The Lamp February/March 2023

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)

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Danielle Blasutto

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50 O’Dea Avenue, Waterloo NSW 2017

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Press Releases

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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

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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

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Subscriptions for 2023

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10

COVER STORY

Overwhelming support for action

Stronger workplace organisation delivers upturn in membership activity.

12 COVER STORY

14

18

Nurses tell St Vincent’s Health: ‘Be a leader’ Mater and St Vincent’s Private Hospital branches decry company “stalling tactics”.

MENTAL HEALTH

Record demand for mental health services

The Black Summer bushfires of 2019-20, followed by the east coast floods and the COVID-19 pandemic had a major impact on the mental health of Australians.

NSW STATE ELECTION

With the NSW state election less than two months away The Lamp looks at some of the critical election issues for nurses and midwives.

26

PRIVATE HOSPITALS Low Healthe Care offer gets thumbs down

Nurses have said ‘No’ to a substandard agreement proposed by the owners of Healthe Care Surgical.

28 INTERNATIONAL Big win on ratios and pay for New York nurses

REGULARS

5 Editorial

6 Competition

6 Your letters

30 What’s

STRIKES SPREAD TO Your rights and entitlements at work p.32 Global nurse rebellion Record demand for services page 28 page 14 page 18

COVER :

74,374 The Lamp is independently audited under the AMAA's CAB Total Distribution Audit. Audit Period: 01/04/2020 31/03/2021 (Yearly Audit) Avg Net Distribution per Issue The Lamp is printed on PEFC certified paper. The paper is certified under the Programme for the Endorsement of Forest Certification (PEFC) which assures consumers that the utilised forestry products can be traced from a certified, sustainably managed forest through all stages of processing and production by a chain of custody process. The Lamp is wrapped in Ecopure film which is recyclable and biodegradable. 8

GENERAL SECRETARY

The next stage in our campaign: the ballot box

The NSW state election on Saturday March 25 gives us a golden opportunity to advance our objective of achieving ratios in the Public Health System.

The last four years since the last state election have been traumatic for our Public Health System and for the nurses and midwives who have been propping it up.

During this time it has been easy to think that the Perottet government and the health workforce have been living in parallel universes.

In the bubble of Macquarie Street, the Premier and his health minister have only just started to move away from their fantastical assertion that the existing staffing system is effective and nurses and midwives are “coping” fine and should stop complaining.

Meanwhile in the real world the relentless pressure that has been exacerbated by COVID has taken a heavy physical and psychological toll on nurses and midwives.

There are numerous empirical studies that back this up.

They show that nurses and midwives are at real risk of post-traumatic stress disorder and are experiencing symptoms of fatigue, burnout, stress, anxiety, and depression.

Last year we had four strikes with massive participation by nurses and midwives and with overwhelming support from the community and even the media.

The message could not have been louder and clearer from those working at the frontline about the fragility of the system and the risks to patient care.

But still the Perottet government stubbornly refused and still refuses to listen and, unconscionably, refuses to act.

On March 25 there will be an opportunity to make the government accountable for this dereliction of duty.

The NSWNMA has consistently put forward our solutions to the problems of our crisis-ridden Public Health System which are based on the implementation of mandated, shiftby-shift ratios.

While the Coalition has ignored nurses and midwives other political parties have listened and responded.

The ALP hasn’t committed to everything we want but they have agreed to many of our proposals and we are confident we can persuade them to do more.

Both the Greens and the Shooters, Fishers and Farmers’ Party have already committed to support mandated safe staffing ratios. There are other issues in this election that are important to us as nurses and midwives and as union members.

The government’s wages policy has systematically eroded the standard of living of nurses and midwives and malignly impacted on their retirement incomes during the decade of its existence.

In 2020-21 at the height of the COVID crisis, as nurses and midwives literally risked their lives at the frontline of the pandemic, the government – with Dominic Perottet as Treasurer –shamefully responded by unilaterally limiting their pay rise to a disgraceful 0.3 per cent.

According to the Australia Institute, the pay caps have cost a nurse or midwife $80,000 each since they were first imposed in 2012.

This policy has to go and the ALP has promised it will if it wins office in March.

Another shameful Perottet government failure is workers compensation. An admirable scheme that was once a strong safety net for injured workers has now been described as “a basket case”. It is a financial and moral disaster which has impacted negatively on many injured workers and their families’ mental health and wellbeing. Most respondents to a survey conducted by the NSW Injured Workers’ Support Network said they experienced suicidal tendencies as a result of their experiences with the NSW workers compensation scheme. In this coming election I would urge you to give a high priority to all these issues and how the respective party policies will impact on your jobs and the care we can deliver to our patients. In particular we have to consider how our vote will advance our goal of having shift-by-shift ratios implemented across New South Wales. The benefits of winning ratios will flow on to everyone who needs care and the standards set in the public health system will be a foundation for establishing the same conditions in the private sector.

Between now and March 25 let’s make one last push to reach out to the community to support us in this critical task of saving our Public Health System. n

While the Coalition has ignored nurses and midwives other political parties have listened and responded.

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Have your Say

LETTER OF THE MONTH

All eyes on the rainbow scrubs

I was lucky enough to experience participating in my first Mardi Gras parade last year as part of the NSWNMA entry, and it was so humbling and emotional to be greeted by the cheers of the crowd calling out “Thank you!” to nurses and midwives, which felt amazing after two long years of COVID-19.

This year, Sydney will be hosting the international LGBTQI festival World Pride, a fabulous event that brings together members of the LGBTQI community from across the globe to celebrate.

The NSWNMA will be marching this year with our colleagues from across the country under the banner of “A Better Healthcare System for All – A Dream Worth Fighting For”. For nurses and midwives this is such an important message, as the pandemic has certainly drawn the public’s attention to the cracks and failures in our healthcare system.

As nurses and midwives, our common dream is to work for a system that treats everyone with fairness and compassion, no matter who they are or where they are from. We would also like a better healthcare system for ourselves! Imagine coming to work and not feeling overwhelmed and afraid due to your patient load? I am excited to be able to share with the public this dream of what our healthcare system could be like, as we march down Oxford Street this year.

If you are watching the Mardi Gras this year, keep an eye out for the rainbow scrubs on the NSWNMA float and give us a cheer!

Emma Gedge, Wollongong Hospital Midwife and Councillor

If there’s something on your mind, send us a letter and have your say. The letter of the month will WIN a gift card. The letter judged best each month will receive a $50 Coles Group and Myer gift card.

Our actions are historic

At the Mater and St Vincent’s Private Hospitals, NSWNMA branch members have embarked on a campaign for nurseto-patient ratios, better working conditions and fair pay rises, as part of our Enterprise Agreement negotiations.

St Vincent’s Health Australia (SVHA) delayed bargaining for over 12 months, which prompted a campaign by members and a petition, signed by over 1,200 staff, seeking a commitment for change from the SVHA executive.

In response, SVHA offered a wage increase much lower than inflation and no commitment to nurse/midwife to patient ratios.

In late November, we escalated our campaign and successfully applied to the Fair Work Commission for a protected action ballot, with members overwhelmingly voting in support of protected industrial action.

On 22 December, hundreds of nurses and midwives at the Mater in North Sydney and at St Vincent’s Private in Darlinghurst joined in one-hour stop work rallies.

This action was historic and marked the first time in over 30 years nurses and midwives at the Mater and St Vincent’s Private had taken industrial action.

NSWNMA members at both hospitals have continued the campaign for ratios by taking part in ongoing protected action wearing badges, speaking with patients, handing out flyers and refusing to do overtime and other non-domestic duties.

Nurses and midwives are working long overtime hours, are constantly short staffed, and are afraid the ongoing poor working conditions will lead to a catastrophic event for a patient or staff member.

Members are frustrated their pleas for more help are being ignored.

Suzanna Ersotelos, Assistant Secretary, Mater Hospital, North Sydney

How management manipulates NHPPD

During December 2022, NSWNMA Coffs Harbour Hospital Branch commenced closure of beds on Medical B Ward. This was in response to local management’s inaction to verbal and written escalation of concerns regarding both nurse and patient safety, due to excessive overtime being relied upon to operate at full capacity. After two days of bed closures, the branch voted to temporarily pause our action as management agreed to enter serious negotiations with the NSWNMA. Management has made it clear that the NHPPD for the ward has consistently been met; however, evident is their omission of the physiological and mental toll the methods being used has had on nursing staff, and the risk to patient safety.

This action has demonstrated how easily NHPPD can be manipulated. For example, the deployment of nurses in positions such as CNE; using nurses with inappropriate skill set from other units, leaving the ward short-staffed; and through the use of excessive overtime. Our branch currently remains in active negotiations.

Branch members would like to thank NSWNMA officers for their time and ongoing support throughout this action. We know this is not isolated to one ward or one hospital, and we hope to empower others to continue fighting for the safety of nurses and patients.

Sue White, Coffs Harbour NSWNMA Branch Vice President and Councillor

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.

Politicians can’t hide from nurses and midwives

With less than two months until the state election, nurses and midwives need to make sure our voices are heard now more than ever. On Saturday 25 March, NSW will make a choice whether to continue with business as usual or demand change. COVID-19 has highlighted to the community how vulnerable our public health system is. But let’s be honest, we all know the systemic issues within the public health system were there prior to COVID-19 and continue today.

I know it’s not an easy task, especially after the last few years; we’re going to have to dig deep. But our patients and consumers, our colleagues, and the wider community need us to hang in there. The NSW Government needs to know we aren’t backing down and we won’t stop until our public health system is adequately resourced. As expected, in the lead-up to an election, there’s going to be drama, and lots of it. So, it’s imperative we don’t allow the current state government to use the drama as a distraction tactic or, in their usual style, to divide and conquer. Both sides of politics need to know they can’t run away from our public health system and the nurses and midwives!

Skye Romer, NSWNMA Councillor, Prince of Wales

Strikes spread to private hospitals

St Vincent’s Health Group nurses and midwives join statewide push for staffing ratios and fair pay.

Nurses and midwives at two leading Sydney private hospitals have taken strike action in support of staffpatient ratios and pay rises that match inflation.

In December, nurses and midwives held one-hour work stoppages at the Mater Hospital in North Sydney and St Vincent’s Private Hospital (SVPH) in Darlinghurst, and put bans on overtime and domestic duties.

The industrial action is known as “protected” because it was endorsed by NSWNMA members in a secret ballot authorised by the Fair Work Commission.

Members voted overwhelmingly (97 per cent at the Mater and 96 per cent at SVPH) to approve “an unlimited number of stoppages of work of between 15 minutes and four hours, while maintaining safe patient care.”

NSWNMA General Secretary, Shaye Candish, described the strike as historic.

“You are breaking new ground. We think your hospital hasn’t taken industrial action for more than 30 years,” she told a rally of nurses and midwives outside SVPH in Darlinghurst.

