inclusive) financial members 501-750 (inclusive) financial members 751-1000 (inclusive) financial members 751-1000 (inclusive) financial members 1001-1250 (inclusive) financial members 1001-1250 (inclusive) financial members 1251-1500 (inclusive) financial members 1251-1500 (inclusive) financial members 1501-1750 (inclusive) financial members 1501-1750 (inclusive) financial members 1751-2000 (inclusive) financial members 1751-2000 (inclusive) financial members And one additional delegate for every additional And additional delegate for every 250one financial members thereafter. additional 250 financial members thereafter.

1 delegate 1 delegate 2 delegates 2 delegates 3 delegates 3 delegates 4 delegates 4 delegates 5 delegates 5 delegates 6 delegates 6 delegates 7 delegates 7 delegates 8 delegates 8 delegates 9 delegates 9 delegates 10 delegates 10 delegates

Information as to the number of financial members in each Information as to thefrom number of financial members in each branch is available the branch secretary, or the New branch is available branch Association, secretary, ortelephone the New South Wales Nursesfrom and the Midwives’ South Wales 1300 367 962Nurses and Midwives’ Association, telephone 1300 367 962 Each branch shall be entitled to elect alternate delegates equal Each shall be entitledof to the electbranch, alternate delegates to thebranch delegate entitlement provided thatequal they to the delegate entitlement of the branch, provided that they shall be entitled to elect at least two alternate delegates. shall be entitled to elect at least two alternate delegates. Candidates for election to the position of delegate or alternate Candidates election position of delegate alternate delegate arefor required to to be the financial members of theorAssociation delegate are required to be financial members of the Association at the date of opening of nominations 1 January 2024. at the date of opening of nominations 1 January 2024. A person is not eligible to nominate for, be elected to, or hold A person to nominate for, be to, or hold any officeisinnot theeligible Association, Committee of elected Delegates, branch any office in the Association, Committee of Delegates, branch If: If: (i) such person holds any office in any other registered trade (i) union such person holds any office in any other registered trade or a like or kindred nature or having objects similar union or a like or kindred nature or having objects similar to the objects of the New South Wales Nurses and to the objects of theother New than South Nurses and Midwives’ Association theWales Australian Nursing Midwives’ Association other than the Australian Nursing and Midwifery Federation, and Midwifery Federation, (ii) such person has been, within the period of two years (ii) immediately such personpreceding has been,thewithin thenomination period of ortwo years date of election, immediately preceding the date of nomination or election, dismissed from any office or position in accordance with dismissed from any office or position in accordance with rule 14 of the Association’s Rules. rule 14 of the Association’s Rules.

Nomination forms may be obtained from the returning Nomination forms may beLaw, obtained from the returning officer, Ms Peta Kava, NEW 50 O’Dea Avenue, Waterloo officer, Ms Peta Kava, NEW Law, 50 O’Dea Avenue, 2017 or from NSW Nurses and Midwives’ AssociationWaterloo member 2017 or fromofNSW Nurses and Midwives’ Association member only section the Association’s website www.nswnma.asn.au only section of the Association’s website www.nswnma.asn.au or telephone 1300 367 962. or telephone 1300 367 962.

Close of nominations Close of nominations

Signed Nominations must be received by the returning officer, Signed Nominations must be Registrar, received by returning officer, as approved by the Industrial Msthe Peta Kava, not later as approved by the Industrial Registrar, Ms Peta Kava, not than 5pm, Friday 16 February 2024. Nominations cannolater t be than 5pwith m, Fthe ridaNSW y 16 Nurses Februarand y 20Midwives’ 24. Nominations cannot be lodged Association. lodged with the NSW Nurses and Midwives’ Association. They may be hand signed, scanned and emailed to They may be hand signed, scanned emailed to returningofficer@newlaw.com.au, or faxed toand (02) 9662 1463, returningofficer@newlaw.com.au, or faxed to (02) 9662 1463, or posted to Returning Officer, Ms Peta Kava, PO Box 6373, or posted to2015 Returning Officer, Ms Peta Kava, PO Officer, Box 6373, Alexandria or hand delivered to Returning Ms Alexandria 2015 or hand delivered to Returning Officer, Peta Kava, NEW Law, 50 O’Dea Avenue, Waterloo 2017. Ms Peta Kava, NEW Law, 50 O’Dea Avenue, Waterloo 2017. Nominations received after the time and date specified will not Nominations b e accepted. received after the time and date specified will not be accepted. Any defect in a nomination must be rectified by the candidate Any in aclose nomination must be .rectified priordefect to the of nominations. A candby idathe te candidate may only prior to the close of nominations. . A c a n d i d a t e withdraw their nomination in writing, and this must bemra eyceiovneldy w eiin r gnoom byitthhderarw etuthrn ffiicneartipornioin r tw ortithin egc,loasned othf insom muinstab tieonre s.ceived by the returning officer prior to the close of nominations. Should more than the required number of nominations be Should than of nominations receivedmore a draw willthe be required conductednumber to determine the order be of received a draw will be conducted to determine the of candidates’ names on the ballot paper at 50 O’Dea order Avenue, candidates’ Avenue, Waterloo at 1names 0am, Ton uesthe dayballot 20 Fepaper bruaryat 2050 24.O’Dea Candidates or Waterloo at 1 0 a m , T u e s d a y 2 0 F e b r u a r y 2 0 2 4 . Candidates or their representatives are invited to witness the draw. their representatives are invited to witness the draw.

