The Lamp May 2008

lamp the

magazine of the NSW Nurses’ Association

volume 65 no.4 May 2008

The more we Print Post Approved: PP241437/00033

PUSH NURSES

The more we

STRESS HEALTH

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ABOUT THE LAMP

C O N T E N T S

Contacts NSW NURSES’ ASSOCIATION For all membership enquiries and assistance, including Lamp subscriptions and change of address, contact our Sydney office.

SYDNEY OFFICE 43 Australia Street Camperdown NSW 2050 PO Box 40 Camperdown NSW 1450 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9550 3667 E gensec@nswnurses.asn.au W www.nswnurses.asn.au HUNTER OFFICE 120 Tudor Street Hamilton NSW 2303 ILLAWARRA OFFICE L1, 63 Market Street Wollongong NSW 2500

Cover story

lamp the

magazine of the NSW Nurses’ Association

volume 65 no.4 May 2008

The more we

The more we push nurses, the more we stress health 14

The more we

Cover

Print Post Approved: PP241437/00033

PUSH NURSES STRESS HEALTH

Image from the NSWNA’s 2008 Fair Conditions. Fair Pay. Nurses Stay TV campaign

News in brief

Workloads

8 8 8 9 9

32 Byron workload dispute heats up 32 Night shift shortfalls at Grafton

10 10 11 11 11 12 12 12 13 13

50,000 new health jobs Rudd inherits Mersey Nurses and midwives to access Medicare ACTU goes into bat for low paid Paid maternity leave vital for families and the economy AMA ‘wobbly’ on health profession register Low-cost loans for aged-care places Government to move aged from hospital Young disabled moved from aged care Specialist treatment for elderly patients ‘Drunken promiscuous’ nurses hit back Aussie nurse helps save UK train victim Mother’s day classic Fijian nurses consolidate solidarity Humanitarian health workers wanted

NSWNA education program 13 What’s on this month

Professional issues 18 Better pay and recognition for skilled-up ENs

Agenda 20 Save Our System – the Garling inquiry 26 Who is running our hospitals?

by John Menadue

Industrial issues 29 Private hospital nurses’ protection countdown 31 AWAs dead but nurses still not secure 31 It’s funny how an election changes things …

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Occupational health and safety 35 Will a national OHS system lower the bar?

Lifestyle 38 Movie reviews 42 Book me

Nursing online 45 Nurses’ crucial role in primary care

Notice 41 Summary of NSWNA Financial Report for the Year Ended 31 December 2007

Regular columns 5

Editorial

by Brett Holmes 6 Your letters to The Lamp 37 Ask Judith 47 Our nursing crossword 48 Diary dates

Competition 38 Win a weekend of delights at Eurobodalla 39 Win a relaxing escape to Lake Macquarie

Special offers 38 100 double passes to see Then She Found Me

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NSWNA COMMUNICATIONS MANAGER Noel Hester T 8595 2153 NSWNA COMMUNICATIONS ASSISTANT Russell Burns T 8595 1219 For all Lamp editorial enquiries, letters and diary dates: Editorial Enquiries T 8595 1234 E lamp@nswnurses.asn.au M PO Box 40 Camperdown NSW 1450 THE LAMP PRODUCED BY Lodestar Communications T 9698 4511 PRESS RELEASES Send your press releases to: T 9550 3667 E gensec@nswnurses.asn.au THE LAMP EDITORIAL COMMITTEE Brett Holmes, NSWNA General Secretary Judith Kiejda, NSWNA Assistant General Secretary Coral Levett, NSWNA President John Lyons, Coonabarabran District Hospital Jonathan Farry, RPA Hospital Mark Kearin, Wyong Hospital Roz Norman, Tamworth Base Hospital Stephen Metcalfe, Lismore Base Hospital Peg Hibbert, Hornsby Hospital ADVERTISING Patricia Purcell T 8595 2139 or 0416 259 845 F 9550 3667 E ppurcell@nswnurses.asn.au RECORDS AND INFORMATION CENTRE – LIBRARY To find old articles in The Lamp, or to borrow from the NSWNA library’s nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnurses.asn.au THE LAMP ISSN: 0047-3936 General disclaimer The Lamp is the official magazine of the NSWNA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Privacy Privacy statement: The NSWNA collects personal information from members in order to perform our role of representing their industrial and professional interests. We place great emphasis on maintaining and enhancing the privacy and security of your personal information. Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information please contact the NSWNA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission.

Subscriptions Free to all Association members. Ex-members can subscribe to the magazine at a reduced rate of $44.

Individuals $60, Institutions $90, Overseas $100.

S R E D A LE ’S W O R R O M TO G INSPIRIN ‘The more we understand what motivates generations that are different to our own, the less likely we are to misconstrue their intentions. Understanding is crucial to healthy effective relationships both at work and in society.’ Avril Henry, speaker at NSWNA Professional Day This year the NSWNA Professional Day will focus on generational change and inspirational leadership.

‘Setting the Pace: Shaping the Future’ aims to build on our shared professionalism and commitment by deconstructing the ‘generation gap’ and enhancing our understanding of each other.

We have engaged internationally recognised experts to explore topics such as inter-generational thinking, inspirational leadership and new ideas about recruitment and retention of nurses and midwives.

Don’t miss this truly dynamic day of presentations and workshops designed to help us connect the experience and expertise of our senior nurses and midwives with the innovation and energy of our younger nurses and midwives.

SPEAKERS AVRIL HENRY is author of Inspiring Tomorrow’s Leaders Today: Breaking Down Generational Barriers At Work.

PETER SHEAHAN is a leading expert in workforce trends and generational change.

ELIZABETH DABARS is the Secretary Elect of the SA Branch of the ANF.

ROSALEE LONGMORE, President of the Saskatchewan Nurses’ Association, has recently undertaken groundbreaking research on the retention of nurses in her province.

PROFESSIONAL DAY RETURNS TO ANNUAL CONFERENCE! VENUE:

AJC Randwick Racecourse, Alison Road, Randwick

WHEN:

Friday, 8 August 2008

TIME :

8.30am registration commences 9.00am – 4.00pm

COST:

Members: $50 Branch Officials: free of charge Non-members: $75 Students: free of charge (limited numbers)

PARKING: free parking available REGISTRATION: go to website for registration form www.nswnurses.asn.au or contact Carolyn Kulling on 85951234 metro, rural 1300 367 962 or email ckulling@nswnurses.asn.au NSW Health has agreed to one day’s leave being granted to nurses and midwives to attend the Professional Issues Day on 8 August 2008.

4 THE LAMP MAY 2008 Authorised by Brett Holmes, General Secretary, NSWNA

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E D I T O R I A L

BY BRETT HOLMES GENERAL SECRETARY

Stressed nurses equals stressed health g Nurses, midwives, doctors and the community all share the same concerns about our public health system.

Wake up, Mr Iemma, and deal with these serious problems.

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n this issue of The Lamp we report on presentations to the Garling Inquiry, which has systematically moved through the state listening to the views of the various stakeholders in our public health system (see page 20).