Shaye said the reputations of SVPH and the Mater as “hospitals of excellence” were upheld only by “nurses’ continuing goodwill in the face of chronic understaffing, fatigue and burnout.”

“Ratios are not an unreasonable request – they are a necessity to deliver safe and reasonable care to your patients and to your community.

“Other state governments and private employers across the country have accepted that ratios are needed to deliver quality health care, yet here in NSW our patients are falling behind.

“Your action is part of a statewide movement of nurses and midwives rising up and demanding that they no longer be taken for granted.”

The ballot came after negotiations with St Vincent’s Health Australia (SVHA) for new enterprise agreements were deadlocked.

The NSWNMA is calling for an annual pay rise of 5.5 per cent, or equal to inflation as measured by the consumer price index – whichever is greater.

The SVHA pay offer of about 10 per cent over three years would be a cut to real wages, with inflation now running at 7.8 per cent.

The company also refused to bargain on ratios, despite another private hospital, Sydney Adventist Hospital, agreeing to ratios last year.

Shaye said nurses regarded SVHA’s “incomplete and insulting” offer as an erosion of the gains they made in previous enterprise agreements. n

First private hospital strike for 12 years

The pre-Christmas strike at St Vincent’s Health Group hospitals in NSW appears to be the first by nurses at any NSW private hospital since 2011. In that year, five Macquarie Private hospitals (Delmar, Manly Waters, Minchinbury Community, Eastern Suburbs and President Private) voted to strike for 24 hours after long negotiations.

Also in 2011, NSWNMA members at Shellharbour Private Hospital gained approval to take protected industrial action. The strike was called off after management made a favourable offer.

‘Your action is part of a statewide movement of nurses and midwives rising up and demanding that they no longer be taken for granted.’

— NSW General Secretary, Shaye Candish

Nurses and midwives to strike again

In January, NSWNMA branches at both hospitals voted to strike again in February after an unsatisfactory meeting with their employer, SVHA. Members said SVHA failed to improve on its earlier inadequate offer for a new enterprise agreement.

This was despite NSWNMA reps from various departments providing “very compelling arguments” to support minimum staffing, shift by shift, said Kate Westwood, NSWNMA branch secretary at SVPH in Darlinghurst. She said NSWNMA reps made it “abundantly clear just how stressful the workloads are” and that nurses were rarely able to leave patient care to attend education sessions. Also, SVHA had still not addressed all claims made by the union in its log of claims submitted in September.

Overwhelming support for action

Stronger workplace organisation delivers upturn in membership activity.

At St Vincent’s Private Hospital (SVPH) in Darlinghurst, Sydney, support for industrial action among NSWNMA members was almost unanimous.

Of SVPH’s voting members, 96 per cent supported “an unlimited number of stoppages of work” of between 15 minutes and four hours while maintaining safe patient care.

“An unlimited number of periodic or indefinite bans” on overtime and a ban on domestic duties such as cleaning was approved by 98 per cent of voters.

During the historic one-hour strike on 22 December, about 200 members and supporters held a spirited rally at Green Park opposite the hospital.

“For SVPH this rally was unprecedented,” said Kate Westwood, a clinical nurse and secretary of the hospital’s NSWNMA branch.

“Many members came to the rally on their days off, from long service and annual leave. It was wonderful to see members bring their children to participate in this heartfelt event – it was very impressive.

“The strong ballot result and rally shows SVPH nurses have decided it is time to take action.

“Members are determined to stop the erosion of nurses’ working

conditions and enable them to deliver the safe and excellent care our patients deserve.”

Kate said many senior nurses have left over the past year, leaving an increasingly junior and inexperienced workforce.

She said SVPH nurses lost valuable conditions in their 2019 enterprise bargaining negotiations “because we weren’t active enough at the workplace level.”

“We need incentives for retention, to reward experienced and senior clinical nurses. However, incentives such as the Magnet Recognition Program and some allowances have

been removed.

“Magnet provided valuable education and professional pathways for nurses and promoted excellence in patient care. This benefited the entire organisation.

“It was an investment in the nursing workforce that helped to promote the hospital, recruit new grads and retain existing staff. We were the only private hospital in Australia to have it.

“Magnet contributed to a feeling of pride that our working conditions were superior to a lot of other hospitals. We don’t feel that way anymore.”

‘Members have been forced to take action, as we can see that our hospital is really suffering as a result of poor staffing levels and reduced expertise.’

— Kate Westwood, branch secretary

DETERMINED TO ADDRESS WORKPLACE ISSUES

Kate added that all nurses are determined to address workplace issues in the current enterprise agreement bargaining process.

“Members have been forced to take action, as we can see that our hospital is really suffering as a result of poor staffing levels and reduced expertise.”

She credits the turnaround in membership activity to the work done to build up the branch and workplace organisation since mid-2021.

“We now have an NSWNMA representative in every hospital department.

“Department reps are responsible for keeping communication lines open between the individual departments and the branch executive.

“The strength of our organisation is having department reps talk to people individually, so they’re getting accurate information from people they know and trust.”

Kate says COVID has made it difficult to hold in-person meetings “but we’ve been able to use new technology to our advantage”.

“It’s always been difficult for nurses to leave their departments to attend branch meetings, even when we are not short staffed.

“But through Zoom, members can gather together in their breaks in the tea rooms, sharing a laptop, or participate via their phones.

“Our branch meetings used to attract a handful of people. Now we have more than 50 nurses coming to meetings in person or via Zoom.” n

Rush to sign action pledge

In the lead-up to the SVPH strike ballot, the NSWNMA branch asked staff to sign a form pledging to take action for ratios and fair pay. In just 10 days, NSWNMA members collected 1143 signed pledges from staff at SVPH and its sister hospital the Mater in North Sydney. Pledge forms were bundled and presented to hospital executives.

“The staff response was overwhelming,” said NSWNMA branch secretary Kate Westwood.

“It wasn’t just nurses who got involved. Doctors, surgeons, physios, radiographers, anaesthetists and receptionists were also keen to sign to show their support.

“SVPH is a hospital that prides itself on excellent care. This is why so many choose to work here.”

She said, however, that staff feel “disrespected and ignored” after St Vincent’s Hospital Australia (SVHA) failed to give a meaningful response to the NSWNMA’s log of claims for better working conditions, staff ratios and fair pay.

Kate described the current SVHA offer for a new enterprise agreement as a further erosion of earlier gains.

“The nurses of SVPH desperately want safe staffing and the support of SVHA to enable us to deliver the excellent care that SVPH prides itself on.

“We want shift-by-shift minimum staffing levels mandated and we urge SVHA to take action now and invest in the amazing nurses of SVPH.”

‘It wasn’t just nurses who got involved. Doctors, surgeons, physios, radiographers, anaesthetists and receptionists were also keen to sign to show their support.’

— Kate Westwood, branch secretary

Nurses and midwives tell St Vincent’s Health: ‘Be a leader’

Mater and St Vincent’s Private Hospital branches decry company

NSWNMA branch officials at the Mater Hospital in North Sydney have challenged their employer, St Vincent’s Health Australia (SVHA), to “be a real leader in health care”.

Branch delegate Libby Wall and branch assistant secretary Suzanna Ersotelos delivered this message during a pre-Christmas rally of striking nurses and midwives.

Suzanna said working the last three years through COVID-19 had been really tough.

“We’ve lost a lot of staff and we’re not hiring enough new staff. We’re working many more hours of overtime, everyone’s tired, and mistakes can happen. We want to keep our patients safe.”

Asked if she had a message for SVHA, she replied: “We want you to be a leader in health care. We want you to make a change in NSW by bringing in staff ratios and increasing our pay.”

Delegate Libby Wall described the growing concerns of midwives trying to care for mothers and babies.

“It’s just becoming more exhausting and more unsafe,” she said.

“A good day for me is if I say I’ve managed to have a break, but very rarely [am I] off on time. That’s why we’re here today; we need things to change.”

She said the company’s pay offer would not even keep pace

with inflation.

“We at least have to go beyond the CPI to make it a real wage increase.

“A lot of nurses with mortgages and young families are dropping to casual because they can’t deal with the heavy workload.

“They need to be able to pay their mortgages and energy bills and get their kids into childcare.”

She said SVHA should show leadership in setting workplace conditions.

“How exciting would it be if we had a waiting list of people wanting to come and work at SVPH? That would be such an exciting thing for management to be able to pick up.”

UNANIMOUS CALL FOR BALLOT

NSWNMA branches at the Mater and SVPH voted unanimously to ask the union to seek a protected action ballot to authorise industrial action.

The resolution, passed by both branches, said it was “frustrated and disappointed with the length of time it is taking for SVHA to respond to our log of claims while continuing to deny nurses and midwives an agreement that recognises their vital contribution to safe patient care.”

The resolution said SVHA was using “stalling tactics” to delay negotiations and the finalisation of enterprise agreements that expired on 31 December 2021.

The Mater nurses’ and midwives’ rally coincided with a similar meeting across the harbour by SVPH nurses.

Among the speakers was Sinead Keane, assistant secretary of the NSWNMA branch at SVPH.

“It’s three days before Christmas; all of us would prefer to be inside getting

‘We’re working many more hours of overtime, everyone’s tired, and mistakes can happen. We want to keep our patients safe.’ — Suzanna Ersotelos

“stalling tactics”.

on with our work, instead of being out here calling for help,” she said.

“But we’ve been calling for help for four years now and nobody has listened to us.

“We have watched loyal and experienced colleagues walk out the door.

“We’ve watched our workloads increase and we can’t deliver the patient care we want to deliver anymore.

“We’ve watched as our conditions have diminished and the cost of living has increased.

“We’re calling for help and no-one is listening.” n

Your fight is ours, say public nurses and midwives

The NSWNMA branch at St Vincent’s public hospital in Darlinghurst sent a message of solidarity to fellow nurses and midwives on strike at the adjacent St Vincent’s Private and the Mater.

Damien Davis-Frank, secretary of the NSWNMA St Vincent’s public hospital branch, told the rally, “This is a fight that we’re all experiencing.”

“Over the last year we have seen the public sector take to the streets four times.

“These conditions we are working under are not fair and not safe for us or our patients.

“We need to acknowledge that this health system is in real danger and we will keep fighting to get things going in the right direction.” n

‘How exciting would it be if we had a waiting list of people wanting to come and work at SVPH?’

— Libby Wall

‘This is a fight that we’re all experiencing’

— Damien Davis-Frank

NURSES AND MIDWIVES AT THE STRIKE AT THE MATER HOSPITAL

Record demand for mental health services

Demand for mental health support across Australia surged to record levels in 2021.

The National Study of Mental Health and Wellbeing (NSMHW) conducted in 2020–21 found that about 17.5 per cent of people aged 16 to 85 had at least one session with a mental health professional about mental health within that year.

In addition, 4.4 per cent (or 864,100) of Australians accessed at least one digital service for their mental health, such as crisis support or counselling services, and online treatment programs or tools.