Voting Voting

If the election is contested a postal ballot will be conducted. If electionofisthe contested postal of ballot conducted. Allthe members relevantabranch the will NewbeSouth Wales All members of the relevant branch of the New South Nurses and Midwives’ Association financial as at 1Wales 0am, Nurses and Midwives’ Association financial as at 1 0ama, Tuesday 20 February 2024 and entitled to vote will be sent Tballot uesdapaper. y 20 FThe ebruballot ary 20will 24 and openentitled on Wedtonevote sdaywill 28be Fesent bruaray ballot paper. The ballot will open on W e d n e s d a y 2 8 F e b r u ar y 2024 close at 5pm, Wednesday 20 March 2024. 2024 close at 5pm, Wednesday 20 March 2024. The method of voting to be observed for this election will be The method voting be observed for this election willmay be first past the of post. Anytocandidate in a contested election first past the post. Any candidate in a contested election may nominate another person to act as their scrutineer at the nominateofanother person to act should as theirring scrutineer at the counting the ballot. Candidates the Association counting of the ballot. Candidates should ring the Association to ascertain the date and time of counting. to ascertain the date and time of counting. Members should ensure that the NSW Nurses and Midwives’ Members should that the of NSW Nurses Association has ensure been advised their curreand nt rMidwives’ esidential Association has been advised of their c u r r e n t r eseim debnetria address as voting material will be posted to each m ’sl a tirnegssm. aAny teriaenquiries l will be poconcerning sted to eacthis h meelection mber’s redsdidreesnstiaals avdod rshould esidenbe tialinawriting ddress.and Anybeenquiries concerning this election addressed to the Returning Officer should in writing and be addressed to the Returning Officer Ms PetabeKava. Ms Peta Kava.

Ms Peta Kava, Returning Officer for the 2024 Election Term Ms Peta Kava, Returning for the 2024 Election Term New South Wales Nurses Officer and Midwives’ Association Election New South Wales Nurses and Midwives’ Association Election

COVER STORY BRANCH BEAT

Branch

Beat

Branch Beat with NSWNMA Assistant General Secretary Michael Whaites

As a result of our ratios campaign, including four statewide strikes in 2022, the NSW Labor Party went to the March 2023 state election pledging to deliver safe staffing in public health. Labor promised staffing ratios in five specialities – emergency departments, intensive care units, postnatal maternity units, and multi-purpose services – and to convert current nursing hours on wards to shift-by-shift ratios. The Labor government’s first budget in September allocated almost $1 billion for ratios. This is a step in the right direction: it will fund the continuation of 1112 temporary nursing and midwifery positions created by the previous government, plus 1200 additional nursing and midwifery positions. However, this funding will not create enough positions to staff ratios in every hospital, ward and unit within the designated specialties between now and the next election in 2027. NSWNMA members will therefore have to push Labor to fund a lot more nursing and midwifery positions in next year’s budget. Branch Beat reports on early moves by John Hunter Hospital (JHH) branch to win political support for more investment in nursing and midwifery hospital safe staffing.

At the time of writing, branch reps had met with four of the five MPs (Kate Washington had to postpone her meeting). First up was Tim Crakanthorp, who met Rachel and NSWNMA member and midwife Gaye McCauley. “It was important that midwifery be represented at the meeting to give a broad picture of the staffing situation,” Rachel said. “When we told Tim the budget allocation would not cover the fouryear rollout of ratios, he asked us to check our figures. “I confirmed the numbers (with NSWNMA head office) and emailed Tim to advise him they were correct. He then contacted the office of the health minister, Ryan Park. “We also spoke to Sonia Hornery, who conveyed our concerns to Ryan Park as well.”

Invite to parliament “Meanwhile, Greg Piper, who is speaker of the Legislative Assembly, invited the branch to visit parliament house. “We are a big, active branch of the NSWNMA and we work closely with other smaller branches around us, so they can get their perspectives and concerns across as well.

MP links expedite branch message to minister Over the years, the NSWNMA branch at JHH in Newcastle has built links with politicians who represent communities served by the hospital. These links allowed branch secretary Rachel Hughes to act fast when the Association called on members to lobby MPs over inadequate state government funding of the promised ratios. Within an hour of getting the Association’s call for action, Rachel had emailed all five local MPs, 28 | THE LAMP AUGUST / SEPTEMBER 2023

setting out the branch’s concerns and requesting meetings. “All replied promptly saying they would be happy to meet us,” Rachel said. “We are in regular contact with them and they are all very approachable.” John Hunter Hospital is in the electorate of Wallsend, represented by Labor’s Sonia Hornery. It also serves the electorates of Newcastle (Tim Crakanthorp – ALP), Port Stephens (Kate Washington – ALP), Lake Macquarie (Greg Piper – Independent) and Charlestown (Jodie Harrison – ALP).

“We invited Waratah mental health branch and branches at Belmont and Maitland hospitals to join our delegation, but Belmont and Maitland reps were not available.” Delegate Claire Bolton, steward Linda Mobbs, Waratah mental health branch rep Sharon Mestern, and Rachel, made the trip to Sydney. “We did a tour of parliament house, sat in on question time, had a meeting with Greg Piper and we also met Jodie Harrison, the Charlestown MP,” Rachel said.

COVER STORY BRANCH BEAT

‘We work closely with other smaller branches around us, so they can get their perspectives and concerns across as well.’ – Rachel Hughes, John Hunter Hospital branch secretary

JHH BRANCH MEETING WITHTHE MINISTER

“Both were very interested to hear our stories and our concerns and offered to help.” Just three weeks after the NSWNMA branch’s initial emails to MPs, Minister Park and Sonia Hornery MP visited JHH to meet the branch.

Broadening the message The JHH branch ensured the minister heard from a broad range of nursing specialities and a wide geographical area.

At the meeting were Kiri Oswald (Waratah Mental Health branch), Monique Murray (Maitland Hospital branch), Laurel Kibble (Maitland Mental Health branch), Matthew Rispen and Cathy McDonald (Belmont Hospital branch), Michelle Smith (Child and Family Community Health branch) and Daniel Mackay, Michelle Birkett and Rachel from the JHH branch.

Collecting evidence

“The minister acknowledged that this year’s budget allocation is not enough to cover ratios in all the designated areas,” Rachel said.

“The whole hospital is currently 90 FTE down and resignations are flowing in fast.

“He said it is a start, but that the government has no more money this year and will try to provide funding for more nurses in next year’s budget. “I emphasised that nurses would continue to leave the profession in droves if they don’t get a date for the rollout of ratios.”

Branch reps went to the meetings armed with evidence of severe short staffing – printouts of dozens of text messages and emails urgently seeking nurses to plug gaps in the previous fortnight’s rosters. “We had 18 pages of printouts for just three areas of the hospital: ED, ICU, and theatres.