It is striking how the many, diverse voices giving evidence to the inquiry have been consistent in giving an analysis of the NSW public acute care system, which is identical to concerns voiced by this union over a long period of time.

Nursing and midwifery are both great professions.

Generally, nurses and midwives love their job but there are not enough of them, they are being asked to do too much and they don’t get enough support.

As illustrated in our TV ads now being broadcast, public hospitals have become giant pressure cookers, ready to explode.

Nurses and midwives know this but many doctors and community members have also been telling Commissioner Garling this. They realise a stretched system is held together by nurses and midwives, and not much else.

Having commissioned the Garling Inquiry, the government must act on the findings and the evidence of the staff and community before it is too late to save our public health system from critical failure.

Here is an opportunity to save our health system from its current state of ill health and now is the time to act.

Only 17% of doctors and 34% of nurses have trust in what their managers are telling them about what is really happening at work. No wonder the system has become so dysfunctional.

It is unsustainable to continue exploiting the goodwill and dedication of nurses to keep the system going.

There has to be a circuit breaker, the government must act.

Nurses and midwives have delivered significant efficiencies in the health system during the past three years. Yet, the Iemma government’s wages policy prohibits recognition for these contributions.

Our pay and conditions claim is underpinned by an analysis of what is required to fix the problems in our public health system. It is blindingly obvious that more nurses and more support for nurses and midwives is the key to improving the quality of patient care and to avoiding the breakdowns that have plagued the system.

Nurses and midwives know it.

Doctors know it. The community knows it.

If the Iemma government and NSW Health want to regain the trust of these key stakeholders in our public health system they should move, and move quickly, to address the urgent issues that have been identified by nurses and midwives and outlined in our claim: fair conditions and fair pay that will make the profession attractive and make nurses want to stay.n

It is unsustainable to keep exploiting the goodwill and dedication of nurses to keep the system going.

A new survey (see page 23) of nurses and doctors conducted by researchers from the University of Sydney, shows that morale is at rock bottom among clinicians.

Around 60% of nurses and doctors in NSW public hospitals have seriously considered leaving the system in the past 12 months. This is a frightening figure.

THE LAMP MAY 2008 5

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LETTER of the month

L E T T E R S

Rebecca Van Kuyk

In reply to Laura Sheridan letter I am writing this letter in response to Laura Sheridan and her letter titled ‘Nothing glamorous about ED’ (The Lamp, March).

Your comparison of the ED to aged care is like comparing chalk to cheese.

I am not disputing the fact that the ED is overworked and understaffed, but quite frankly, I do not think you have worked in aged care recently, because if you did you would not have said the things you did.

How can you say that aged care residents do not pose high acute care needs? In nursing homes these days you are caring for residents with tracheostomies, peritoneal dialysis, PEG feeds, and other high care requirements. Quite often your staff ratio is one AiN to four to six residents on the morning shift, one AiN to 12 residents on the afternoon shift and one AiN to 30 residents on the night shift. The RN has to somehow fit two very long and tedious medication rounds in each morning and afternoon shifts as well as look after the very sick (often palliative) residents, deal with their families, have staff meetings, replace staff when they call in sick, do dressing rounds, attend to doctors when they come in, write in the care plans, write in the progress notes, and if they manage a small miracle the RN may squeeze in a very shortened meal break.

RN’s in nursing homes rarely leave work on time. Yes, everyone says it is a 24 hour profession and the next shift can finish your work, but in aged care the next shift is just too swamped in their own duties.

You can’t skimp on resident care otherwise you are not a good nurse. You can’t skimp

on the care plans or progress notes because that is where your funding is and if a facility loses funding then they have to cut costs and too often that means reducing staff which are already overworked.

I was incensed about your statement of ‘inappropriate nursing home referrals’.

Nursing homes do not have resident doctors and quite often we have to wait for a GP to come and review their patient. Now this could take up to a couple of days and it is usually very late in the evening after they have closed their practice. Often they visit more than one nursing home so it may be after 9pm before they arrive. When we send our residents to hospital, they are very, very ill and nearly always require more than just IV antibiotics. Our residents usually require blood transfusions, x-rays, surgery, etc.

In your letter you mention that you have ‘Advanced Clinical Nurses’ to aid you in carrying out patient care and speed things up.

Well in nursing homes we have each other, a BP machine, a thermometer, a stethoscope and that is it! We do not have the luxury of an ECG machine or a pulse oximiter!

By the sounds of your letter you have no real idea as to the pressures that aged care AiNs, EENs, ENs and RNs face.

To all ED nurses out there, if you have to triage an elderly resident from a nursing home, no matter what time of the day, please spare a thought to the aged care nurses and what they had to go through to look after that person, trying to figure out what was wrong with them with limited resources. Also, many aged care nurses care so much about their residents that they even visit them in hospital outside of their working hours! Sometimes the staff are the only family that these people have and we most certainly don’t send residents to hospital willy-nilly!

Rebecca Van Kuyk, RN, Chesalon Nursing Home Editor’s Note: We have received a number of responses to the letter ‘Nothing Glamorous about ED’ since the last Lamp.

MATER HOSPITAL 30 & 40 YEAR GRADUATES REUNION Calling all graduates from the September 1978 to September 1981 group and October 1964 to March 1965 Groups from Mater Private Hospital, Crows Nest. All ex-Mater nurses are encouraged to attend the upcoming Annual Mater Reunion lunch to be held on Sunday, 26 October 2008, to coincide with the 30th anniversary since this group commenced their training.

6 THE LAMP MAY 2008

Come and celebrate the good times, reminisce and catch up with old friends. Further details, venue will be supplied closer to date.

For all information please contact Christine Kirby on 0414 550 419 or ckirby@nswnurses.asn.au for the 30 year reunion and Patricia Purcell for the 40 year reunion on 0416 259 845 or patricia@ppms.net.au

Julianne Scott

In reply to Laura Sheridan letter The views expressed in Laura Sheridan’s letter in the March Lamp will no doubt provoke feelings of sadness, disappointment, frustration and annoyance among many members, as they did with me.

It is upsetting to see published disparaging statements against fellow professionals. Statements such as ‘apples and oranges’ and ‘placing … aged care nurses … in the same category as acute care would not be fair or justified’. This is unbelievable stuff.

These statements are not only false, but also exacerbate the difficulties in attracting and retaining RNs in aged care.

What we should be doing is showing solidarity and supporting each other in whatever field we work in, and working together to solve the funding and staffing problems across the whole of our health system. There is no place for bagging each other.

Residential nursing centres are just that, a place where people reside, and these people are just as entitled to present at emergency departments as anyone else. Ms Sheridan’s statement, ‘a lot of these elderly patients who present are not critical, but take up a lot of time’, smacks of an attitude that older patients are of less worth other members of the community (such as a drunk driver who has smashed up a car full of people?).

At my Nursing Centre for example, we care for a highly decorated WWII fighter pilot, and my former Director of Nursing from training days, both of whom, together with other residents, have contributed immensely to our society. Just because they are older does not diminish their value or entitlement to treatment and respect.