The study, funded by the Australian Government Department of Health and Aged Care, involved more than 5500 people aged 16 to 85 and was released by the Australian Bureau of Statistics (ABS) last year.

The ABS says the study is the “gold standard” for information on the prevalence of mental disorders in Australia.

Commenting on the study, assistant minister for mental health and suicide prevention, Emma McBride, said the record demand for mental health support was especially pronounced among young people.

Federal health minister, Mark Butler, said the study indicated bushfires, floods and the pandemic had a “major impact” on mental health.

Linda Fardell, head of health

and disability statistics at the ABS, said the study showed one in five Australians (21.4 per cent) experienced a mental disorder in 2020–21.

In the category of mental disorders are panic disorder, agoraphobia, social phobia, generalised anxiety disorder, obsessive-compulsive disorder and post-traumatic stress disorder.

Anxiety disorders were the most common group of mental disorders, affecting nearly 17 per cent of people. Fardell said about 7.5 per cent of Australians had an “affective or mood disorder” such as depression, while 3.3 per cent of people had a substance use disorder. n

‘Bushfires, floods and the pandemic had “major impact” on mental health.’

The Black Summer bushfires of 2019–20, followed by the east coast floods and the COVID-19 pandemic have had a major impact on the mental health of Australians.

Surge in psychological injury claims

Psychological injuries are taking a severe and worsening toll on the NSW healthcare workforce.

The rate of compensation claims for psychological injuries among nurses and midwives in NSW has increased by an alarming 150 per cent over the last nine years, a study shows.

The study found workers in healthcare and social assistance (HSA) filed almost double the number of psychological injury claims made to icare, the state-owned insurer, compared to workers in all nonhealthcare industries.

The study was commissioned by the Healthy Lives Research Group at Monash University and released in November.

Using data from more than 200,000 workers, the study examined the psychological health of HSA workers and the risk factors that lead to higher instances of psychological injury among them.

It describes nurses, midwives, ambulance officers and social workers as “highly impacted jobs”.

Among nurses and midwives, the most common causes of psychological injury related to “interpersonal relationships at work, including with co-workers (harassment and bullying) or members of the public (occupational violence)”.

Stress and anxiety were found to be the most common type of psychological injuries, accounting

for two-thirds of cases. Post-traumatic stress disorder was most common among ambulance officers.

The duration of disability in psychological injury claims among nurses and midwives, aged and disability carers, ambulance officers, social workers, and administrators and managers also increased over the last nine years.

HSA workers with psychological injury claims have prolonged periods of work disability, with time off work exceeding 13 weeks in more than 50 per cent of claims.

Psychological injuries accounted for 25 per cent of the total time lost due to any injury in the HSA industry.

In contrast, psychological injuries accounted for 16.7 per cent of time lost due to any injury in other industries.

Social, demographic and occupational risk factors for psychological injury claims in HSA workers included “older age, higher levels of socioeconomic disadvantage, and working full-time”.

“Study findings demonstrate a pressing need to focus on prevention and early intervention in the HSA industry, in order to minimise the frequency of psychological injury and the associated disability,” the study authors said. n

Nurses, carers among worst affected

Psychological injury claims have grown rapidly in the HSA industry in NSW over the past nine years, most notably since 2015/16.

The strongest growth was among nurses and midwives (150.6 per cent growth), ambulance officers (138.5 per cent) and social workers (104.1 per cent).

There was a 31.2 per cent increase in claims for psychological injuries among aged and disabled carers.

Mental health nursing in decline

In a 2019 submission to the Productivity Commission, the NSWNMA said public mental health services in NSW had received inadequate funding since “deinstitutionalisation” became policy in the 1980s.

The union also warned that “leakage” of mental health funding to other areas of health had created systemic issues in the state’s mental health services.

The submission said LHDs had failed to acknowledge the competency, education and experience of specialist mental health nurses, leading many to move to other areas of health or leave the profession altogether.

The current workloads and the added strain of the COVID pandemic have exacerbated the situation with many services bringing in staff with no mental health training and little experience.

Richard Noort is a 40-year veteran of mental health nursing and a member of the NSWNMA’s Council. He trained as a mental health nurse at the former Rozelle psychiatric hospital in Sydney and has worked in the Illawarra region for most of his career, which spans in-patient and community services, acute assessment teams and court liaison. He says mental health has been

downgraded as a specialised stream of nursing in university training.

LACK OF CLINICAL PLACEMENTS

“Some universities don’t even have a mental health component in their clinical placements – they only provide lectures about very basic stuff,” he says.

“There are a couple of unis that offer a diploma or masters in mental health but they don’t have significant clinical placements related to that degree.”

He says nursing students at Wollongong University, for example, can no longer do a post-graduate term in mental health.

“The nurses do their post-grad year through the hospital system and then apply for a transfer to a mental health unit if they are interested.”

Richard says young nurses who enter mental health units are apparently expected to learn by example.

“However, their potential mentors

– the experienced mental health nurses – are retiring or leaving due to excessive and unsafe workloads. Some mental health units only recently employed a CNE in their ward, and they often get taken out of their roles to fill clinical vacancies.

“As a result, we are losing the beginning practitioners really quickly because they are thrown in the deep end without adequate support.

“If we’re going to maintain our mental health workforce, we’ve got to look at a better way of providing support and education to the people who are choosing to come into the profession.”

COMMUNITY CARE NEEDS FUNDING

In the 1980s, under the policy of “de-institutionalising care”, NSW reduced its in-patient mental health bed base and transferred patients to community care.

The surge in demand for mental health support highlights the inadequacy of mental health services in NSW, and it’s having an impact on mental health nurses.

‘Many wouldn’t be in prison in the first place if they had access to decent mental health services.’

— Richard Noort, NSWNMA councillor

However, successive governments at the state and federal level have failed to provide the money, services or staff needed for community services to meet the demand.

Richard calls the policy “a complete and utter failure”.

This is one of the reasons the NSWNMA is calling for minimum safe staffing levels in acute and community mental health, says Assistant General Secretary Michael Whaites.

“Members everywhere are saying that inadequate services and poor staffing levels across the system have led to an endless cycle that causes on-going harm,” he says.

“When an individual needs a psychiatric intensive care unit bed, someone else is transferred to an acute ward before they’re ready. This leads to someone else being transferred to sub-acute, and then someone being discharged into the community early who then may not be able to access the care they need in a timely manner. They then need admission to an acute bed, and so it goes on.

“Our members are reporting an increase in workplace injuries due to understaffing and inappropriate patient placement. This leads to units being short staffed which leads to more injuries”.

MENTAL HEALTH UNITS OVERWHELMED

Richard says methamphetamines have raised the levels of agitation and psychosis, which are best managed by nurses with acute care experience.

Mental health units are “overwhelmed with presentations from people with short-term acute psychiatric needs and there’s just not enough beds available for them.”

He says people with chronic mental illnesses who are not adequately supported can “become disenfranchised and socially disadvantaged very quickly.”

“This can lead to homelessness,” he says.

Richard says it is estimated that up to 60 per cent of people serving a sentence or remanded in custody have some form of mental illness

“Justice Health have mental health staff including nurses in every jail. They do a good job of providing mental health assistance to people in custody provided they have adequate staffing.

“However, many wouldn’t be in prison in the first place if they had access to decent mental health services.”

Michael Whaites says we need more beds and community mental

health services and argues that increasing the services should be complemented by increasing our capacity for nurses to complete formal mental health training.

The key to rebuilding the mental health workforce will be the introduction of nurse to patient ratios and maximum face to face hours in community mental health, he says.

“Unless there is a circuit breaker which leads to safer workloads for mental health nurses we’re not going to have the workforce to meet the needs of our communities, and we’re seeing demand grow, not reduce. It’s time the government agreed to our claim.” n

Get involved

Are you interested in developing, or helping others develop, mental health nursing? Check out the Bob Fenwick Mentoring Programme on page 34.

‘Unless there is a circuit breaker which leads to safer workloads for mental health nurses we’re not going to have the workforce to meet the needs of our communities .’ — Assistant general secretary Michael Whaites

‘Let it rip’ left health system exposed

The Coalition’s “let it rip” approach to COVID-19 condemned vulnerable people to an early death and left understaffed hospitals facing surging rates of illness.

In December 2021, newly minted Premier Dominic Perrottet embarked on a “let it rip” approach to the Omicron variant of COVID-19 in NSW.

Backed by Prime Minister Scott Morrison, Perrottet dropped the state’s last remaining restrictions on mask-wearing, mandatory QR code check-ins and venue capacity limits.

As a result, Omicron ran rampant. Within weeks Perrottet was forced to backtrack and reimpose mandatory mask wearing indoors, density limits and QR code check-ins.

It was too late.

As OzSAGE, an independent, multi-disciplinary group including infectious disease and public health experts, put it, the Coalition’s “let it rip” strategy “condemned many people to death” and placed an enormous strain on an already exhausted health system.

Among those left vulnerable by “let it rip” were patients with cancer and other immunosuppressed people, and those with co-existing health conditions.

Worst hit were nursing home residents, left vulnerable by the Morrison government’s failure to adequately prepare the aged care sector nationwide.

Department of Health and Aged Care data showed Australia’s nursing homes had reported 2055 deaths related to COVID in the first six months of 2022. The number dwarfed the death tolls of 231 in 2021 and 686 in 2020. In NSW, nurses and other healthcare workers were left to clean up Perrottet’s shambolic mess.

AN “ALARMING” BURDEN ON HOSPITALS

Our hospitals, badly understaffed before COVID-19, suddenly had to deal with surging rates of COVID. Emergency departments were overwhelmed and suspected COVID patients mixed with nonCOVID patients over long periods in waiting rooms.

During January 2022, more than 6000 health workers were forced to isolate on a single day.

Six months later, on 15 July, there were still 2719 health workers in isolation across the state.

The NSW state election is on 25 March . The Lamp looks at some of the critical election issues for nurses and midwives.

‘Their persistence in saying the system is coping reveals a complete disregard for the truth.’ — NSWNMA general secretary Shaye Candish

Exhausted nurses came under intense pressure to work overtime and return to work after shorter isolation. As OzSAGE reported, the burden placed on the public hospital system was “alarming and under-reported”. However, Perrottet and his health minister claimed that hospitals were adequately staffed and “coping” with the strain.

Such cavalier remarks left nurses and midwives rightfully furious, said Shaye Candish, NSWNMA general secretary.

“Their actions and inactions have led us to this. Their persistence in saying the system is coping reveals a complete disregard for the truth,” Shaye said.

“It is outrageous that Dominic Perrottet continues to spin the lie that our public healthcare system is ‘strong’.

“He repeats this lie while nurses and midwives are exhausted, working excessive overtime and hospitals remain short-staffed. Patient care is suffering.” n

Coalition is a laggard on safe staffing

The Liberal–National Coalition that runs NSW has been left behind by other parties on the issue most crucial to the safe operation of our hospital system: enforceable minimum ratios to ensure safer staffing.