“We wanted to show the MPs why we are so upset with the small number of positions covered by the budget announcement – we experience these staff shortages on a daily basis. A couple of the MPs said the printouts were a real eye-opener that strengthened our case.” n

THE LAMP AUGUST / SEPTEMBER 2023 | 29

PROFESSIONAL EDUCATION

Student to New Graduate COUNT TOWARDS CPD HOURS

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Join the NSW Nurses and Midwives’ Association as we help to prepare you to transition from being a nursing or midwifery student to becoming a New Graduate. There will be plenty of time to ask questions of the presenters throughout each session. This webinar series will be held across 3 x Tuesdays, 4pm to 6pm:

Tuesday 23 January 4pm to 6pm

Tuesday 30 January 4pm to 6pm

Tuesday 6 February 4pm to 6pm

About the NSWNMA What does transitioning mean Know your award and how to read your payslip

Professional Obligations Law and Ethics

Documentation Annual CPD Obligations Reflective Practice

Can’t attend on the day? These sessions will be recorded and made available following in Member Central and the Student Portal. Register and we will notify you when the series is online and ready to be viewed.

2024 Education Calendar The education calendar for 2024 is under development, with many of our education sessions being published online already! Go online to see our calendar of CPD education events.

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A service run by nurses and midwives, for nurses and midwives. Nurse & Midwife Support offers free, confidential and 24/7 health and wellbeing support to nurses, midwives and students across Australia.

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YOUR RIGHTS

Ask

Shaye

When it comes to your rights and entitlements at work, NSWNMA General Secretary Shaye Candish has the answers.

It has been a busy few months at the Association as work continues to win better lives for our members. We continue to focus on introducing real, enforceable ratios and are working hard to deliver a new safe staffing system that is transparent, accountable and enforceable. We continue to work to ensure aged care workers in the private sector receive the full benefit of the funding provided for 15 per cent wage increases awarded by the Fair Work Commission’s decision, and ensuring the legislation requiring nurses 24/7 and a minimum number of nurse/care minutes per resident is being enforced. But let’s get back to your existing workplace entitlements and ensuring you have access to what you are entitled to …

When can I access FACS leave?

Association membership fees during parental leave

I work at a public hospital in NSW and I have applied for Family and Community Services (FACS) leave due to some complicated circumstances where I had to provide urgent support to a member of my household. My manager has said that FACS leave does not apply. When can I access FACS leave?

I am about to commence a period of parental leave. What happens to my membership and fees during this leave?

Clause 32 of the Public Health System Nurses’ and Midwives’ (State) Award 2023 contains the provisions for granting of FACS leave and clause 4 of the NSW Health Leave Matters Policy Directive contains additional guidance. FACS leave has broader application than personal carers leave as it can be accessed for a range of personal and community service obligations, unplanned emergencies and pressing necessity. Sometimes there is debate about what a pressing necessity or unplanned emergency is, which can lead to your employer being reluctant to grant FACS leave. If you have had an application refused, please contact the Association for advice and assistance. 32 | THE LAMP DECEMBER / JANUARY 2024

Members who commence a period of parental leave can request a parental leave fee waiver for the period of leave. During that time the following benefits will continue to be provided to the member: • basic guidance and support in relation to work • access to the online education portal iLearn, where a member can complete education to meet annual CPD obligations • access to discounts and savings on household goods and services through Member Advantage • continued subscription to the NSWNMA magazine, The Lamp. At the end of a parental leave waiver, membership recommences, as does full coverage of NSWNMA services and benefits provided through membership. To request a parental leave waiver, members can contact our Membership team.

Repayment of Rural Workforce Incentive Scheme I am working for NSW Health in a rural area of NSW and received a payment package under the Rural Health Workforce Incentive Scheme. I have been in my position for 13 months and am considering resigning. Is it true that if I do resign, that I will have to pay back the money that has already been paid to me? There has been a history of challenges in attracting and retaining health workers in particular rural areas of NSW. The Rural Workforce Incentive Scheme was developed to provide a range of financial and non-financial benefits to attract and retain employees at these locations. Health workers who receive payments under the conditions of this scheme and leave their role within 18 months of receiving the incentive may be required to make repayment of all or some of the money paid. The policy has not been clear or evenly applied and, through advocacy by the Association, is being redrafted to provide more transparency and fairness. Please contact the Association for further details of what repayment may apply to you in your situation.

What are the public holidays over Christmas 2023? The public holidays coming up over the Christmas period are: • Monday 25 December (Christmas Day) • Tuesday 26 December (Boxing Day) • Monday 1 January 2024 (New Year’s Day)

Generally, you should get a penalty if you are required to work on a public holiday. If you need further advice, please contact the Association.

Leave approvals for Christmas My manager has declined my annual leave request for the Christmas period. I always take Christmas off and this is something I have done for many years. Is this allowed? Annual leave approvals should be considered by the manager, who will need to balance all staff requests during holiday periods when more staff wish to access leave. Approvals may need to take into consideration if a staff member has previously been granted leave over Christmas periods, to balance granting leave to employees who may not have previously received leave

during those periods. Those who have had the Christmas period off in recent years might, unfortunately, have to work through Christmas to allow others an opportunity to have the festive break. You should discuss your application and the reasons it was not approved with your manager, to see what alternatives are available to you. You can also contact the Association for advice.

Christmas shutdown I work for a public hospital and my NUM has told me that our unit will close over Christmas and I have to take my annual leave. Is this true?

wherever possible and, in many workplaces, can direct staff to take leave with reasonable notice. If you work in a unit such as operating theatres, elective surgeries would stop but emergency surgeries would still occur. Staff can elect to take annual leave and others may be redeployed to other wards if available as long as the nurse is not working outside of their scope of practice. Shutdowns can occur in both the public and private systems. You can contact the Association for advice.