The measures outlined in Dianne Lang’s letter (same issue of The Lamp) would go a long way to helping solve aged care/ED problems, but in the meantime I feel that we all need to show some compassion and get on with the job.

Julianne Scott RN JP, Tweed Heads Nursing Centre

Got something to say?

Send your letters to: Editorial Enquiries email lamp@nswnurses.asn.au fax 9550 3667 mail PO Box 40 Camperdown NSW 1450 Please include a photograph along with your name, address, phone and membership number. Letters may be edited for clarity and space.

Christine Earlam

Lack of faith in public hospital management Hello to all at the NSWNA. Just wanted to say how great it was to hear Brett Holmes speaking on ABC Radio this morning.

Brett spoke of the lack of faith public hospital nurses have in management at this time. He has certainly identified a major problem in health services.

I am employed by Cumberland Hospital as part of Sydney West Area Mental Health Service. I work at the back of Westmead Hospital in the Child & Family Unit of Redbank House. The only toilet facilities for nursing staff are patient toilets. Our nursing staff numbers include Therapy Care Workers (TCW) who were employed when Redbank House was part of the Department of Education. These workers are unable to do even basic nursing duties yet they are counted in staff numbers on the ward. This increases the load of children allocated to trained staff – or ‘primary nurses’.

Our RNs and EENs carry a higher load of primary patients because the TCWs are present as ‘nursing numbers’. To add insult to injury the TCWs are paid more than our EENs! As you can imagine, this does nothing for staff morale. Our very supportive NUMs have attempted to address these issues with senior management, but to no avail.

Well done guys – and thanks for ‘keeping your finger on the pulse’.

Christine Earlam, EEN & 3rd Year Student RN, Charles Sturt Uni.

Equally value all nurses I have read with interest, and some dismay, the recent letters from ‘name withheld’ and others. I have been nursing for almost 50 years and have worked in most areas, from remote to posh-private – in schools, prisons, community, aged care, drugs and alcohol and many, many more.

I have worked in all roles from last on the roster to Director of Nursing for a large authority. Never have I thought that one branch or job was more skilled or better than another. When will we accept that nursing is therapeutic, that the actions we take as nurses have a direct effect on the

health and wellbeing of a fellow human being, their families and friends. We as nurses are of equal value, whether putting in cannulas on a 16-year-old, or holding the hand of a dying 90-year-old.

Our roles are not that different in that we, in whatever situation, are using knowledge and skills to ease the suffering of others. We as nurses are of equal value. Someone once said ‘If we don’t hang together we will hang alone’ May I paraphrase that; ‘If we don’t hang together we are hanging ourselves’.

Please let us support and applaud our different skills and take pleasure in what we have – the joy of being a nurse. Yes, 50 years on I am still working full-time and still find joy and satisfaction in each and every day.

Anne Whiting, RN

Roz Norman

ENPA conference meeting the needs of ENs I noted with interest a flyer that was included with a recent copy of The Lamp. This flyer detailed an ‘Enrolled Nurse Conference’ to be held in Sydney in November.

I believe it is important to clarify that this conference is not connected in any way with the annual conference of the Enrolled Nurse Professional Association of NSW (ENPA). Ausmed Conferences Pty Ltd is organising the November conference on behalf of a special interest group of the Australian Nursing Federation (ANF) – the National Enrolled Nurse Association (NENA).

Both enrolled nurse groups were formed some years ago, with NENA affiliating with the ANF and maintaining close ties with that organisation. ENPA was formed by NSW enrolled nurses to meet their own needs and expectations.

Members of ENPA have chosen to remain autonomous from any other group, allowing the Association to fill an important role as a voice for ENs in NSW. We have developed strong and effective relationships with TAFE, the Chief Nurse’s Office, the Nurses and Midwives Board, the NSW College of Nursing and the NSWNA. We appreciate the continued support they offer. ENPA believes it is in the best interest of members to maintain the autonomy of

the group as it allows members to have input into policies being developed by these various organisations and promotes enrolled nursing within the profession. As an autonomous organisation, ENPA is only answerable to its members.

The ENPA Enrolled Nurse Conference shall be held at Penrith RSL Club on 18 and 19 September 2008. This conference will focus on enrolled nurses, their experiences and the issues that affect ENs in the workplace. We also endeavour to ensure that costs are kept to a minimum to enable the maximum numbers of enrolled nurses to attend. Unlike the NENA conference, speakers will generally be ENs or occasionally RNs, or others who have a special interest in the role of the EN. We believe it is important that most speakers are sourced from the EN workforce as conference attendees prefer to learn from colleagues who have an understanding of their role as an EN. This conference also ensures ENs have the opportunity to have input into issues affecting them and their workplace environment.

Roz Norman, EEN

EVERY LETTER PUBLISHED

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LETTER of the month The letter judged the best each month will be awarded a $50 DJ’s voucher, courtesy Medicraft, Australia’s largest manufacturer of hospital beds and furniture. For more information on Medicraft products, visit www.medicraft.com.au or call 9569 0255.

THE LAMP MAY 2008 7

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N E W S I INN BBRRI IEEFF

50,000

Rudd inherits Mersey

NEW HEALTH JOBS fter more than a decade of under-investment in our health system, the Rudd Government is beginning to address problems with the planned introduction of up to 50,000 new vocational training places.

In what has been described as the single biggest injection of workers into the Australian health system in history, the Federal Government will target areas of chronic skills shortage such as nursing, dental health and Indigenous health.

Deputy Prime Minister Julia Gillard and Health Minister Nicola Roxon announced the plan at what was a largely health-dominated Council of Australian Governments (COAG) meeting in Adelaide.

‘The Rudd Government recognises that addressing the health workforce crisis is critical to delivering better health services and to achieving long-term health reform,’ the ministers said. ‘[We are] investing in the health and education systems that are required to build a modern Australia that can meet the challenges of the future.’

The training places, to be created over the next three years, will roll out from January 2009.

They will include enrolled nurses, dental health workers, allied health assistants, ambulance officers, and Aboriginal health workers.

State and Territory health ministers along with council health and productivity working groups have committed to work with Skills Australia to implement the training places.

Skills Australia will be asked to report to COAG in July 2008 on a method for allocating these priority places.

The vocational training places are part of the Rudd Government’s commitment to provide 450,000 new vocational education and training places to address skill shortages in the economy.

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8 THE LAMP MAY 2008

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he Howard Government’s takeover of Tasmania’s Mersey Hospital last year is now expected to cost taxpayers almost $20 million extra a year.

And this figure may increase further if critical care services have to be restored as promised by the previous government.

According to the current Federal Government, the blow-out is the result of duplicated administrative costs incurred by the removal of the hospital from the Tasmanian health system.

The Howard Government announced earlier last year that the take-over would cost the Commonwealth about $45 million a year, despite warnings from the state government that the hospital’s annual operating costs would be closer to $64 million.