When this edition of The Lamp went to press, the Coalition hadn’t moved far from the position laid down by Premier Perrottet and Health Minister Hazzard at the height of the pandemic – that the existing staffing system is effective and that nurses should stop complaining and learn to “cope”. Meanwhile, in the real world, increasing work pressure is taking a heavy physical and psychological toll on nurses and midwives.

A recent survey of NSWNMA members in public health shows nine in every 10 nurses and midwives have had their workload increased since the pandemic.

The survey also shows that work pressure is forcing many experienced nurses and midwives to search for other jobs in the sector, or quit the profession early.

Further, almost half the union membership has been asked to work outside their usual scope of practice – mostly without the necessary education and training.

In October 2022, the NSW Labor opposition recognised the need for action and promised to introduce mandated, shift-by-shift staffing if it wins the March state election. Labor pledged to phase in our claim for EDs, ICUs and maternity – and minimum shift-by-shift nurse numbers in multi-purpose services with a 24-hour ED.

It also pledged to convert all existing nursing-hours-per-patient-day wards to a shift-by-shift system.

Labor hasn’t committed to all that we are seeking – important areas still need to be addressed. However, as NSWNMA General Secretary Shaye Candish put it, Labor has made “a promising start towards long overdue reforms”.

In the NSW Parliament, the Greens have tabled ratios legislation and the Shooters, Fishers and Farmers’ Party also support mandated safe staffing ratios.

This means our campaign for shift-by-shift ratios now has serious momentum.

This is due to the hard and often brave work done by NSWNMA members in their workplaces and in the community.

Members voted overwhelmingly to hold four statewide strikes in 2022. Many nurses and midwives who stopped work and marched with placards and banners in our cities and country towns had never been on strike before.

Despite veiled threats of reprisals, nurses put themselves in front of TV cameras, in their local newspapers and on the radio to tell the public the true state of our hospitals.

Thousands of nurses used social media to persuade others to their point of view and organise action at a local level. They collected signatures on petitions and lobbied members of parliament.

The next step in the campaign involves asking the community to use their vote in the upcoming election to support nurses and midwives. n

The wages cap is an attack on nurses’ and midwives’ living standards

The Perrottet government’s wages caps have so far cost NSW nurses and midwives $80,000 each.

The NSW Government’s wage cap is a disaster for everybody, but especially for women says NSWNMA general secretary, Shaye Candish.

“NSW is the second worst paid state in Australia because of this policy, making it near impossible to attract and retain staff in such a tight labour market,” Shaye explains.

“It’s clearly a bad policy for nurses and midwives, but it also has dire implications for regional economies and communities and the health sector overall.”

A report by the Centre for Future Work at the Australia Institute into the impact of the wage caps since their introduction in 2012, shows public sector nurses and midwives will suffer a cumulative loss of $120,000 in pay by 2023–24.

“By the 2021–22 financial year, wages for an experienced nurse/ midwife working full-time were $335 lower per week – or about $17,500 for the year – as a result of these pay caps in place since 2012,” it says.

“On a cumulative basis, this wage suppression amounts to a combined loss of $80,000 in wages since the wage caps were first imposed.”

The impact of the wage caps has become especially acute with the steep rise in inflation, the report says.

“Real wages for nurses and midwives have already fallen over 3 per cent in the last two years, reducing their real purchasing power by $3000 per year, per employee.”

The Australia Institute report says the pay caps have contributed to falling real wages and made it more difficult to attract workers to vital service roles like health care. n

2.19% in the 10 years since the pay caps were imposed, pay has grown at an annual rate of 2.19 per cent across all classifications

4% in contrast, in the 20 years before the cap was imposed, average wages grew at almost 4 per cent per year.

On a cumulative basis, this wage suppression amounts to a combined loss of $80,000 in wages since the pay caps were first imposed.

If the pay caps are retained those losses will accumulate further over the next two financial years: to $390 per week in lost wages and a cumulative loss of $120,000 per nurse by 2023-24.

‘NSW is the second worst paid state in Australia because of this policy, making it near impossible to attract and retain staff in such a tight labour market.’

— NSWNMA general secretary Shaye Candish

The wages cap reduces superannuation too

The NSW Government’s wages caps not only hurt nurses and midwives while they are working – they also have lasting, harmful consequences after they retire.

By 2021–22, an experienced nurse or midwife had already lost over $1700 in superannuation contributions on top of the $17,500 reduction in their wages that year. Forecast forward, that loss of annual contributions swells to over $2200 by 2023–24, according to the report by the Australia Institute. After a decade of capped pay, super balances for experienced nurses and midwives were almost $7800 lower than if the pre-cap wage trajectory had been maintained. The loss grows quickly in future years – by 2023–24 the typical nurse or midwife will have lost over $12,500 in their super balance.

The wages cap makes it likely that more nurses will join the growing proportion of the population who cannot afford to buy a home.

NSWNMA general secretary, Shaye Candish, says that thanks to the NSW government’s ongoing wage caps, most nurses and midwives will fall well short of the thresholds considered for a “comfortable” retirement.

“Nurses and midwives across NSW will be unable to retire in dignity, the longer these cruel wage caps remain in place.” n

$7800

by

2021–22 $12,500 by 2023–24

WHERE THE PARTIES STAND ON WAGES Coalition

The Coalition capped wages at 2.5 per cent from 2012 to 2020.

In 2020–21 during COVID, pay rises were limited to 0.3 per cent.

In 2020-21 during COVID, nurses and midwives only received a 0.3 per cent pay rise.

They are still committed to a cap on public sector wages.

The Greens

The Greens are committed to repealing the NSW Public Sector Wages Policy, removing the wage cap on public sector workers and restoring the autonomous NSW Industrial Relations Commission as the independent umpire in industrial disputes.

Labor

Leader Chris Minns says Labor will abolish the wages cap and replace it with a system of bargaining based on productivity.

‘Nurses and midwives across NSW will be unable to retire in dignity, the longer these cruel wage caps remain in place.’

— NSWNMA general secretary Shaye Candish

Dominic Perrottet turned workers comp into a basket case

Workers Comp was once a strong safety net for the injured at work. It has become a source of further harm for many injured workers, a parody of management incompetence and scandal and a millstone around the necks of taxpayers.

In 2015, when he was the New South Wales treasurer, Dominic Perrottet replaced the old WorkCover scheme with a new entity called icare.

A 2020 joint investigation of icare by the Sydney Morning Herald/ABC Four Corners uncovered “mismanagement of the state government-run scheme in NSW” and problems that led to “delays and denials of medical treatment, making some workers sicker and delaying their return to their jobs”.

The investigation also obtained government documents that revealed “as many as 52,000 injured workers in NSW have been underpaid up to $80 million dollars in compensation for loss of wages in one of the biggest underpayment scandals involving a government agency in the country”.

The return-to-work rate – a key industry indicator of how well a workers’ compensation scheme is working –significantly declined under the new system. Despite icare’s appalling performance and mismanagement, salaries for executives soared. In 2020, it was reported that icare executives were the best paid in the public sector.

Before icare was formed in 2015, the two highest paid employees had an average salary of $305,000.

Five years later, there was a 22-fold increase in the number of executives – to 45 people who received an average of $300,000.

The salaries of the top seven executives averaged $660,000.

In November 2022, it was announced that icare CEO Richard Harding was getting a $247,000 pay rise to take his salary to over $1 million.

It has also been plagued by scandal. An $11 million contract was awarded to a small New Zealand company owned by the son of an icare consultant – who owned shares in the company.

The biggest losers from Dominic Perrottet’s botched restructure of workers comp have been injured workers.

A report in 2022 by the NSW Injured Workers’ Support Network revealed harrowing stories of acute mental stress among injured workers.

Most respondents to a survey said they experienced suicidal tendencies as a result of their experiences with the NSW workers’ compensation scheme. Taxpayers and employers have also been big losers, with the NSW Treasury raising serious concerns about the financial sustainability of icare.

In June 2022, the government injected $1.9 billion into the fund with Treasury warning that icare would require billions more in additional funding. n

Making injured workers’ lives harder

A survey by the NSW Injured Workers’ Support Network found that:

• 78 per cent of respondents had been unable to return to work

• nearly 80 per cent agreed that their experience with the scheme had negatively affected their mental health and wellbeing

• over 60 per cent said the experience with the scheme had negatively affected the mental health and wellbeing of their immediate family

• 73 per cent said they had experienced suicidal thoughts as a result of their claim .

Privatisation makes the cost-of-living crisis worse

Privatisation has made electricity, water and road tolls, among other daily expenses, more expensive as the cost of living spikes. Our public hospitals, too, are always at risk of being sold off.

Privatisation and its impact on the cost of living is looming as a major issue in this state election. Both major parties have a track record of selling off public assets and services, but the ALP will go into the March election with a commitment to end any more privatisations.

“We’re not just opposed to privatisation – we’ll ban it,” ALP leader Chris Minns has said. Labor says $93.6 billion worth of public assets have been sold by the Coalition in the more than a decade it has been in power.

“The state used to get enormous dividends from those assets that would pay for schools and hospitals and essential frontline workers,” Chris Minns said. The Coalition has refused to rule out any further privatisations. In fact, privatisation is still a fundamental part of the party’s platform.

NSW public hospitals have not been exempt from the privatisation trend. In the 1990s, Port Macquarie Base Hospital was sold off to private operator Mayne Nickless by the then-Coalition government. In 2004, the state government had to buy back the contract at a cost of $35 million.

In 2019, the current Liberal–National government tried to sell off five NSW regional public hospitals – Wyong, Goulburn, Shellharbour, Bowral and Maitland – but were forced to back down after a fierce campaign run by the NSWNMA, with widespread support from local communities and other unions.

In northern Sydney, residents lost two public hospitals – Manly and Mona Vale – in return for the privately operated Northern Beaches Hospital.

The Liberal-National Coalition tried to sell five regional NSW public hospitals but fierce opposition by nurses, midwives and their local communities forced it to backtrack.

Coalition offers little solution to regional woes

The year 2022 was notable for a parliamentary inquiry’s damning indictment of regional health services – and the Coalition government’s weak response.

The dire condition of NSW regional health services was laid bare by a parliamentary inquiry in 2022. It found that people outside Sydney, Newcastle and Wollongong face “significantly poorer health outcomes, greater incidence of chronic disease and greater premature deaths” as a result of chronic underfunding and critical staff shortages.

It decried a “historical failure by various NSW and Australian governments to attract, support and retain health professionals, especially doctors and nurses in rural, regional and remote areas”.

Inquiry chairman Greg Donnelly, a Labor MP, said staff were “pushed to breaking point” by “unsustainable working hours, poorly coordinated recruitment and retention strategies, inadequate remuneration, lack of resources, threats to physical safety and a culture of fear”.

The inquiry held 15 public hearings and received more than 700 submissions, including from NSWNMA members who gave evidence at the hearings.