Shutdowns can occur over the Christmas/New Year period and annual leave is encouraged if you are not providing essential services. Managers are encouraged to release employees

NSWNMA’s podcast Life of the academic nurse influencer Critical Care with Kylie Child and Family Health Nursing with China Lawrence

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Listen on THE LAMP DECEMBER / JANUARY 2024 | 33

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Recruitment incentive scheme

Our collective strength is in our numbers – the larger the membership, the louder our voice. You can help build the NSWNMA by recruiting a member.

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T IFFT -GGI EED ARRD CCA

Once you have recruited 4 new members you will be entitled to an $80 e-gift card. For every new member you sign up after that, you will receive a $20 e-gift card. Digital gift cards are emailed to recruiters at the end of financial year and valid for 3 years. Gift cards are not deemed to be income for the purposes of taxation.

*Conditions apply. To participate in this recruitment incentive scheme, you must be a financial member of the NSWNMA (Associate Members are not eligible to enter). Every new member’s application form must be accompanied by some form of payment – cheque, money order, direct debit, credit card authorisation form. Recruiter’s name and membership number must be written in the space provided on each new member’s application form. New recruits must remain as financial members for at least 3 months before being recognised by the scheme.

Update your details and win Have you recently moved house or changed jobs? Changed your classification or email?

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Are you a dual-registered nurse/midwife?

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Keeping your membership details up to date is very important. If you’re a dual-qualified nurse/ midwife, you can now update your role in the NSWNMA member portal.

NEWS IN BRIEF

UNITED KINGDOM

AUSTRALIA

Union commitment to closing the gap continues A partisan campaign derailed the Voice campaign but the NSWNMA and other unions remain committed to improving the lives of Aboriginal and Torres Straits Islander people, particularly in the area of health. The NSWNMA said the result of the Voice referendum was disappointing but it respected the decision of the voting public. “We recognise that although the Voice has not been endorsed, there is still a wide-spanning appetite to deliver improvements for the traditional custodians of our lands,” said Assistant General Secretary Michael Whaites. “At the NSWNMA, we have an ongoing part to play in this, namely in health care, and we are proud that work is underway in this area.

Let it rip and let old people die According to former British PM Boris Johnson, COVID-19 was “just nature’s way of dealing with old people” and he didn’t buy “all this NHS overwhelmed stuff”. An inquiry into the British government’s handling of the pandemic heard shocking evidence from former British Prime Minister Boris Johnson’s top science adviser Patrick Vallence, who detailed the chaotic and callous management of the crisis in his diaries Vallence’s contemporaneous notes, dated from August 2020, expressed his opinion that Johnson was keen to let “the young get on with life and keep the economy going” – which Vallance described at the time as a “quite bonkers set of exchanges” Vallance noted that “[Johnson] says his party ‘thinks the whole thing is pathetic and COVID is just nature’s way of dealing with old people’”.

“Closing the gap between Indigenous and nonIndigenous care is a priority for our union. “We continue to stand with Aboriginal and Torres Strait Islander peoples and are committed to championing health reform that uplifts some of our country’s most disadvantaged communities.” The ACTU also reaffirmed its commitment to justice for First Nations peoples. “The union movement has stood with First Nations peoples throughout this (Voice) campaign, as we have for recognition of citizenship, an apology for the Stolen Generations, the return of stolen wages, and in struggles for land rights,” it said. “We offer our continued support to the aspirations and needs of Aboriginal and Torres Strait Islander communities,” said ACTU President Michele O’Neil.

‘We are committed to Vallance’s diary also recounted how then Conservative chief whip championing health Mark Spencer told a cabinet meeting in December 2020 that “we reform that uplifts should let the old people get it and protect others”. some of our country’s Brenda Doherty, who lost her mother during the pandemic, told The Guardian: “He clearly didn’t see people like my mum as human most disadvantaged beings, and thousands of others died unnecessarily after the communities.’ same mistakes were repeated because of Johnson’s callous and brutal attitude.”

It is estimated that 230,669 people have died from COVID-19 in Britain. The majority of deaths were of people aged 75 or older.

‘We should let the old people get it and protect others.’ — Conservative chief whip Mark Spencer 36 | THE LAMP DECEMBER / JANUARY 2024

— NSWNMA Assistant General Secretary Michael Whaites

NEWS IN BRIEF

AUSTRALIA

UNITED KINGDOM

Increases in parental leave New laws introduced to federal parliament in October will allow for families to access 26 weeks of paid parental leave by 2026. This is the largest increase to paid parental leave since the beginning of the scheme in 2011. This follows previous changes made by the Albanese Government that started from 1 July 2023, to make the scheme more accessible, flexible and gender-equitable. Parents already have access to 20 weeks of paid leave, but under the changes that amount will increase by two weeks each year from July 2024, until the 26-week rate is reached in 2026. Once the scheme is fully implemented from July 2026, the 26 weeks will be able to be shared by both parents. It also increases the number of weeks reserved for each parent to four weeks. ACTU President Michele O’Neil welcomed the changes. “After a decade of neglect by the previous government, this bill is a significant improvement by providing more paid leave and creating a more equal balance of caring responsibilities among parents,” she said. “It’s not only a good policy for women, but it’s also a good economic policy that will boost the economy by supporting working families to share their skills and experience with the workforce. “There is still more to be done to improve and expand Australia’s PPL scheme, including the extending of the scheme to 52 weeks, increasing the rate of pay from its low level of the National Minimum Wage, and paying superannuation on parental leave.”

‘This bill is a significant improvement after a decade of neglect.’ — ACTU President Michele O’Neil

Some ultra-processed foods have ‘properties of addictive substances’ Food addiction is estimated to occur in 14 per cent of adults and 12 per cent of children. An analysis of 281 studies from 36 different countries published in the British Medical Journal found that “ultraprocessed food addiction” was estimated to occur in 14 per cent of adults and 12 per cent of children. “There is converging and consistent support for the validity and clinical relevance of food addiction,” wrote Ashley Gearhardt, one of the researchers and a psychology professor at the University of Michigan. “By acknowledging that certain types of processed foods have the properties of addictive substances, we may be able to help improve global health.” Recent studies have linked ultra-processed foods (UPFs) such as ice-cream, fizzy drinks and ready meals to poor health, including an increased risk of cancer, weight gain and heart disease. Global consumption of the products is soaring and UPFs now make up more than half the average diet in the UK and US. Now researchers say the way some people consume such foods could “meet the criteria for diagnosis of substance use disorder”. Behaviours that could meet these criteria include intense cravings, symptoms of withdrawal, less control over intake, and continued use despite such consequences as obesity, binge-eating disorder, poorer physical and mental health, and lower quality of life, they said.