According to departmental documents, the projected price tag now stands at $64 million. The unprecedented federal intervention went against advice from many academics and health experts at the time.

The Federal Health Minister Nicola Roxon announced plans last month to find a private, religious or charitable organisation to operate the hospital, rather than follow the previous government’s intention to run it through a community trust.

This follows advice that it would cost millions more annually to run as a Federal Government concern because the Commonwealth has no bureaucratic means with which to manage the Mersey.

The Federal Government has also commissioned a study to determine whether it is safe and feasible to run an intensive care unit at the hospital.

A high-dependency unit has begun operation but Minister Roxon said the existing takeover contract did not bind the government to resuming the ICU if it was found to be unsafe.

The Minister expects the findingslater this month and will include the recommendations in the tender, which currently has no budget allocation for the ICU.n

Nurses and midwives to access Medicare

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urses and midwives may get greater direct billing access to Medicare, particularly where doctors are in short supply, under reforms currently being considered by the Federal Government.

Health Minister Nicola Roxon believes this is one option worth canvassing in the government’s current review of the complex schedule of fees paid to medical practitioners under Medicare.

The review is now being extended to include the longer-term debate over what ‘non-medical assistance’ the Medicare schedule should include.

Ms Roxon said that while GPs have a key role coordinating care for patients, nurses and allied health professionals could be viable alternatives where doctors are in short supply.

In an attempt to get high quality services more equally distributed across

the country, the Minister is considering allowing a number of professional allied health service providers (including nurses) to provide scheduled health services in certain circumstances.

The move may further sour relations between the Federal Government and the AMA, which is out-of-joint over the proposed national registration scheme for doctors; the exclusion of the AMA from the national ideas summit; and the $220 million pledge to set up super clinics that place doctors on a more level pegging with nurses, dietitians and other health professionals as members of a ‘health team’.

Ms Roxon believes the review of the schedule should ultimately benefit nurses, midwives and GPs and that there should be a better balance between the way the government pays for preventative care and procedural medicine, such as tests and surgery.n

ACTU GOES Paid maternity leave INTO BAT vital for families FOR LOW PAID and the economy he ACTU has repeated its call for a $26-a-week minimumwage rise amid claims by some employer groups for pay cuts of up to 7%.

ACTU Secretary Jeff Lawrence said unions were particularly outraged at such submissions to the Australian Fair Pay Commission (AFPC) when basic living costs were rising dramatically.

‘Petrol, housing and other basic living costs are all going up. What will families live on if they don’t get a pay rise?’ said Mr Lawrence.

‘It is unacceptable for major employers to propose that low paid workers should not get a pay rise or that casual workers should suffer pay cuts … considering that the salaries of executives went up a massive 30% last year and even the head of the Fair Pay Commission got a $38,000 pay rise – 16 times the rate of inflation.

‘The proposed 7% pay cut could mean a [loss] of almost $40 a week – or $2,000 a year – for an adult working full-time casual in a restaurant.’

The Federal Government’s submission, meanwhile, included no suggested figure for the rise.

The Australian Industry Group has called for any rise to be restricted to $13.30 a week, while the Australian Chamber of Commerce and Industry has suggested a rise of $10-$11 a week – an increase that would actually see families’ living standards continue to slide backwards.

Pressure is building on the AFPC as its ruling, due in July, falls in a year when almost half of all federally-registered collective agreements are up for renegotiation.

‘Many employers simply haven’t got the message from the Australian people and are still trying to make record profits and give excessive bonuses to CEOs at the expense of ordinary workers,’ said Mr Lawrence.

‘The Australian public voted to get rid of WorkChoices so that their living standards would be protected.’

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nions, business, and the Human Rights and Equal Opportunity Commission (HREOC) have joined forces in a call for a national, taxpayer-funded paid maternity leave scheme for all Australian women.

HREOC Sex Discrimination Commissioner Elizabeth Broderick, ACTU President Sharan Burrow and Australian Industry Group (AIG) CEO Heather Ridout demonstrated their commitment to the cause by issuing an unprecedented combined press release and co-authoring an article in the national media last month.

‘In an extremely tight labour market Australia’s continuing economic prosperity depends on encouraging more women back into the paid workforce after they’ve had children,’ said Ms Burrow.

‘At the moment, Australia has one of the lowest workforce participation rates in the OECD for women aged 25 to 44 – part of the problem is a lack of paid maternity leave and other measures to support primary carers.’

Ms Broderick says the coming together of the three influential organisations is a watershed moment in the long campaign for Australia to catch up with the international community on paid maternity leave.

‘Two-thirds of Australian women have no access to paid maternity leave.

HREOC has long recommended a national, government-funded, 14week paid maternity leave scheme as a basic minimum standard for Australian women,’ she said.

Australian Industry Group Chief Executive Heather Ridout said the AI Group supports an appropriate period of publicly-funded paid maternity leave, consistent with community and international standards and at the level of the federal minimum wage.

‘There is no doubt that a national maternity leave scheme would deliver tangible benefits to business, employees and to the broader economy and society and, of course, for the children themselves,’ she said.

‘The coming together of the three influential organisations is a watershed moment in the long campaign for Australia to catch up with the international community on paid maternity leave’ Elizabeth Broderick, HREOC Sex Discrimination Commissioner.

The ACTU, AIG and HREOC will make individual submissions to the Productivity Commission, currently examining the merits of a national scheme on behalf of the Federal Government.

The Commission has been asked by the Federal Government to conduct a thorough examination, and provide an opportunity for public participation, and submit a report to the government for public release by February 2009.n THE LAMP MAY 2008 9

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N E W S I INN BBRRI IEEFF

AMA ‘WOBBLY’

Low-cost loans ON HEALTH for aged-care places PROFESSION

REGISTER

ormer ANF secretary Jill Iliffe has accused the AMA of throwing a ‘wobbly’ by withdrawing support for a new national registration system for health professionals at the recent Council of Australian Governments (COAG) meeting in Adelaide.

Jill said the AMA had split the consensus established between nine health professions, despite earlier signing off on a joint letter to the Prime Minister supporting a national approach.

Regardless of the AMA’s objection, COAG will push ahead with plans to establish the national registration and accreditation scheme by July 2010.

According to AMA president Rosanna Capolingua, doctors don’t want a national registration system but rather a national register of doctors and a continuation of the current state-based regulation and registration system.

Dr Capolingua believes a single national bureaucracy will be more bureaucratic than the present eight state and territory bureaucracies.

As nurses make up more than 50% of the health workforce, the ANF expects the national body will be represented at both state and territory level to manage the processes, such as local level complaint investigation.

‘The ANF fully supports the Federal Government’s move to national registration, although there is a need for more information and consultation with health professionals, through the Department of Health and Ageing, about what the final model will look like,’ Ms Iliffe said.

Ms Iliffe said the system made sense given the mobility of the nursing workforce.

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10 THE LAMP MAY 2008

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he Federal Government will provide $300 million in zero real interest loans for aged-care providers to build or expand aged-care beds in areas of ‘high-need’.