The NSWNMA submission pointed out that residents in regional, rural and remote parts of NSW have higher rates of coronary heart disease, stroke, chronic kidney disease, mental ill-health and diabetes, but less access to health services.

Our submission said regional health services are characterised by poor staffing and skill mix, with nurses and midwives routinely working in isolation.

They have limited access to continuing education; rely on colleagues to provide unpaid, on-call support; suffer from inadequate security; and bear the burden of a doctor shortage.

The doctor shortage puts “a huge burden of responsibility” on NSWNMA members, who experience widespread problems with accessing on-call and telehealth doctors, the submission said. After considering submissions, the inquiry recommended that NSW Health “expedite its review of the nursing and midwifery workforce with a view to urgently increasing nurse and midwifery staffing numbers based on local need across rural, regional and remote NSW”.

The NSW Coalition government responded by agreeing to fund extra nurses and midwives for regional areas, and a recruitment and retention incentives package. However, this response was inadequate because it “ignored evidence-based workplace solutions, such as safe nursing and midwifery staffing ratios”, said NSWNMA general secretary, Shaye Candish. She said services would remain inadequate and unsafe until the government adopted shift-by-shift ratios.

“Unless the government addresses the shocking working conditions staff are enduring, patients will continue to be at risk,” Shaye added.

‘Unsustainable working hours, poorly co-ordinated recruitment and retention strategies, inadequate remuneration, lack of resources, threats to physical safety and a culture of fear.’

— NSW Parliamentary Inquiry

Government ignores ‘culture of fear’ warning

The parliamentary inquiry into regional healthcare reserved its harshest language for NSW Health’s treatment of staff. It found there is “a culture of fear operating within NSW Health in relation to employees speaking out, and raising concerns and issues about patient safety, staff welfare and inadequate resources.”

The inquiry recommended the government establish a new independent ombudsman to tackle serious governance issues across regional hospitals. However, the government rejected this recommendation, claiming the job was already being done by the NSW Ombudsman and Health Care Complaints Commission.

WHERE THE PARTIES STAND ON REGIONAL HEALTHCARE Coalition

Announced an incentive scheme to attract and retain staff in rural and remote areas in 2022. The scheme included incentive packages ranging from $5000 to $10,000 per worker per year of service.

Established a 15-member panel to help NSW Health to implement recommendations of the Rural Health Inquiry, including the development of a new Regional Health Plan.

Rejected the NSWNMA’s claim for an allowance for FLECC/ENECqualified regional and rural nurses and an additional RN to be rostered on-call for sites without 24/7 access to medical officers.

Labor

Promised minimum nurse-to-patient ratios in multi-purpose services (MPS): 3/3/3 (am:pm:nd) nurses as a minimum in MPS where there is a 24/7 ED. At least two nurses will be RNs and staff must be FLECC/ENEC-trained.

Like other safer staffing measures promised by Labor, the MPS ratios will be “phased in over time”.

Promised to implement recommendations of the Rural Health Inquiry “in full”.

Committed to an additional 500 paramedics in regional and rural NSW.

The Greens

Called for mandated nurse-to-patient ratios in regional and rural hospitals following last year’s Rural Health Inquiry report but received no support from the Coalition or Labor.

Called for an independent Rural and Remote Health Commissioner to monitor and report on the performance of NSW Health in meeting rural health workforce and health outcome targets, and to advise the state government on health policy and reform.

Advocates telehealth in rural and regional EDs “where this service supports and does not replace on-site staffing”.

Low Healthe Care offer gets thumbs down

Nurses and midwives have said ‘No’ to a substandard agreement proposed by the owners of Healthe Care Surgical.

Nurses and midwives employed by Healthe Care Surgical (HCS) in NSW have voted strongly to reject an unsatisfactory company offer for a new enterprise agreement.

In a secret ballot, 79 per cent of voting employees voted ‘No’ to the offer.

The company had proposed a mere 2.5 per cent annual wage increase with no meaningful improvement to unsafe staffing levels.

The NSWNMA’s assistant general secretary, Michael Whaites, said the vote forced HCS back to the negotiating table.

“NSWNMA members made it clear throughout almost 12 months of negotiations that staffing levels across all facilities are unsafe,” he said.

“Members felt strongly that the agreement should have safe nurseto-patient ratios, and pay rises sufficient to meet increases in the cost of living.”

HCS employs about 1700 nurses at 12 private hospitals in NSW. It is owned by Pacific Equity Partners, a private equity firm.

PAY OFFER A SLAP IN THE FACE

The NSWNMA is conducting negotiations through a Bargaining Organising Committee (BOC). It is made up of NSWNMA officials and about 20 representatives from NSWNMA branches across the HCS network.

One BOC member, nurse Kylie Stirling, described the offer of a 2.5 per cent per year pay rise as “nothing short of demoralising and a big slap in the face”.

“This would put Healthe Care nurses at a huge financial disadvantage,” said Kylie, who is president of the NSWNMA’s Maitland Private Hospital branch.

“We’re not asking for anything unreasonable, just a fair pay rise that is in line with the increasing cost of living.”

She pointed out that interest rates, and food, petrol and electricity prices are all going up.

“If we don’t get a fair and decent pay rise that reflects all of the hard work the nurses undertake every day, we will be even further behind the increasing cost of living and rising inflation.”

UNSAFE WORKLOADS

Kylie said nurses’ workloads are constantly increasing “with the patients getting sicker, with higher care needs and increasing presentations”.

“At my hospital, a ward nurse on day or evening shift can at times be looking after eight patients, including general care and managing any deteriorating patients.

“This can increase with unexpected sick leave, when staff are unable to be replaced, putting an even greater burden on the staff.

“At night, it could be 1:10 with just two nurses on the ward.

‘We have hung in there for a long time, but now it’s getting to a crisis point.’

— Kylie Stirling, Maitland Private Hospital branch

HEALTHE BRANCH

OFFICIALS

“I’ve never seen these levels of staffing in my 30 years of nursing.

“With those sorts of numbers, you can’t give the care you want to give and the patients deserve.

“We are nurses and we do what we do because we care. We have hung in there for a long time, but now it’s getting to a crisis point.

“Nurses are really starting to feel the effects of inadequate staffing on themselves, their families and on the patients.”

Like other HCS branches, Maitland Private Hospital branch has a dedicated WhatsApp group and private Facebook group for branch members and officials to discuss issues at their hospital.

Kylie said that as a BOC member, she attended all Zoom meetings with union officials and other branch reps, and all negotiation sessions with management.

“That means I’ve been able to take accurate information back to my branch and the members and keep them up to date.”

“As a BOC member, you feel vulnerable at times because you are going into these meetings with upper management and fighting for better conditions for nurses.”

“However, something has to change. HCS needs to listen to its nurses because we have had enough and we’re not going to take it anymore.” n

Management gets a greeting card

During negotiations, NSWNMA branches promoted their claims for safe staffing by encouraging nurses to contribute to an online greeting card, which was delivered to management. Nurses were asked to fill out the card by outlining their experiences of staffing in HCS facilities. Almost 400 nurses wrote contributions.

“The greeting card got an excellent response,” Kylie said. “These were true stories from nurses relating their personal experiences of working on the wards.

“The card showed there is a similar level of frustration and anxiety about unsafe staffing across all HCS hospitals.” n

Love of the job doesn’t pay the bills

Video messages from NSWNMA branch leaders helped to win support for the union’s ‘Vote No’ campaign.

Among the speakers were Beth Riley, secretary of the Brisbane Waters Private Hospital Branch and Elly Wright, secretary of the Lingard Private Hospital Branch.

Beth described the company proposal for a 2.5 per cent annual pay increase as “an insult and an actual pay cut. Inflation is currently running above 6.5 per cent.”

“We deserve more to do the valuable hard work we do for Healthe Care and what we provide for our patients,” she said. “Remember, Healthe Care Surgical is making a profit out of you and me and our hard work.”

Elly said she and the people she works with are worth more than 2.5 per cent over the next few years.

“With the cost of living set to increase, failure to increase (the pay offer) will only mean we cannot afford to buy the things we need to buy, to keep a roof over our heads and keep our families fed and safe and warm.

“Love of the job does not pay the bills.”

On the NSWNMA’s claim for safer staffing, Elly said, “We need more staff on our wards and in every unit of the hospital.

“We need to attract and retain our current nurses and the only way to do that is through safe patient ratios.” n

‘The board of HCS clearly was not listening to nurses’ concerns about being burnt out, the risk of psychological injury and unsafe workloads.’

— Michael Whaites, assistant general secretary

Big win on ratios and pay for New York nurses

Strikes lead to 19 per cent pay rises and ratios with strong enforcement, including financial penalties.

More than 7000 nurses from two New York City hospitals, Mount Sinai Hospital, and Montefiore Medical Center in the Bronx, went on strike in January for three days.

The strike ended with groundbreaking agreements that increase staffing levels and enforcement. The contracts also contain 19 per cent pay increases and protected healthcare benefits, according to the New York State Nurses Association (NYSNA).

At Mount Sinai, the hospital agreed to staffing ratios for all inpatient units with “firm enforcement”.

The contract reached with Montefiore entails “new, safe staffing ratios in the Emergency Department, with new staffing language and financial penalties for failing to comply with safe staffing levels in all units,” said the union.

Matt Allen, one of the nurse leaders at Mt Sinai Hospital, said that the central problem in New York state isn’t a lack of trained nurses, but rather that they aren’t being incentivised to remain in the profession.

In New York, there are about 170,000 registered nurses who are not practising bedside nursing, according to the NYSNA.

“If you improve the staffing, if you improve the working conditions, people are going to come back to the bedside. That’s the way we are looking at it,” he told the New York Times.

COVID DECIMATED NURSE NUMBERS

Allen said the impact of understaffing during the pandemic for both patients and nurses has made him and his colleagues “angry” and “empowered to be taking a stand”.

“It was just a traumatic experience for lots of us nurses to go through,” he said.

“It’s further depleted our staffing by people retiring early, people burning out and leaving the profession or leaving bedside nursing.”

During the strike hospital management accused nurses of abandoning their responsibilities saying they had walked “away from the bedsides of patients”.

“Their behaviour at the negotiating table mimics the behaviour they show us on the units every day,” said Matt Allen.

“They’ve been dismissive. They’ve been disrespectful. They ignore us. “They’re blaming us for abandoning patients and being irresponsible. But the hospital’s been abandoning patients for the past several years when they refuse to give us adequate staffing.”

When the dispute was settled, Mount Sinai and Montefiore said in separate statements that they welcomed the agreements with the union. “It is fair and responsible, and it puts patients first,” said Mount Sinai.