‘By acknowledging that certain types of processed foods have the properties of addictive substances, we may be able to help improve global health.’ — Ashley Gearhardt, researcher, analysis published in British

Medical Journal

THE LAMP DECEMBER / JANUARY 2024 | 37

NEWS IN BRIEF

EUROPE

WORLD

Price gouging grips Europe Corporate profiteering is driving European inflation as wages lag badly, says prominent Asian financial service Nikkei. In July alone, consumer prices of food and other products rose more than 10 per cent in Germany, for the 15th consecutive month, and inflation surged to over 14 per cent in Britain. By one estimate, roughly 50 per cent of price increases in Europe stem from local companies passing higher costs on to consumers or jumping on the inflation bandwagon. As price increases outpace wage growth, consumption has sagged in the region. Soaring food prices threaten livelihoods, Nikkei reports. A survey of households by the European Commission found the perceived rate of inflation over the past year has risen to 26 per cent among low-income families, the highest in 20 years. The hardship posed by higher food and other prices has led to protests across Europe. According to the Organisation for Economic Co-operation and Development (OECD), corporate profits in Germany rose 24 per cent from the last quarter of 2019 – before the COVID19 pandemic – to the first quarter of 2023, while labour costs rose only 13 per cent. Similar trends can be observed in most other European countries. OECD research has demonstrated that in Australia corporate profits have also been a major driver of inflation. The ACTU has commissioned an “Inquiry into Price Gouging and Unfair Pricing Practices” to examine the cause and effects of price gouging on Australian working people.

‘The rate of inflation over the past year has risen to 26 per cent among low-income families.’ — European Commission survey of EU households

38 | THE LAMP DECEMBER / JANUARY 2024

The ‘common good’ is key in dealing with the next pandemic Unlocking the full potential of health technologies developed in response to COVID-19 requires equitable access, says WHO. COVID-19 showed that we have the scientific and manufacturing capabilities to develop and mass-produce safe and effective vaccines quickly in the face of novel threats, said Mariana Mazzucato, Chair of WHO’s Council on the Economics of Health for All. “But though this scientific breakthrough saved countless lives during the last pandemic, the benefits were not equitably shared. One year after the rollout of the COVID-19 vaccines, approximately 73 per cent of administered doses were concentrated in high- and upper-middle-income countries, whereas only 0.9 per cent had reached low-income countries. “This disparity was even more pronounced for mRNA vaccines, which were primarily used in wealthy countries that initially hoarded supplies. Meanwhile, pharmaceutical companies maintained tight control over licensing and production, allowing them to reap eye-watering profits.” Stricter governance over these pharmaceutical giants matters, she said. Both the Oxford–AstraZeneca and Pfizer–BioNTech (mRNA) vaccines received considerable public funding – $445 million for BioNTech and $1.3 billion to Oxford–AstraZeneca – and both benefited from large advancepurchase commitments. “While public funding for production of Oxford–AstraZeneca’s vaccine was conditioned on the company setting lower prices in the interest of accessibility, Pfizer–BioNTech was permitted to set higher prices, and then rebuffed calls for it to offer licensing agreements and technology transfers. “Next time, governments must ensure that contract provisions reflect the common good and regulate excess profit-taking.”

‘Next time, governments must ensure that contract provisions reflect the common good and regulate excess profit-taking.’ —Mariana Mazzucato

NEWS IN BRIEF

AUSTRALIA

Queensland appoints Chief Midwife The Queensland Government has committed to expanding maternity services, to address staffing shortages and improve working conditions. The Queensland Government has pledged $16 million for regional, remote and rural Midwifery Group Practices (MGPs), and has also created the role of a state Chief Midwife to help navigate the profession’s ongoing issues. “This is a significant outcome for women, babies and midwives right across the state who deserve safe, quality and appropriate midwifery services,” said Queensland Nurses and Midwives’ Union (QNMU) secretary Kate Veach. The QNMU and the Australian College of Midwives (ACM) had campaigned for improvements, including holding a rally outside parliament house.

ACM Chief Midwife Alison Weatherstone said the announcement would “change the future of midwifery in Queensland and nationally”. Kate Veach said MGPs provide continuity of care, with midwives working with women and babies during pregnancy, birth and postbirth. They also enable women, particularly those in rural and remote areas, to give birth close to home. She said the QNMU looked forward to further discussions with the health minister on other commitments pursued by the union, including ratios to safeguard inpatient maternity care, and

publicly funded home birthing, to give women choice in how and where they birth. Evidence shows continuity of care models such as MGPs result in a 24 per cent reduction of pre-term births and a 16 per cent reduction in pregnancy and neonatal loss.

AUSTRALIA Candish says delaying testing would put lives at risk and the government should listen to the scientific evidence. “Harm minimisation is the best-practice approach, and it recognises people should be supported to reduce harm to themselves and the wider community. “Pill testing is an effective step to prevent overdoses and unnecessary deaths. It can also help people make informed decisions about taking drugs and lead to behavioural changes.”

Clinicians call for pill testing trial Drug checking can help keep people safe, say health professionals NSW Nurses and Midwives’ Association, the Royal Australian College of General Practitioners, the Health Services Union, the Royal Australasian College of Physicians, and the Australian Salaried Medical Officers Federation have called on the state government to start drug checking in NSW. This follows the deaths of two young people at a recent music festival, and with predictions of a hot summer ahead.

The health group says an evaluated pilot program will also provide vital information for further discussion at the NSW Drug Summit next year.