The Cabinet recently approved the plan, which is expected to create 2,500 permanent residential aged-care places in regional and ‘undersupplied’ areas.

The Federal Minister for Ageing Justine Elliot said applications under the program would be accepted as early as next month and would be processed by the department’s Ageing and Aged Care Division.

‘This is about finding new ways to get proven providers – through low cost finance – to establish aged-care services in areas where they were previously unlikely to invest,’ said the Minister.

‘It is also about preparing Australia for the challenges of the 21st century and our nation’s long-term needs. For the past 12 years, the previous government neglected aged-care and the needs of older Australians.’

Current research shows that Australia is facing a substantial demographic shift as our population ages and life expectancy rates approach those of the longest in the world. Australians born today can expect to reach an average of 80.9 years of age – 78.5 for men and 83.3 for women.

Aged-care will become an increasingly crucial sector during the next 40 years as the number of people aged older than 65 will increase from 13% to more than 25% of the population.n

‘This is about finding new ways to get proven providers to establish agedcare services in areas where they were previously unlikely to invest.’

Justine Elliot, Federal Minister for Ageing

GOVERNMENT

TO MOVE

AGED FROM Young disabled HOSPITALS moved from aged care he Federal Government has allocated $158 million over five years to free-up 2000 acute-care hospital beds currently occupied by the frail aged awaiting aged-care places.

The plan will allow states to create ‘transitional’ facilities in existing or new buildings to care for those waiting for aged care placements and support others to return to their homes while they wait.

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‘It costs almost 11 times as much to provide a hospital bed than it does to provide an aged-care place.’

According to a Productivity Commission report, the average cost of a hospital bed was $1,117 a day, while the average cost of an aged care bed was about $100 a day.

‘It costs almost 11 times as much to provide a hospital bed than it does to provide an agedcare place,’ the Minister for Ageing, Justine Elliot, said.

‘If [the previous government] had created sufficient aged-care services, it would have cost $83 million a year rather than $937 million a year.

‘This is about making sure that older Australians get appropriate aged-care and making sure that hospital beds are available to Australians of all ages waiting for treatment.’

According to Labor policy documents, the plan will create 2000 transitional places for approximately 2300 elderly patients currently occupying public hospital beds.

Mrs Elliot said she was working with Federal Health Minister, Nicola Roxon, to implement the election commitment through the Council of Australian Governments.

U

nder-resourced nurses in aged care facilities, forced to care for younger people with disabilities, will welcome a joint FederalState plan to relocate these residents.

The Federal and State governments have allocated $190 million over five years to move young people with disabilities from nursing homes and into appropriate care.

Approximately 6,500 people in Australia aged under 65 currently live in aged care facilities because they have no where else to go.

In what is largely an unknown phenomenon, young people with a variety of disabilities regularly fall through the

health-care and compensation safety net often ending up in nursing homes where staff do not have the facilities or resources to properly care for them.

According to the Young People in Nursing Homes National Alliance, many of these people have sustained catastrophic injuries in situations where compensation is not available.

Others, often without health insurance, have developed degenerative neurological diseases like multiple sclerosis, muscular dystrophy or Parkinson’s disease.

Aged care facilities are not designed to cater for the very different and often intensive needs of these younger residents.n

Specialist treatment for elderly patients

T

he NSW Government has announced funding to run 16 Medical Assessment Units (MAUs) in public hospitals to provide better care for older patients.

‘MAUs are a new type of ward where specialist doctors, nurses and allied health professionals design and lead the care of older patients with chronic illnesses,’ said NSW Health Minister Reba Meagher.

MAUs have already opened at 11 hospitals: John Hunter, Liverpool, Royal Prince Alfred, Royal North Shore, Wollongong, St Vincent’s, Bankstown, Prince of Wales, Concord, Sutherland and Canterbury. Another four will soon follow at Nepean, Westmead, Gosford and Campbelltown hospitals.

‘The Iemma Government will invest $56 million each year to support MAUs,’ the Minister said.

‘The number of people aged 75 years and older who are going to public hospital emergency departments is rising by 20%

each year. The key challenge for our health professionals, and for government, is to find the best way to provide the right type of care that these patients need.

Evidence tells us that often these patients don’t need emergency care and a busy emergency department is therefore not the best place for them.

‘People with life-threatening or critical injury and illnesses will continue to be treated in the emergency department. But the evidence tells us that often these patients don’t need emergency care and a busy emergency department is therefore not the best place for them.

‘The doctors and nurses working in these units are telling us that they are making a difference to the treatment of elderly and chronically ill patients,’ she said.n THE LAMP MAY 2008 11

s

N E W S I INN BBRRI IEEFF

‘DRUNKEN, Aussie nurse helps PROMISCUOUS’

NURSES

HIT BACK ritish nurses, branded ‘grubby, drunken and promiscuous’ by a Tory MP, have responded to criticism with the release of a pocket-sized standard of conduct, performance and ethics.

The guide, launched last month by the UK’s Nursing and Midwifery Council (NMC), comes in the wake of a series of criticisms of nurses’ behaviour and skill levels.

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We are providing the public, patients and relatives with the key principles of the code of conduct.

The booklet outlines the four key principles of UK nurses’ conduct, which require nurses to maintain professional boundaries and keep their skills up to date.

NMC president Nancy Kirkland said she wanted patients to know what to expect from nurses.

‘The code will help the public understand that nursing has changed. We are providing the public, patients and relatives with the key principles of the code. This will be an opportunity to see quite clearly what they expect nurses to be delivering and that is a step we have never, ever taken before.’

Last month, the Conservative MP Lord Mancroft, a former heroin addict, branded nurses ‘grubby, drunken and promiscuous’ and ‘slipshod and lazy’ during a Lord’s debate, after he was admitted to the Royal United Hospital in Bath.

He alleged nurses had dirty hair and fingernails and chatted to each other about their sex lives and alcohol intake in front of patients.

12 THE LAMP MAY 2008

save UK train victim

T

hree quick-thinking nurses in the UK, including an Australian immigrant, helped save the life of a 16-year-old boy who was hit by the train they were travelling in.

The women, who were travelling from Manchester to Clitheroe last month, helped keep the boy alive until paramedics could reach them.

Stephanie Zak and Justine Ibbotson, both from Clitheroe, got off the train to tend to the youngster who was hit as he walked alongside the tracks. Their friend, Lorraine Martin stayed on board and helped shocked and traumatised passengers.

The teenager remains in a serious condition in hospital after the accident but a spokesman for the ambulance service said that the nurses’ quick thinking helped to keep the boy alive.

The group had been shopping in

Manchester for the day. Mrs Martin, who emigrated to Australia four years ago, was in the UK on holiday.

‘We just did what any nurse would do in that situation – it is instinctive to help.’

‘We just did what any nurse would do in that situation – it is instinctive to help,’ Mrs Zak said.

‘The boy was unconscious and suffered very serious head injuries, but he was breathing and we helped to keep him stable until the paramedics could get up to the track.