Philip Ozuah, the chief executive of Montefiore Medicine, said the hospital was “grateful for the dedication and commitment of our nurses, who have served through very challenging circumstances over the past several years.” n

‘They’re blaming us for abandoning patients and being irresponsible. But the hospital’s been abandoning patients for the past several years when they refuse to give us adequate staffing.’ — Matt Allen, Mount Sinai nurse

British nurses and midwives launch unprecedented strikes

It is the first strike action in the Royal College of Nursing’s 106-year history.

On 15 December, around 100,000 nurses and midwives across England, Northern Ireland and Wales went on strike for 12 hours. Another strike in England and Wales took place on 20 December. The strikes were repeated on 18–19 January.

Nurses and midwives are demanding a pay rise of five per cent above inflation, which is running at 14 per cent. The Royal College of Nursing (RCN) says that their pay fell by six per cent in real terms over the last decade and lags behind nurses and midwives in other developed countries.

The strikes are about more than money, say experts.

“Pay is the lightning rod; it’s attracting all the energy,” Jim Buchan of the Health Foundation told The Economist.

But it “cannot be disentangled” from working conditions, he said.

During COVID an enormous number of nurses left the NHS.  Figures published by the NHS in September revealed a shortage of 47,496 nurses, meaning nearly 12 per cent of jobs are unfilled. Those who remain must work harder, as they tackle a waiting list that has ballooned from 4.6 million to 7.2

million in early 2020.

Pat Cullen, general secretary of the RCN, said the strike was “a difficult decision taken by hundreds of thousands in a bid to be heard, recognised and valued”.

In a recent RCN survey, only 18 per cent of nurses said they had enough time to provide the quality of care they would like to.

A survey by pollster YouGov found that almost two-thirds of Britons supported the nurses’ strikes. n

Key facts that explain the British nursing strike

• Typical salaries for nurses have fallen by 5.9 per cent in real terms compared to 2010/11 levels

• Depending on how inflation changes, the Nuffield Trust – a health research institute –predicts that nurses’ realterms pay this year will fall to around 10 per cent below levels in 2010/11

• The average nurse in England earned around £35,989 (A$63,045) a year prior to the latest pay settlement

• There are an estimated average of 17,000 nursing posts unfilled on any given day in the NHS

• 1 in 9 nurses left active service over the course of a year between 2021 and 2022 in England.

‘Pay is the lightning rod; it’s attracting all the energy.’

— Jim Buchan of the Health Foundation

Protect the NHS. Protect Nursing. Protect the public. Your fight is our fight

#FairPayForNursing

PROFESSIONAL EDUCATION

Face-to-face CPD Education Opportunities!

Planning is well underway for our 2023 education with many sessions launched to the end of June 2023.

More sessions are in the process of being arranged so keep an eye out for our education emails!

Waterloo

Medications: How we do it better

Wednesday 15 February, 9am to 4pm, 6 CPD Hours

Student to New Graduate (face-to-face and online)

Friday 24 February, 9am to 4pm, 6 CPD Hours

Law, Ethics and Professional Standards in nursing and midwifery

Thursday 23 March, 9am to 4pm, 6 CPD Hours

Understanding your annual CPD obligations workshop

Thursday 6 April, 9am to 12.30pm, 3 CPD Hours

Aged Care Seminar

Friday 28 April, 9am to 4pm, 6 CPD Hours

Midwifery Seminar

Friday 19 May, 9am to 4pm, 6 CPD Hours

Environmental Health Seminar

Friday 2 June, 9am to 4pm, 6 CPD Hours

Penrith

The Deteriorating Patient

Monday 13 March, 9am to 4pm, 6 CPD Hours

Gymea

Clinical Communication and Documentation

Wednesday 26 April, 9am to 4pm, 6 CPD Hours

Blacktown

Diabetes in Aged Care

Tuesday 16 May, 9am to 3pm, 5 CPD Hours

Port Macquarie

NSWNMA Professional Roadshow

Thursday 30 March, 9am to 4pm, 6 CPD Hours

Tamworth

The Deteriorating Patient

Thursday 18 May, 9am to 4pm, 6 CPD Hours

Newcastle

Medications: How we do it better

Thursday 8 June, 9am to 4pm, 6 CPD Hours

CPD hours for these courses can be calculated by the time you spend actively learning. This will vary between individuals, as further selfdirected learning can be included (e.g. reviewing the associated resources and completing the reflective questionnaires).

Go online for more information about each course and to register.

PORT MACQUARIE

Progressing rural, regional & remote nursing & midwifery careers

THURSDAY 30 MARCH

9AM – 4PM

Ticket price: $50

Undergraduate nursing and midwifery student: Free

Lunch provided, including morning and afternoon tea

The NSWNMA and Charles Sturt University have collaborated to bring this empowering event to Port Macquarie. Hear from inspirational industry leaders and researchers as they showcase innovative models of care and ways of advancing nursing and midwifery capabilities in rural, regional and remote health.

PROFESSIONAL EDUCATION

KEYNOTE SPEAKER: TRISH LEMIN

Trish’s nursing career has taken her from rural emergency departments to being deployed to fire zones and to Wuhan, China early in the pandemic. Working as a district trauma clinical nurse consultant is where Trish found her true passion in the nursing profession. Trish also has experience in academia as a nursing lecturer and researcher.

As recipient of the ‘NSW nurse of the year 2021’ award in recognition of her work in Emergency management, Trish’s goal is to ensure patients with severe injuries receive the best care in regional and rural hospitals. She believes this will be achieved by increasing nursing skills and capability in regional NSW around disaster preparedness. Trish currently works as the disaster nurse manager within the Mid-North Coast LHD.

PROGRAM

• NSW parliamentary inquiry into rural, regional and remote (RRR) healthcare – outcomes and recommendations

• Nurse Practitioners – improving holistic care in RRR communities

• Supporting nurses and midwives to stay rural

• Early Career Nurse and Virtual Nurse Assist Projects

• Health workforce retention in rural and remote regions

• Educational pathways to support rural, regional and remote career progression

• Midwifery care in regional and rural contexts

• Panel discussion – your opportunity to speak to our presenters

• Implementing allied health interventions for rural patients

• Keeping up with your CPD - all you need to know for recording and reflecting on your continuing professional development.

• Opportunity to tour Charles Sturt University’s state of the art clinical simulation facilities.

Ask Shaye

A new year … more of the same or a chance to break with the past?

One month into the new year, Christmas cheer has understandably dimmed, even quicker for many of you who worked through the entire festive period. Now’s a good time to look back on positives and look forward with hope.

The year 2022 saw improvements in workers’ rights through access to paid domestic and family violence leave, parental leave changes and, for some working in aged care, a sorely needed pay rise has been agreed to, although it is yet to be implemented.

What then for 2023? There is hope for aged care via implementation of federal legislation requiring RN 24/7, and in turn mandated RN and care minutes per resident. Members in private health are campaigning for workplace and staffing improvements in a way not seen previously. Public health members are well into their intense struggle for improved staffing levels, conditions and pay. Improvements only exist when we enforce them, and the key to doing that is knowing your rights.

So, I look forward to even more “Ask Shaye” questions and seeing further wins in 2023.

Domestic and family violence leave I work in public health and saw something about new domestic and family violence leave. What is this about?

From 1 January 2023, the NSW Government has made available to all government sector workers, including casuals, access to 20 days’ paid domestic and family violence leave per calendar year (non-cumulative). This leave can be used without the need to exhaust other existing leave entitlements first. This is a most pleasing continuation of governments of all persuasions responding to worker and union campaigns over many years to provide way better support to combat this blight on our community. Check out IB2022_047 for more information.

Aged care COVID-19 vaccination requirements

What is the current law about workers being vaccinated for COVID-19 in aged care?

The Public Health (COVID-19 Care Services) Order (No 2) 2022 expired at the end of November 2022. Accordingly, all legal requirements under that order, including vaccination mandates, are no longer in place. For the aged care sector, though, advice and direction from the NSW Chief Health Officer remains in place, which continues to strongly encourage aged care workers to be up to date with all vaccinations, including COVID-19 and influenza. Aged care facilities will also continue to apply local policies for vaccination and mask requirements, for example, under a work, health and safety framework.

Arbitrary use of annual leave

I work in a public hospital and wasn’t rostered my usual hours. One shift was then paid as annual leave to maintain my contracted hours without my knowledge. Can they do that?

In short, no. You should be rostered your contracted hours and any shortfall cannot be arbitrarily made up by using your annual leave. Furthermore, Clause 30(vi) of the Public Health System Nurses’ and Midwives’ (State) Award, makes clear that the use of single annual leave days can only occur if “convenient to both the employer and the employee”, i.e., by mutual agreement.

Eligibility for parental leave

My partner had our child on 16 September 2022. I now want to access the new parental leave available for partners but was told I am not eligible. Is that right?

Unfortunately, and disappointingly for you and many other parents, based on the above information, this would be correct. The enhanced arrangements only apply to children born – or adopted or out-of-care-home care placement – on or after 1 October 2022. As your child was born prior to that date, your leave and access arrangements would continue to be those in place prior to the new provisions being rolled out.

However, check out the FAQs attached to IB2022_036 or IB2021_029 for more definitive information on your rights.

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

Minimum payment for a casual shift at Ramsay

What is the minimum payment for a casual nurse working at a Ramsay hospital?

Under clause 3.4.3 of the Ramsay Health Care Australia Pty Limited and NSW Nurses & Midwives’ Association and ANMF NSW Branch Enterprise Agreement 2021–2023, a casual employee will be paid a minimum of three hours’ pay each time they are required to work. Remember that this minimum engagement should also be paid where a casual shift is cancelled with less than two hours’ notice.

Update on the aged care work value case

What has the Commonwealth Government said about the 15 per cent work value increase for aged care workers?

As reported in the last edition of the Lamp, the Commonwealth Government intervened in the work value case and supported a wage increase. However, and quite disappointingly, just before Christmas, the government proposed to the Fair Work Commission that the 15 per cent increase should be funded and paid in two steps: 10 per cent from 1 July 2023, and the remaining 5 per cent from 1 July 2024. The timing of the increase will now likely need the determination of the Commission later this month.

COVID-19 vaccination in public health

I work in a public hospital, and while I have had two COVID-19 vaccinations, I don’t really want a third. I am being pushed by the hospital to have it. Do I need to have the third? This issue has remained the subject of some confusion. Under PD2022_030 issued on 28 July 2022, an existing worker who is non-compliant with the third COVID-19 vaccination requirement can continue to work but must comply with all riskreduction strategies if working in a Category A position. So, you can’t be ‘forced’ to have the third in your existing role, but as part of this process, you are required to submit a Non-Participation Form acknowledging that you will comply with specified riskreduction strategies and the use of designated PPE.

Nurse & Midwife Support o ers free, confidential and 24/7 health and wellbeing support to nurses, midwives and students across Australia.

BOB FENWICK MENTORING GRANTS PROGRAM

Can help towards your CPD hours

APPLICATIONS OPEN 1 FEBRUARY 2023

CLOSE 12 MARCH 2023

Applications are open to registered nurses who want a unique opportunity to further their mental health nursing career by participating in this innovative Program.