“Pill testing is an effective step to prevent overdoses and unnecessary deaths.” — NSWNMA General Secretary Shaye Candish

CROSSWORD SOLUTION

In late 2019, an NSW coroner recommended the state introduce pill testing. Harriet Grahame found “there was significant evidence” that “intensive and punitive drug policing operations” were increasing drugrelated risks and harm. Drug checking already operates in 28 countries around the world, including Australia.

NSWNMA General Secretary Shaye THE LAMP DECEMBER / JANUARY 2024 | 39

YOUR RIGHTS

Professional Perspectives I am dual-qualified but currently am only employed as a nurse. I want to do some casual shifts as a midwife to keep up my registration, can I work casually as a midwife? To maintain dual registration as a nurse and midwife, you must meet the NMBA's Recency of Practice registration standard as a nurse and as a midwife. If so, you can work in either professions and there is no reason why you could not pick up shifts as a midwife in addition to your nursing shifts, if the employer has shifts available and your employment contract has you as both a nurse and midwife. The hospital I work at is undertaking multiple medical terminations every week and it is affecting my mental health. Can I conscientiously object? The Abortion Law Reform Act 2019 states that if a practitioner has a conscientious objection, they must disclose this to the person delegating the work as soon as practicable and transfer the care to another practitioner who does not have a conscientious objection. This conscientious objection does not extend to emergency care. The ANMF has a policy regarding conscientious objection. It states that discriminatory or adverse action should not be taken against a health practitioner with a conscientious objection, and that there should be appropriate counselling available to meet their needs. Please call Nurse & Midwife Support if you need further assistance: 1800 667 877 I have been on the nonpractising register as a 40 | THE LAMP DECEMBER / JANUARY 2024

The Association’s professional team answer your questions about professional issues, your rights and responsibilities.

midwife for over 15 years but I still work clinically as a nurse. Is there a time limit on the amount of time I can remain non-practising? No, there is no time limit to being on the non-practising register provided you continue to pay the registration fee. Once you are on the non-practising register, you are not required under the National Law to meet registration standards of recency of practice, fulfil continuing professional development, or have professional indemnity insurance. Due to the amount of time you have spent nonpractising, you will be unable to re-enter the workforce without further study. I work in a community setting. Sometimes, patients in my care are admitted to hospital. Am I permitted to look at their notes using electronic medical records, to check their progress while they are in hospital?

Practice hours count if you use your skills and knowledge as a health practitioner in your profession, these can be remunerated or not. If you are unsure, please contact the Association for individual advice. If you do not meet recency, you may be asked to complete supervised practice or a re-entry to practice program. I have recently been employed by a nursing agency. The agency is asking that I attend manual handling education before commencing work. Is it my responsibility to source this education? The Work Health and Safety Act 2011 No. 10 (NSW) outlines the duty of care held by an employer. Under the act, your employer has a duty to ensure you are provided with the training and instruction to protect you from risk that can arise from the workplace. So, if it is mandatory your employer should be providing you with the training.

No, if you are not involved in the care of that person at that time, you do not have the authorisation to view their records. Electronic medical records belong to the LHD or the facility and to access these notes, authority is required. That is, approval from the LHD or facility. Nurses and midwives have an ethical and legal obligation to protect a person’s privacy, which is included in the NMBA code of conduct.

Can I count routine yearly education, such as basic life support, towards my CPD hours?

I have not practised a total of 450 hours in the last five years. Do I still meet recency of practice? What happens next?

For more information visit:

If you have not practiced for a total of 450 hours in the last 5 years you may not meet recency.

Activities can only be counted if they are relevant to your context of practice and where you have engaged in new learning. Routine yearly education cannot be counted unless there is something new that you have learned.

https://www. nursingmidwiferyboard.gov.au/ codes-guidelines-statements/faq/ recency-of-practice.aspx

COVER STORY NURSING RESEARCH AND PROFESSIONAL ISSUES The Australian Journal of Advanced Nursing (AJAN) is the peer-reviewed scholarly journal of the Australian Nursing and Midwifery Federation (ANMF). The mission of AJAN is to provide a forum to showcase and promote a wide variety of original research and scholarly work, to inform and empower nurses, midwives and other healthcare professionals, to improve the health and wellbeing of all communities and to be prepared for the future. ‘Can personal psychological resources reduce burnout and turnover in Australian hospital nurses?’ S Eley, P Hassmen,

L Mollart, D Noble, A Mereles, J Mallyon, P Irwin,

Australian Journal of Advanced Nursing Vol. 40 No. 3 (2023): June–August 2023

This research evaluates the impact of using an academic electronic medical record program to build first-year nursing students’ confidence and skill in using e-documentation during their hospital clinical placement.

This study adopted a crosssectional survey design. The survey assessed nurses’ experiences of burnout, psychological capital, and intentions to leave nursing. Respondents indicated a high degree of experienced burnout. Much of the nursing burnout and intention to leave literature focuses on negative rather than positive aspects of the work environment. Positive responses to workplace stimuli promote positive attitudes, such as empowerment, job satisfaction, and organisational commitment, which have a tangible impact on personal and occupational wellbeing. This may explain why nurses with stronger personal psychological resources experienced less burnout and voiced fewer intentions to leave the profession. The survey results showed that nurses would benefit from initiatives to enhance their psychological resources. Targeted interventions to develop psychological capital should therefore be examined in a nursing population. This can change policy, thereby benefitting the healthcare system. https://www.ajan.com.au/index.php/ AJAN/article/view/1129/191 ‘The impact of using an academic electronic medical record program to build first-year nursing students’ confidence and skills in using e-documentation: a quasiexperimental study’

Australian Journal of Advanced Nursing Vol. 40 No. 3 (2023): June– August 2023

Registered nurses are the largest user group of health information technology systems, such as patient electronic medical records (eMR). As such, nurse undergraduate programs need to reflect contemporary practices and respond to emerging trends, including digital technology; however, integration of eMR learning has not occurred in many countries. A total of 105 students completed the surveys. Only 23 per cent of respondents received training on eMR and electronic observation charts during hospital clinical placement. There was a significant increase in participant confidence and knowledge in documenting in electronic adult observational charts and notes after using the academic eMR program and attending clinical placement. Three themes emerged from the qualitative data: preparation for practice is essential; more exposure increases confidence; and, do not forget the patient. https://www.ajan.com.au/index.php/ AJAN/article/view/1078/193 ‘Australian nurses’ satisfaction and experiences of redeployment during COVID-19: a service evaluation’ G Chu, K Connelly, A Mexon, B Britton, J Tait, V Pitt, K J Inder, Australian Journal of Advanced Nursing Vol. 40 No. 3 (2023): June–August 2023