‘The train was going slowly because we had just left Bolton station. If we were going any quicker he wouldn’t have stood a chance.’n

MOTHER’S DAY CLASSIC Union friends are invited to attend the 2008 Mother’s Day Classic in support of the Breast Cancer Foundation on Sunday 11 May from 7am to 10.30am at either The Domain or Parramatta Park. If you or your family members would like to walk or run to help raise funds, go to www.mothersdayclassic.org to register.

Fijian nurses consolidate solidarity

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utraged at the poor treatment of colleagues forced out of stateowned housing to make way for civil servants, more than 400 Fijian nurses showed up in force to the Fiji Nursing Association’s (FNA) annual general meeting in Nadi last month.

Described by FNA general secretary Kuini Lutua as the biggest turn out in her seven-year tenure, the meeting addressed

key issues and concerns facing nurses in the tiny island nation today.

Delegates raised issues regarding the non-payment of allowances and overtime and also voiced concern on the treatment of colleagues forced out of state-owned housing to make way for civil servants.

They said nurses should be treated as equally as the highly-regarded civil servants because of their crucial role in society.n

Humanitarian health workers wanted

s Basic Foot Care for RNs & ENs 5-6 May, Coonamble, 2 days A VETAB accredited course that aims to provide nurses with the competence to provide basic foot care.

Members $203 Non Members $350 s Assistant in Nursing Forum 9 May, Camperdown, 1 day This forum is an experiential workshop presented by Professor Lynn Chenoweth on Person Centred Dementia Care. Person Centred Care (PCC) is a process that aims to support quality of care and improve the quality of life for residents with dementia.

Members $30 Non Members $50 s Legal & Professional Issues for Nurses and Midwives 23 May, Newcastle, ½ day Topics covered include the Nurses and Midwives Act 1991, potential liability, documentation, role of disciplinary tribunals including the NMB, writing statements.

Members $39 Non Members $85 s Basic Foot Care for AiNs 19 May, Wagga Wagga, 1 day This course aims to provide AiNs with the competence to provide basic foot care.

Members $85 Non Members $150

Margaret Bell (left), NSWNA member and midwife from the Blue Mountains, attends to three newborn triplets in Darfur.

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urses interested in taking their lifesaving skills to humanitarian hot-spots around the world are invited to an information night with Medecins Sans Frontieres (MSF) at the Nepean Hospital on 27 May. MSF staff will provide information on what the organisation does while explaining the recruitment procedures and qualifications required to become a field worker.

MSF medico, Dr Peter Hakewill, described his first mission as a life-changing experience. ‘In Uganda, the merest gesture was lifesaving: rehydrating a child or giving them a course of antibiotics. The first week

I arrived, the doctor I replaced left and I realised I was the only doctor in the whole district. It was just me. I remember feeling awed by that responsibility.’

Annually, more than 3,000 doctors, nurses and support staff, alongside more than 25,000 international workers, assist in trouble spots around the world, helping those living on the edge of human tolerance.

In 2007, 91 Australians and New Zealanders worked on MSF project.

The presentation will be held in the South Block Lecture Theatre of The Nepean Hospital, Kingswood, Western Sydney at 7pm, Tuesday, 27 May.n

s Enrolled Nurses Forum 30 May, Camperdown, 1 day This forum for enrolled nurses will explore some of the key issues affecting the practice of enrolled nurses, particularly since the implementation of the new training package qualifications but also in recognition of the increasing demands for enrolled nurses to advance and expand their practice.

Members $30 Non Members $50

TO REGISTER or for more information go to www.nswnurses.asn.au or13ring THE LAMP MAY 2008 Carolyn Kulling on 1300 367 962

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C O V E R S T O R Y

… Unfair

The more we push nurses, the more we stress health. … 16 hour days

The more we push nurses,

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ur campaign for a fair pay rise and fair conditions for nurses in the public health system has cranked up with the launch of a television advertising campaign.

The advertisement shows the

14 THE LAMP MAY 2008

incredible pressure nurses are working under, with little support and too much to do, taking them away from giving care to patients.

NSWNA General Secretary Brett Holmes says it will be a tough fight to get a fair deal out of the government and the

ad informs the public about what we are asking for and why.

One of the central roles in the ad is filled by Sheila Kumar, a former nurse, who now works as an actor and singer. Sheila’s mother and sister are also nurses. Sheila says she feels

workloads

… Not enough nurses.

Unless the State Government acts now, over 20,000 nurses thinking of leaving, could leave.

FAIR CONDITIONS. FAIR PAY. NURSES STAY.

the more we stress health privileged to have a role in the NSWNA’s ad campaign.

‘I haven’t worked as a nurse for some time (although I’m still registered) due to working on my acting and singing pursuits. Some of the main reasons I left, though, are exactly what we see in this

ad: being overworked and under-staffed on such a regular basis, doing 16-hour shifts. It was really beyond a joke.’

‘In my early 20s, when I was just a junior nurse, there was a really high turn-over rate of nurses in the Intensive Care Unit I worked in – so much so, that

I was pretty much in a senior position within six months because everyone kept leaving. This kind of pressure (especially on junior staff), combined with a lack of training and resources, was quite terrifying and stressful – considering people’s lives were at stake.’n THE LAMP MAY 2008 15

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C O V E R S T O R Y

Nurses campaign for fair pay

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ublic health system nurses and midwives across NSW have been busy showing their support for the NSWNA’s 2008 Fair Conditions – Fair Pay campaign. From hosting barbecues and brekkies to donning campaign t-shirts and badges, NSWNA branches have been showing their support by holding events and gatherings to highlight the key issues in our claim and sign up new members to the Association.

NSWNA organisers have been getting out amongst it too, connecting with branch members, updating member contact sheets, delivering campaign materials, t-shirts, coffee and biscuits to nurses on the frontline.

The key pay features of the NSWNA claim are:

c

5% per year pay increase for all nurses and midwives; c extra increases for permanent fulland part-time staff classified RN8 and above to recognise their experience and increased responsibilities.

While acuity continues to increase and nurses’ workloads keep growing, NSW will not be able to attract and retain enough nurses and midwives while pay levels aren’t right. Fair pay is the first step to making sure nurses stay in the public health system.

‘Members are determined to fight for long overdue pay rises and improved conditions,’ said NSWNA Assistant General Secretary Judith Kiejda. ‘This is a once-in-a-four-year opportunity to improve our pay and conditions.’n

DELEGATES GIVE THE SHIRTS OFF THEIR BACKS FOR FAIR PAY Delegates gathered at Camperdown last month to make sure they had their T’s crossed and their message on song as they finalised campaign strategies.

WHAT YOU

CAN DO c Wear your badge. c Put up posters. c Sign up workmates to the NSWNA. c Sign the campaign postcard and return to NSWNA. c Wear a campaign t shirt. c Organise campaign activities at your workplace. c Contact the NSWNA or visit www.nswnurses.asn.au for more information. c Join the nurses’ campaign on facebook www.facebook.com/group. php?ged=24057856064 16 THE LAMP MAY 2008

COMMUNITY SUPPORTS NURSES’ CAMPAIGN. NSW nurses have been reporting lots of moral support from community groups. Here Wollongong EEN Julie Hines assisted a ‘Friend of the Hospital’ signing a nurses’ support badge card.