OPPORTUNITY FOR CAREER DEVELOPMENT

What is it?

The Program aims to encourage less experienced mental health nurses to take the opportunity to be mentored by a more experienced colleague, assisting them to achieve their mental health professional practice goals.

Who can apply?

Any registered nurse currently working in NSW public mental health services is eligible to apply. Mental health nurses with less than two years’ experience or working in NSW rural and remote areas as well as Aboriginal or Torres Strait Islander nurses currently working in mental health are all strongly encouraged to apply.

What will each mentoring grant include?

n Matching with a mentor in a Local Health District (LHD) other than their own for up to five consecutive days to pursue their mental health areas of interest.

n Being provided with travel, accommodation and meal allowance, while remaining a fully paid employee of their regular mental health service during their placement.

Seeking mentors for the Program

If you are a senior mental health nurse, you can help build the specialty of mental health nursing by nominating yourself to become a mentor. Simply use the Mentor Details Form or contact the Program Manager for more information.

How do I apply?

More detailed information about the Program (including a video interview of past participants) can be found on the NSW Nurses and Midwives’ Association website www.nswnma.asn.au

2023 EXPRESSION OF INTEREST FORMS WILL BE AVAILABLE FROM

1 FEBRUARY 2023. If you require more information contact the Program Manager by email: mhmgrant@nswnma.asn.au or contact Cathy Matias on 1300 367 962

Registered Nurses working in NSW Public Mental Health Services

A service run by nurses and midwives, for nurses and midwives.

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Ubud, Bali

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Luxurious and tranquil resort hidden in the countryside featuring modern Balinese architecture with 3 separate pools a specialty spa, restaurant, and a pool bar.

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Phuket, Thailand

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ALL OFFERS: For full t&c’s go to https://travelbenefits.ubookdirect.com. Subject to availability and block-out dates. Canggu, Bali: valid for travel until 30 June 2023. Rate based on 4 adults for a min 5-night stay. Ubud, Bali: valid for travel until 30 June 2023. Rate based on 2 guests for a min 2-night stay. Phuket, Thailand: valid for travel to 31 October 2023. Rate based on 2 adults, minimum 5-night stay. ^ Speed boat day pass excluding meal # Apr – Nov guarantee, Dec-Mar subject to room availability.

UNITED STATES Young nurses feel COVID pain the most

The pandemic has disproportionately pushed younger nurses away from the profession, at a time when they are desperately needed, US surveys have found.

A 2022 American Nurses Foundation survey found that younger nurses were particularly likely to be unhappy in their careers, with 31 per cent of those aged 25 to 34 reporting that they intended to leave their position within the next six months, compared to 18 per cent among those 55 or older.

This is not surprising, when young nurses were especially likely to report being in poor mental health, with 66 per cent of those under 35 reporting feeling anxious, compared to 35 per cent of those 55 or older.

Younger age is also generally a risk factor for nurse burnout, according to a 2021 meta-analysis published in the Journal of Advanced Nursing.

“This may be because less experienced nurses are not used to handling extreme situations like a pandemic,” reported Time magazine.

During COVID, US health staff worked in gruelling conditions, with a heavy burden falling on young nurses.

The American Nurses Foundation survey found 86 per cent of nurses under 35 were required to work beyond their shift at least weekly –compared to 58 per cent for all nurses.

And nurses with two to 10 years’ experience felt considerably less able to take time off when requesting leave (34 per cent) compared to nurses with 41 to 50 years’ experience (53 per cent) and 50+ years’ experience (57 per cent).

New laws take up Respect@work recommendations

The federal parliament has passed new laws that implement several of the key recommendations of the Respect@work report, which were ignored by the previous government.

The report from sex discrimination commissioner Kate Jenkins was released in early 2020.

There are significant changes in the new laws, which will make Australian workplaces safer for women:

• They prohibit hostile work environments.

• There is a “positive duty on employers” to eliminate sex discrimination, sexual harassment and victimisation at work.

• They give the Australian Human Rights Commission (AHRC) powers to monitor and assess compliance with the “positive duty”.

• They allow representative bodies such as unions to initiate actions in the courts on behalf of people who have experienced unlawful discrimination.

• They require public sector agencies to report annually to the Workplace Gender Equality Agency on six key indicators.

ACTU President, Michele O’Neil, described the new laws as “a significant step forward for women in work in this country”.

“We congratulate the Albanese government and Attorney-General Mark Dreyfus on taking action that will make workplaces across the country safer for women,” she said.

“These reforms were ignored by the previous government, who repeatedly failed to act to address the mistreatment of women in workplaces, including their own.”

‘ 66 per cent of (nurses) under 35 reported feeling anxious.’

AUSTRALIA

‘These reforms were ignored by the previous government, who repeatedly failed to act to address the mistreatment of women in workplaces, including their own.’ — ACTU President, Michele O’Neil

One in four skipping meals due to cost-of-living crisis

According to a poll conducted by the ACTU, 56 per cent of Australians have cut back on essential items and 24 per cent have skipped meals due to the current cost-of-living crisis.

The poll of 3000 people found that 21 per cent had sold assets to keep up with rising costs and 14 per cent had been forced to move to or look for more affordable housing.

The ACTU says the poll data shows how vulnerable the Australian workforce and economy is after ten years of record-low wage growth. Recent Australian Bureau of Statistics (ABS) data also shows that retail sales are beginning to decline and consumer confidence has dropped 25 points over the last 12 months.

ACTU Secretary, Sally McManus, says the new Secure Jobs, Better Pay laws are a great step towards getting wages moving and giving working people the tools they need to bargain for wage growth

that keeps up with the cost of living.

“A decade without wage growth followed by deep real-wage cuts means millions of Australians are cutting back, skipping meals and being forced out of their homes,” she said.

“Employers publicly arguing against wage growth are directly undermining the Australian economy.

“A quarter of Australians cannot afford enough food for three meals a day. This is a crisis that requires a systemic response. We need to rethink how our financial institutions, like the RBA, combat inflation and protect the interests of working people.”

CROSSWORD SOLUTION

‘Employers publicly arguing against wage growth are directly undermining the Australian economy.’

— ACTU Secretary Sally McManus

New Zealand offers overseas nurses residency to meet shortfall

New Zealand has offered overseas nurses and midwives an immediate pathway to residency, as the country tries to address an acute shortfall of health staff.

The then Prime Minister Jacinda Ardern said changes to the immigration system meant those eligible could get fast-tracked residency. The new criteria started from last December.

Ardern quoted the World Health Organization’s estimate that the globe was likely to be short of 10 million health workers by 2030, and said New Zealand already had one of the easiest pathways for nurses to live and work.

“In a crowded market, let’s make the message even simpler. Our message to nurses everywhere: we are the best place to live, work and play; you will be able to seek immediate residence,” she told Radio New Zealand.

“With wages growing faster than inflation and with the ninth-lowest inflation out of 38 OECD countries, we have much to offer.”

Record numbers of nurses had been applying to work in New Zealand but the government had been asked to simplify things, she said. “We were attracting nurses; we want to get ahead of the issue, though.”

The New Zealand Nurses Organisation estimates the country needs around 4000 more nurses.

“Since the pandemic, 3474 nurses have arrived in country, but it’s clear we need to do more to encourage nurses to choose New Zealand,” said Immigration Minister, Michael Wood.

Thousands more Australians died in 2022 than expected

COVID or COVID-related causes behind the rise.

Late last year, the Australian Bureau of Statistics (ABS) released a report of mortality statistics that showed there were 17 per cent more deaths (16,375) in Australia than the average expected between January and July 2022.

Another report by the Australian Actuaries Institute (statisticians who specialise in assessing risk for insurance companies), using a different methodology, found a 13 per cent excess mortality for the first eight months of 2022 (approximately 15,400 deaths), reported The Conversation.

Just over half of the excess mortality – 8200 deaths – are deaths from COVID. Another 2100 deaths are deaths with COVID. The remaining excess of 5100 deaths makes no mention of COVID on the death certificate.

The actuaries’ report suggests that the excess deaths not identified on death certificates as being due to COVID came from long COVID and interactions with other serious health conditions.

Excess deaths also came from delays in emergency care as our health systems buckled under pressure, and delays in routine care as people avoided healthcare settings due to fear of catching COVID.

There is also evidence that a higher proportion of people made less healthy lifestyle choices during lockdowns, such as drinking more alcohol and exercising less.

It is almost certain some of the excess deaths are from undiagnosed COVID.

‘The New Zealand Nurses Organisation estimates the country needs around 4000 more nurses.’

‘ Excess deaths also came from delays in emergency care as our health systems buckled under pressure, and delays in routine care as people avoided healthcare settings due to fear of catching COVID.’

China faces ‘difficult winter’

A spike in cases is predicted as the country changes strategy. On 8 December, China’s central government lifted almost all of its severe COVID-19 pandemic restrictions, responding to popular discontent two weeks after protests sprang up around the country, reports the British Medical Journal (BMJ ).

The new changes will mean travel between regions and entry to most venues will no longer be restricted by the health code or require proof of a recent negative test.

The health code will still restrict access to schools, nursing homes, hospitals, and clinics.

The relaxing of the health code system was one of 10 new prevention and control measures put forward by the government. Other measures include a reduction in the number of neighbours locked down when a case is discovered and all lockdowns should end after five days if no new cases emerge.

Those with mild or no symptoms are now allowed to quarantine at home instead of at government centres.

The end of zero COVID was announced by China’s vice premier Sun Chunlan.

“With the decreasing toxicity of the omicron variant, the increasing vaccination rate, and the accumulating experience of outbreak control and prevention, China’s pandemic containment faces a new stage and mission,” she said.

However, experts are predicting a difficult winter, the BMJ reported, with the onset of the flu season and as the Chinese mix more freely.

New Zealand passes world-first tobacco ban

New Zealand has passed into law a unique plan to phase out tobacco smoking by imposing a lifetime ban on young people buying cigarettes.

The law states that tobacco can’t ever be sold to anybody born on or after 1 January 2009. Included in the new legislation are other measures to make smoking less affordable and accessible, including dramatically reducing the legal amount of nicotine in tobacco products and forcing them to be sold through specialty tobacco stores, rather than at corner stores and supermarkets. The number of stores legally allowed to sell cigarettes will be reduced to a tenth of their existing levels – from 6000 to just 600 nationwide.

When introducing the legislation, associate health minister Ayesha Verrall said: “For decades we have permitted tobacco companies to maintain their market share by making their deadly product more and more addictive. It is disgusting and it is bizarre. We have more regulations in this country on the safety of the sale of a sandwich than on a cigarette.

“Thousands of people will (now) live longer, healthier lives and the health system will be $5 billion better off from not needing to treat the illnesses caused by smoking, such as numerous types of cancer, heart attacks, strokes, amputations.”

NEW ZEALAND

‘We have more regulations in this country on the safety of the sale of a sandwich than on a cigarette.’