Redeployment to an unfamiliar environment can be challenging; however, it can also present an opportunity for staff to learn new skills. During the COVID-19 pandemic, the need to redeploy health professionals, particularly nurses, increased dramatically. Evaluating nurses’ satisfaction and experiences related to redeployment during the pandemic is essential for future surge planning. Nurses who were redeployed to wards different from their regular workplaces were invited to participate in the survey. Areas of redeployment included various medical and surgical wards, intensive care units and the emergency department. Three main themes influenced nurses’ redeployment experience: “staff friendly and welcoming”, “patient allocation”, and “support”. Redeployment of healthcare workers during a pandemic is inevitable. This study highlighted that despite close to half the redeployed nurses reporting a positive redeployment experience, only a few were satisfied with redeployment. This indicated that more work is required to support nurses during redeployment, to increase satisfaction. Future workforce redeployment needs to consider healthcare workers’ needs and must strive to improve satisfaction, to build a sustainable and resilient healthcare system. This study highlighted that although redeployment is challenging, staff can have a positive redeployment experience when supported. Elements associated with a positive redeployment experience were explored in this study, which can inform policy and prepare nurses for future surge demand. https://www.ajan.com.au/index.php/ AJAN/article/view/1047/192 THE LAMP DECEMBER / JANUARY 2024 | 41

COVER STORY

MEMBERSHIP FEES 2024

NSW Nurses and Midwives’ Association – in association with the Australian Nursing and Midwifery Federation In 2024, NSW Nurses and Midwives’ Association membership fees will adjust modestly by 2% instead of the anticipated 4% as per our Rules. Annual

Quarterly

Monthly

Fortnightly

Registered Nurse & Registered Midwife $837.00

$209.25

$69.75

$32.18

$178.00

$59.33

$27.38

Enrolled Nurse $712.00

Assistant in Nursing & Assistant in Midwifery+ $587.00

$146.75

$48.91

$22.56

Undergraduate Bachelor of Nursing / Midwifery & Enrolled Nursing Dip. Nursing* $294.00

$73.50

Membership fees are tax deductible. All membership fees include GST. + Trainee AIN/M’s have their fees waived for the period of their traineeship.

$24.50

$11.30

* Students working in a nursing role while undertaking an Undergraduate Bachelor of Nursing/Midwifery or Diploma of Nursing.

Membership fees are based upon pay increases linked to the Public Health System Nurses’ and Midwives’ (state) Award. In 2023, public sector members received a 4% pay increase. However, the NSWNMA Council has determined a 2% fee adjustment given the challenging economic climate. From 1 January 2024, the 2% rise of between 12 to 31 cents per week, dependent on your classification, will occur. Remember, your membership fees are tax deductible, and the NSWNMA is the only registered industrial organisation in NSW representing nurses and midwives. Membership fees enable us to provide you with industrial, legal and educational support throughout the year, including your access to iLearn (with 200 hours of free CPD!), and member discounts and offers with our iSave benefits. Whether you work in a public or private health service, aged care or primary health sector, we are here to support you, and to advocate for the interests of all nurses and midwives.

ABN 63 398 164 405 | Authorised by S. Candish, General Secretary

Contact the NSWNMA if you are:

There are some things you shouldn’t handle alone. 42 | THE LAMP DECEMBER / JANUARY 2024

Asked to attend a disciplinary or fact finding interview with your employer Threatened with dismissal Instructed to provide a statement for any reason Contacted by the Health Care Complaints Commission or the Nursing and Midwifery Council of NSW Contacted by police or solicitors in relation to a Coronial Inquest

Call us on 1234 8595 (metro) or 962 367 1300 (non-metro) Email gensec@nswnma.asn.au

www.nswnma.asn.au

INSURANCE BENEFITS

For NSWNMA Members

Insurance protection when you need it most The NSWNMA is committed to protecting the interests of nurses and midwives by purchasing a range of insurances to cover members.

Journey Accident Insurance provides cover for members who are injured as a result of an accident while travelling between their home and their regular place of employment.

Professional Indemnity Insurance* provides legal representation and protection for members when required. Make sure your membership remains financial at all times in order to access the insurance and other benefits provided by the NSWNMA.

UNSURE IF YOUR MEMBERSHIP IS 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

www.nswnma.asn.au * The Professional Indemnity Insurance policy also includes Public and Products Liability cover. THE LAMP DECEMBER / JANUARY 2024 | 43

YOUR

health+wellbeing

Tips to thrive in your graduate year

1. Prioritise good nutrition

2. Move your body

3. Find a mentor

When we are transitioning into a new job that brings a lot of change, choosing foods that best support brain function will help us to think more clearly, make better decisions, and assist us to feel mentally healthy.

Exercise is an important way to stay well during your grad year. Most people are aware of the need for exercise but struggle to engage in it for a variety of reasons. Here are some things to keep in mind:

Having a mentor to provide guidance and support through the grad program can be invaluable.

• Meal planning is key. There will be times when you are tired, may have low energy, or don’t have the time to cook, so having prepared meals ready to go in the fridge or freezer is super helpful. • No matter what else you skip, make sure you eat. Eating regular meals when you are working will ensure you have the energy and clarity of thought to support yourself through each shift.

44 | THE LAMP DECEMBER / JANUARY 2024

• Any exercise is better than no exercise. • Not all exercise has to be highintensity cardio. Try something like a 5–10-minute yoga session when you get home from work. • Finding a form of exercise you enjoy is the key to sticking with it!