TAKING THE WORD TO THE WORKPLACE

4 Boggabri District Hospital nurses got into the spirit of Campaign 08 and sent their blessings

MORE MEMBERS, STRONGER VOICE Memberships are on the rise as nurses across the state prepare to stand together during the campaign. Erin Moore, RN from Newcastle’s John Hunter Hospital, re-activated her membership. ‘I’d been so busy I’d forgotten to renew it – but it’s great to be back’,’ she said.

to Sydney: (left to right) Jacquilyn Boxsell EN, Jan Varcoe Nurse Manager, Fiona Geddes RN and Amanda Boxsell RN.

4 Campbelltown Hospital’s Tareq Alqudsi RN and Linda Evans RN took a break to check out the finer details of Campaign 08.

THE LAMP MAY 2008 17

Photo courtesy of The Irrigator

PJS FOR FAIR PAY. Leeton night shift nurses served up a cooked brekky in their pjs to highlight the inadequate penalty rates for night duty nurses. Branch President Leeanne Driscoll (left) with members (from left) Marion Kirk, Vikki Purcell, Marian Aliendi and Robyn Whittaker.

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PROFESSIONAL ISSUES

Better pay and recognition for skilled-up ENs

EEN Vicki Peters reckons Enrolled Nurses rock!

g The NSWNA’s 2008 pay claim seeks to recognise and reward ENs for their rapidly growing contribution to health care delivery across NSW.

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hen successful aerobics instructor and restaurateur Vicki Peters was visiting a friend in hospital in 1997, she had what can only be described as a vocational epiphany.

She remembers turning to her 18 THE LAMP MAY 2008

husband and saying out of the blue, ‘Honey, I think I want to be a nurse!’

Ten years later, Vicki epitomises the new generation of highly-skilled ENs for whom the NSWNA is seeking better recognition and recompense in its current pay campaign.

Vicki spent two years as an AiN at Westmead Hospital before returning to

her hometown of Taree as an EN. Since then she has been continually increasing her skills through various courses and programs – attaining her EN Medication Endorsement as part of a pilot program at Manning Base Hospital and her Certificate IV in wound care and emergency nursing from TAFE through distance education.

She was a member of the NSWNA Enrolled Nurse Working Party, sat on the Manning Base Hospital’s Nurses Advisory Council and spoke at the NSWNA’s Professional Day conference three years ago.

Vicki’s current qualifications will allow her to undertake the new Advanced Diploma of Nursing commencing this year at TAFE. As an integral member of Manning Base Hospital’s High Dependency Unit (HDU), she is now qualified to administer lifesaving medications and perform many other advanced practices such as catheterisation and cannulation.

‘It has been incredibly labour intensive doing up to three hours study daily working long shifts. Without the support of my family it simply would not have been possible.’

Until the NSWNA negotiated a $15 a week pay rise for EENs in 2005 there had been no recent additional base pay rises to reward the professional development of ENs like Vicki.

NSWNA Assistant General Secretary Judith Kiejda said the current EEN pay scale has been an improvement in recognising ENs greater scope of practice but more needs to be done.

‘It’s time to go to the next step and reward ENs’ increased work value in other areas of practice,’ she said.

The NSWNA’s 2008 Fair Conditions, Fair Pay claim seeks to make life a little fairer for nurses like Vicki by expanding the classifications of ENs so they can be paid more fairly for their increased skills and their rapidly growing contribution to health care delivery across NSW. This reflects in the new national TAFE qualifications for ENs at Certificate IV, Diploma and Advanced Diploma levels that ensure ENs are appropriately prepared to perform these evolving roles.

The NSWNA pay claim, currently lodged with NSW Health, also seeks the insertion of a new classification of Enrolled Nurse Specialist for ENs (with specialty qualifications or experience) who undertake an extended role authorised by their employer.

A main thrust of the NSWNA pay claim is to attract and retain enough experienced nurses and midwives to care for the growing and ageing population in NSW and foster a culture of professional development among nurses so that skills are not wasted or lost.

Judith believes it is vital that we attract and retain more nurses like Vicki.

‘Vicki exemplifies the kind of EN who has become an integral part of the contemporary health care system. It is essential to the future of health care in NSW that the skills of these dedicated nurses are recognised and rewarded,’ Judith said.

To Vicki, nursing was always a vocation and money was never her primary motivation – but she knows only too well how important it is to be paid fairly.

‘It was tough, especially at the beginning. I had to relocate myself and the kids and live apart from my husband.

They were all incredibly supportive and I couldn’t have done it without them. Today I love my job. ENs are

professionals and this is a path we choose – we see it as a career rather than a job and we should be paid accordingly,’ Vicki said.

‘Manning Base Hospital management understands the crucial role we play in the hospital system and has been very supportive. We negotiated with them and managed to extend the Clinical Nurse Educator’s hours to 11pm, which was fantastic as we got a lot more assistance towards our competencies.

‘Vicki exemplifies the kind of EN who has become an integral part of the contemporary health care system.’

‘For a long time, the HDU wasn’t thought to be the place for ENs but attitudes are shifting. When my CNE introduced the Professional Portfolio program to Manning Base it really fasttracked my professional development.

‘The upskilling of ENs in the HDU is now well supported by the RNs. Most of them see us as a crucial helping hand, and to us, they are an incredible

THE EDITH CAVELL TRUST Scholarships for the academic year

• an accredited nursing conference or seminar relevant to applicant’s clinical practice.

Applicants should meet one of the following criteria:

• attend full-time, relevant post-basic studies at an approved institution for a period or periods of more than six months;

2. Registered or enrolled nurses who wish to attend: • an accredited clinical nursing education course of six months or less, either full-time or part-time;

Now Vicki’s kids have grown up she is keen to continue her career and hopes life will be easier for ENs who follow. It has been a long journey from that hospital visit a decade ago and, she suspects, one epiphany is enough for her family in this lifetime.

‘Whenever I say, “ooh, that job looks interesting” they all jump on me and yell nooooooo.’n

2009

Applications for the Edith Cavell Trust Scholarships are now being accepted for 2009. Members or Associate Members of the NSWNA or the Australian Nursing Federation (NSW Branch) are invited to apply.

1. Student nurses undertaking full-time courses leading to initial registration as a nurse.

source of knowledge and skill that we tap into constantly.’

Similarly, Vicki is passionate about passing her knowledge and wisdom along to the next generation of nurses. She participates in the Mentoring Program and sees it as a wonderful way to connect with nurses who are starting out.

‘I love showing younger ENs that they can go ahead and do these things too,’ she said.

3. Properly constituted nursing organisations, faculties or schools of nursing or registered or enrolled nurses wishing to:

• undertake an academically approved research program in the theory and practice of nursing work;

enrolled with the NSW Nurses’ Registration Board (or the Registration Board of the state where practising).