— NZ associate health minister Ayesha Verrall

CHINA

‘The health code will still restrict access to schools, nursing homes, hospitals, and clinics.’

ACROSS

1. Mismanagement (17)

10. Red (7)

11. A surgical device that utilizes electrical current or light to stop bleeding (10)

12. An tool for measuring the acuteness of the sense of smell (9)

13. Nuptial (7)

15. Ocular pain caused by light (9)

17. Graft of bone into a bone cavity (5)

19. Various plasma components involved in the clotting process (11.5)

21. Repeated postponement (13)

23. Erythrocyte (1.1.1)

24. The branch of medicine dealing with study of the soft tissues of the body (9)

27. Bronchoalveolar lavage (1.1.1)

28. A synthetic estrogen used in oral contraceptives. (9)

30. Earache (7)

32. Belonging to them (5)

33. A cell and protein-rich fluid that extravasates from the capillaries (7)

34. The outer granule-free layer of cytoplasm (9)

35. Deoxycorticoid (1.1.1)

DOWN

1. Mismanagement (17)

10. Red (7)

11. A surgical device that utilizes electrical current or light to stop bleeding (10)

12. An tool for measuring the acuteness of the sense of smell (9)

13. Nuptial (7)

15. Ocular pain caused by light (9)

17. Graft of bone into a bone cavity (5)

19. Various plasma components involved in the clotting process (11.5)

21. Repeated postponement (13)

11. Symbol for cerium (2)

14. Chemical symbol for actinon (2)

16. Nodular inflammatory lesions (11)

18. Before childbirth (10)

20. Generalised anxiety disorder (1.1.1)

22. Up-to-date (7)

25. Symbol for germanium (2)

26. Inner, central (5)

27. To lose blood (5)

29. Orthotopic Heart Transplant (1.1.1)

31. A hiatus (3)

The Lost Song Of Paris

Sarah Steele

Hachette Australia

RRP $32.99

ISBN 9781472294296

Inspired by incredible true events and heroines of the Resistance, The Lost Song of Paris is a heart-wrenching and unforgettable story of lost love, danger and espionage, and one remarkable woman’s bravery in World War Two, from the bestselling author of The Missing Pieces of Nancy Moon and The Schoolteacher of Saint-Michel.

All books can be ordered through the publisher or your local bookshop. Call 8595 1234 or 1300 367 962, or email library@nswnma.asn.au for assistance with loans or research. Books are not independently reviewed or reviewed using information supplied by the publishers.

The Last Love Note

Emma Grey

Penguin Random House

RRP $32.99

ISBN 9781761047626

In the aftermath of crushing grief, sole parent Kate Whittaker must learn to live and love again. It’s been tough raising her young son and wrangling a university fundraising job, an overbearing mother, and a best friend intent on matchmaking her with someone new.

A sparkling Australian romantic comedy that will break your heart into a thousand shards and piece it back together again.

A World of Curiosities

Louise Penny Hachette Australia

RRP $32.99

ISBN 9781399702294

The brilliant new Chief Inspector Gamache novel, soon to be a major TV series.

It’s spring and Three Pines is re-emerging after the harsh winter. But not everything buried should come alive again. Not everything lying dormant should return. But something has.

A young man and woman have reappeared in the Sûreté du Québec investigators’ lives after many years. The two were young children when their troubled mother was murdered, leaving them damaged, shattered. Now they’ve arrived in the village of Three Pines. But to what end?

S PECIAL INTERES T SPECIAL INTEREST

Tom Clancy Red Winter

Marc Cameron Hachette

RRP $32.99

ISBN 9781408727812

For the 20-year anniversary of Tom Clancy’s classic novel Red Rabbit, this is a white-knuckle prequel set in 1985, introducing a never-beforeseen Jack Ryan at the beginning of his career.

1985: A top secret F117 aircraft crashes into the Nevada desert. The Nighthawk is the most advanced fighting machine in the world and the Soviets will do anything to get their hands on its secrets.

In East Berlin, a mysterious figure contacts the CIA with an incredible offer – invaluable details of his government’s espionage plans in return for asylum. It’s an offer they can’t pass up.

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.

NURSING RESEARCH AND PROFESSIONAL ISSUES

Improving Nurses’ Work–life Balance: Insights from a Team-based Rostering Pilot

Timewise

This report describes a pilot initiative to implement a teambased rostering system for nurses, with the aim of increasing nurses’ input into their working patterns and improving their work–life balance. The ultimate goal is to aid the retention of nurses in the NHS. The project worked with 240 nurses in seven wards in three hospitals. Significant improvements were realised in three areas: meeting nurses’ work–life preferences; increasing nurses’ input into rosters; and improving collective responsibility for creating the roster.

The work started with the knowledge that getting and keeping staff is now the number one challenge for the NHS. The NHS Long-Term Plan recognises that poor work–life balance is a key reason nurses leave the profession. In shift-based environments, each nurse’s working pattern is defined by the roster. Flexible working is poorly defined, and often has little to do with work–life balance: too often, it means nurses being flexible to meet service demands, with little control, and at the expense of their own work–life balance.

Team-based rostering starts from the premise that everyone has work–life balance needs and preferences, and that these need to be openly and collectively negotiated, adult to adult, among all those on each ward roster, within the constraints of service and financial needs.

https://timewise.co.uk/wp-content/ uploads/2019/09/Timewise-NursingReport-2019-1.pdf

The

Effect of Using Participatory Working-Time Scheduling Software on Employee Well-Being and Workability: A Cohort Study Analysed as a PseudoExperiment

Rahman Shiri, et al Healthcare 2021, 9(10), 1385

This observational study analysed, as a pseudo-experiment, the use of participatory working time scheduling software that was associated with increased employees’ perceived control over scheduling of shifts, and improved sleep and self-rated workability. Shift workers are at increased risk of health problems. Effective preventive measures are needed to reduce the unfavourable effects of shift work. This study explored whether use of digital participatory working-time scheduling software improves employee well-being and perceived workability by analysing an observational cohort study as a pseudo-experiment.

Participants of the Finnish Public Sector cohort study with payroll records available between 2015 and 2019 were included. The study estimated the propensity score of using the participatory workingtime scheduling software on the baseline characteristics using multilevel, mixed-effects logistic regression and assigning inverse probability of treatment weights for each participant. Then it used a generalised linear model to estimate the effect of using the participatory working-time scheduling software on employees’ control over scheduling of shifts, perceived workability, self-rated health, work–life conflict, psychological distress and short sleep.

During a two-year follow-up, the participatory working-time scheduling software reduced the risk of employees’ low control over scheduling of shifts. The use of the software was not associated with changes in psychological distress, self-rated health and work–life conflict.

https://www.mdpi.com/22279032/9/10/1385/htm

Shift Work in Healthcare: Rapid Research Summary

Institute for Safety, Compensation and Recovery Research

The contents of this report focus on the key articles from a review of the literature on shift work in health care.

Shift work is broadly defined as any work conducted outside of “normal” working hours. “Normal hours” are defined as those between 7am and 7pm, Monday to Friday. Therefore, shift work usually requires an individual to work outside the standard sleep-wake cycle.

Shift workers are at a greater risk of physical and mental health conditions, including type 2 diabetes, obesity, cardiovascular disease, high blood pressure, digestive problems, depression and anxiety. Shift work is associated with a higher risk of workplace injuries, motor vehicle accidents, sick leave and absenteeism compared to daytime work. There is an adverse effect on the shift workers’ cognitive function, delayed reaction time, impaired information processing, and lapses in attention occur because of inadequate sleep and circadian (biological clock) misalignment. Most healthcare workers who are responsible for the care of those with suspected or confirmed COVID-19 will be shift workers, i.e., employees working in acute and aged care health and residential settings where 24/7 staffing is required to care for patients/ residents. A proportion of nonclinical staff in healthcare settings and those working in hotel quarantine will also be shift workers.

https://research.iscrr.com.au/__data/ assets/pdf_file/0003/2560773/284_ TRAN_REP_Shift-Work-in-Healthcare_ FINAL_150221.pdf

Times have changed and rostering practices are increasingly recognised as a critical factor to be considered in discussions about retention in the nursing and midwifery workforces.

De-stress, not distress: How to unwind after work

We all have the best of intentions to improve our ‘wind-down’ time, especially after a night shift – but sometimes, our best intentions evaporate. The good news is you can change. Here are a few ideas.

Set the stage even before you start your shift

Coming home to a nurturing environment will help you wind down after a stressful day. That won’t happen automatically, though. You have to set the stage before you leave. What do you enjoy about your space? What makes it feel like home? Fresh flowers, your pet, your precious succulent pot, your own music, your yoga mat, your laptop with your next travel plans, the new cushions on the couch, your knitting? It doesn’t matter what they are, only that your space makes you feel good when you step inside.

End the day with a positive ritual

Create your own rituals and habits to close out the day and leave your stress behind. Remove your lanyard and take a deep breath. Visualise all the pressure and intensity of the day leaving your body and mind with each breath. Leave the workplace with some farewells and affirmations to and from your colleagues.

Use your commute

Me time

On the way home, take a moment to appreciate something you did well that day, or congratulate yourself for making it through something difficult. Play your favourite music or podcast. Whether you’re driving, walking, cycling or taking public transport, try to turn your commute into a small moment of ‘me time’.

Plan for something exciting Having a project to work on or a plan to look forward to can bring joy. Think about a weekend away, plan a surprise party, or brainstorm for a present you have to buy. Sometimes, thinking about doing something wonderful can be as much fun as actually doing it.

Stay connected

Invest the time in your friendships. If you’ve got a good friend who is available during your commute, make the effort to reach out on the phone for a brief chat. Even the shortest connection will help you transition out of your work persona and ground you back in your home life.

Reaching out reminds us that friends are there, and it can help dismiss the feeling of being alone.

Embrace your downtime

Finding ways to de-stress at the end of your workday or on the commute home can help you arrive home de-stressed and ready to relax. It seems counterintuitive, but sometimes we have to prepare to relax.

Embrace the positive qualities of entering your own space: time with your family and friends, a quiet night at home alone, or a refreshing sleep.

Leave work behind

If there are work issues that you need to write down in a journal, or on your list to attend to tomorrow, do it as soon as possible after you get home, to help you let it go until tomorrow. Removing your work clothes can also help you leave the day behind.

This is your time – own it!

Relax and enjoy your precious space and enjoy your relaxation, your recreating and recharging. You deserve it!

If you’re having trouble winding down after work and need a chat, give Nurse & Midwife Support a call on 1800

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Meeting your Continuing Professional Development (CPD) obligations is now even easier with this great new benefit for NSWNMA members. As a financial member you have access to over 200 CPD modules – all part of your Association membership.

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Your own personalised ePortfolio and CPD tracker so you can provide evidence to the Nursing and Midwifery Board of Australia (NMBA) of participation in CPD annually.