A mentor can be anyone with more experience than you, like a NUM or senior nurse/midwife, and preferably someone you have a good rapport with, who makes you feel comfortable and whom you can be honest with. You should feel validated and positive about the support and advice they offer. If you’re not sure how to ask them to be your mentor, you don’t have to overcomplicate it; just ask if you can have coffee with them sometime.

BROUGHT TO YOU BY

4. Advocate for a roster that works for your health, not against it We know this isn’t always easy to achieve in every workplace, especially at the beginning of your grad program when you may not have much flexibility with your roster due to being paired supernumerary or on the shift as an educator/preceptor. However, as time goes by you should be able to request some of your roster preferences, or swap shifts with other staff members. It’s important you have a roster that allows you to get enough sleep, have recovery time after shifts, and ensure a work/life balance where you have sufficient time for selfcare, and time with friends and family. You are more likely to enjoy your work and sustain yourself in the profession long-term if your roster suits your needs as much as possible. Try to avoid working lates/earlies and plan your night shifts in advance in a way that works for you. Working too many shifts in a row can burn you out, so try to split your shifts up with a day or two off in between. Practice asserting your boundaries so you feel more secure turning down requests to take on extra shifts.

5. Take care to unwind after work Sometimes it takes conscious effort to leave the stress and anxiety of the workplace at the workplace. Try to consciously adopt rituals to help you make the transition – like removing your lanyard, and then taking a deep breath. Think positive: on the way home think about one or two positive

things that happened that day or acknowledge something you did well. Plan to do an activity you will look forward to when you get home, such as a hot shower, a walk in the park or seeing a friend.

6. Create and protect work/ life balance The grad year can be all consuming. Many grads have found it difficult to maintain a life outside of work. This is natural and to be expected, as you will become immersed in the work while you are learning. However, to sidestep burnout, it is critical to devote time to yourself in your non-working life. • Carve out social time with friends and family. • If you need it, protect quiet time for yourself, too. • Keep up with any interests or hobbies.

7. Manage your stress response Stress is inevitable; we all experience it. Stress itself is not the enemy; in fact, we all need some stress in our lives to grow, change, and motivate us to learn. What you want to avoid is staying in a high-stress state for long periods. The stress you will experience at work is often beyond your control. What you do have control of is your internal response to that. You can learn ways to better cope with stress

so that when faced with difficult circumstances, you feel better able to manage it and support your resilience. Tips for stress management: • Journaling can be a positive way to process your experiences. • Avoid regularly using alcohol and/or other drugs as a stressmanagement tool. • Practice mindfulness or meditation – try a mediation app or mindfulness podcast.

8. Build your support team The graduate year can be mentally and emotionally demanding, so seeking out extra support can be beneficial. • Nurse and Midwives Support is available 24/7. For free, confidential, nationwide support contact 1800 667 877 or by email. • Form a support group with other graduate nurses and midwives and get together regularly to discuss any issues you might have. The graduate year can be tough. If you feel like you’re struggling, reach out. Remember, you don’t have to carry everything alone.

Nurse & Midwife Support provides free and confidential support 24/7 to nurses, midwives and students Australian wide. If you would like to speak to someone call 1800 667 877. THE LAMP DECEMBER / JANUARY 2024 | 45

CROSSWORD

test your

Knowledge

ACROSS 1. Vestibular window (8.9) 9. More prolonged (9) 12. Echo-planar imaging (1.1.1) 13. A pouch or sac in marsupials (9) 14. Unrehearsed, without advance preparation (9) 15. Intersections or crossings of two lines (9) 17. Showing off, flaunting (11) 18. Nastiest (7) 20. The gullets (9) 22. Real, genuine, or actual (4) 23. Incapable of developing a normal immune response (17) 24. To match in sound (8) 46 | THE LAMP DECEMBER / JANUARY 2024

27. Small masses of tissue in the form of a swelling, knot, or protuberance (5) 29. Relating to the skin (9) 30. Adequate, sufficient (6) 32. A native sodium carbonate (5) 34. A widely used industrial solvent that causes cancer and liver and lung damage (17) DOWN A structure in the liver (9.8) 2. Abnormal smallness of the eye (13) 3. Disembark (3.4) 4. Retransplant (9) 5. Wartlike (11) 6. Examiner, inspector (11)

7. Unashamed (13) 8. A disease of unknown cause or mechanism (10.7) 10. To consume food (3) 11. The state of being genetically related (7) 16. Symbol for holmium (2) 19. Gastric (9) 21. To make pleasant to hear (9) 22. Collectively, jointly (8) 25. Observation care unit (1.1.1) 26. Tuberculin unit (1.1) 27. Having the flavour of nuts (5) 28. A type of gene (1.1.1) 31. Sash worn on a Japanese kimono (3) 33. A single unit (3)

NSWNMA members now have FREE access to ubookdirect’s Worldwide Travel Club. What you get with your membership: Unlimited year-round access to worldwide properties at the industry’s lowest prices. Access to ubookdirect’s optimized algorithm that swiftly sorts hotels based on the day’s best deals. Highly discounted flash sales in Peak and Holiday seasons. Handpicked packages with value-add inclusions. www.ubookdirect.com/partner/nswnma

JOIN NOW

THE 2023 – 2024 NSWNMA MEMBER RECRUITMENT PRIZE

Recruit a new member and go into the draw to win a

$1,500

WORLDWIDE TRAVEL VOUCHER The NSWNMA has partnered with travlect to reward you! Recruit a new member and you could win a $1,500 travel voucher that can be used on accommodation anywhere around the world. Every member you sign up over the year gives you an entry in the draw! Travlect offers all NSWNMA members discounted rates on 1000s of hotels Australia wide and all around the world. Never pay full price for a holiday again. Visit travlect.com/partner/nswnma or call 1300 959 550. The NSWNMA will cover return flights for two from Sydney to the value of $3,000.

PRIZE DRAWN 1 JULY 2024 RECRUITERS NOTE: Join online at www.nswnma.asn.au

If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form, so you will be entered in the draw. Conditions apply. Prize must be redeemed by 30 June 2025. Voucher is for accommodation only. Peak and high season dates may incur a surcharge. Voucher is not transferrable nor redeemable for cash and cannot be used in conjunction with any other offers.