Applicants must use the official Edith Cavell Trust application form. Details of the Edith Cavell Trust Rules are available on request and will also be supplied with the application form.

For further information or forms, contact: The Secretary – The Edith Cavell Trust PO Box 40, Camperdown NSW 1450

• conduct or fund a relevant professional or clinical nursing educational program.

Tel: Mrs Glen Ginty, 1300 367 962 Email: gginty@nswnurses.asn.au Web: www.nswnurses.asn.au

Applicants must be currently registered or

Applications close 5pm on 31 July 2008 THE LAMP MAY 2008 19

SAVE UR SYSTEM

T

he Garling Inquiry into the NSW acute care system is well into its journey around the Area Health Services, taking evidence from different stakeholders about the shortfalls in the system.

The Inquiry takes place in public hearings at hospitals and other facilities in order for Commissioner Garling to have a first hand look at hospital conditions as well as to take evidence.

The NSWNA’s solicitor Bob Whyburn has been present at all the hearings to provide support for any members who wish to give evidence to the Inquiry. He said many people see this as our last hope to save the system.

‘A lot of people feel relieved, they want to have their say and they want something done. If not, it is the end of the system. They are hopeful something will come of it.’

Bob said, what is clear from observing the proceedings, is that the issues the NSWNA has put on the table for the government’s consideration for years, are the ones surfacing at the Inquiry from a cross section of witnesses.

‘There is an obvious convergence between the issues that need to be resolved and what nurses are looking for in their new pay and conditions negotiations.

g The Garling Inquiry is systematically making its way around the state taking the pulse of the NSW public health system.

Predictably, the prognosis is alarming.

‘Making the nursing profession more attractive, especially to overcome the chronic shortage of experienced nurses and the difficulty in getting people to work at nights, is the key to solving the ongoing crises.’

NSWNA General Secretary Brett Holmes

‘A wide range of witnesses including many doctors and community members have stressed that the system is held together by nurses and if they leave, the system will collapse,’ said Bob. ‘At hearing after hearing, the evidence is overwhelming that nurses’ workloads are extreme. Senior nurses have described how their staff are constantly increasing their productivity with more patients, higher acuity and less hours to devote to caring.

‘The burden on nurses on night shift is particularly grim, with insufficient medical staff and almost no allied health staff. It all falls to the nurses to keep the show going,’ he said.

Bob Whyburn said Commissioner Garling has taken a lot of interest in how so much of nurses’ time, particularly the NUMs, is taken up with paperwork and

‘The burden on nurses on night shift is particularly grim, with insufficient medical staff and almost no allied health staff. It all falls to the nurses to keep the show going.’

NSWNA’s solicitor Bob Whyburn 20 THE LAMP MAY 2008

non-clinical roles. He has taken note of the inordinate amount of time it takes to fill vacancies.

‘There are lots of stories being told to Commissioner Garling of the serious dearth of experienced nurses in the system, resulting in less support for young nurses and back up for doctors,’ he said.

NSWNA General Secretary Brett Holmes isn’t surprised by the nature of the stories being given to the Commission.

‘It is totally consistent with what our members have been telling us for years and what our research has been saying,’ he said.

‘The Iemma Government needs to look at our public hospital pay and conditions claim in this light. The most serious weaknesses in the system are the chronic shortage of experienced nurses and the difficulty in getting people to work at nights. Making the nursing profession more attractive, especially to overcome these issues, is the key to solving the ongoing crises.

‘The NSWNA will provide support to any member who wishes to appear before the Commissioner. Giving evidence is not a breach of the code of conduct. If a nurse wishes to give evidence in private that can be arranged.’

Commissioner Garling is expected to deliver his report by the end of July.n

Exhausted nurses’ goodwill is evaporating

A

new survey reveals the NSW public health system is on the brink of collapse, goodwill to management from clinicians has all but disappeared and many doctors and nurses are exhausted and considering working elsewhere.

The Workplace Research Centre at University of Sydney examined the views and experiences of doctors and nurses about their current working conditions in the NSW public health system. The key issues identified in their subsequent report are: c Around 60% of nurses and doctors in NSW public hospitals have seriously considered leaving the system in the past 12 months; c Levels of trust between these clinicians and their hospital managers are among the lowest of any workforce in Australia. While around 70% of Australian workers report they can trust their manager to inform them about what is really happening at work, only 17% of doctors and 34% of nurses in NSW public hospitals have such trust; c Work intensification is more severe among these clinicians. While 50% of Australian workers report that more and more is expected of them each year at work, among NSW public sector doctors the proportion was 80% and among nurses a staggering 95%.

The survey revealed a culture of extreme hours worked by both doctors and nurses working full-time and part-

time. While the majority (60%) of fulltime nurses surveyed work between 40 and 50 hours a week, a further 8% work more than 50 hours a week.

On average, full-time doctors work 53 hours per week, and part-time doctors work, on average, 33 hours per week.

Full-time nurses work, on average, 43 hours a week, while part-time nurses work, on average, 29 hours a week.

Two thirds (64%) of nurses surveyed undertake unpaid work. Of these, two

thirds work an average 3.4 extra unpaid hours a week.

The authors of the report say that with such high average working hours, it is not surprising that levels of reported exhaustion are extremely high. Only 6% of public health system doctors and nurses reported that they are ‘rarely’ or ‘never’ exhausted at work, while more than half (52%) are ‘always’ or ‘usually’ exhausted. Alarmingly, junior doctors are always exhausted to some degree.n

NURSES AND DOCTORS SHARE CONCERNS r John Buchanan, one of the authors of the survey, said the joint collaboration between doctors and nurses to commission the report showed how concerned they are about the desperate state of the system.

‘There is a uniformity in the results – doctors and nurses are saying the same thing.The survey raises serious concerns about clinicians leaving the system and all agree there is a deep underlying problem with the system,’ he said.

NSWNA General Secretary, Brett Holmes, said the survey confirmed feedback coming to NSWNA officials for some time now and highlighted the importance of the Garling Inquiry and this year’s pay and conditions talks between the NSWNA and NSW Health.

‘We will be asking the Garling Inquiry to address these issues.

D

‘The serious morale problem must be addressed by the government. They can do that by agreeing to our wages and conditions claim and putting a new agreement in place by 30 June when the old one expires,‘ he said.

Dr John Buchanan

THE LAMP MAY 2008 21

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A G E N D A

All say, our health g Witnesses including doctors, nurses and community members have provided evidence Paul Moran, Specialist Anaesthetist and GP, Coffs Harbour Hospital

Veronica Croome, DON at Gosford Hospital, Acting ADON, NSCCH

Nurses are the backbone of the system and those at the coalface who are really the most important.The clinical nurses are of paramount importance when it comes to the delivery of high-quality patient care.

This not only needs to be said, but also [shown] in the way we treat them, to demonstrate that we really do respect what they do and the job we expect them to do and that involves both adequate financial remuneration and also demonstration by the way they’re treated.Then I think the grinding and the grating that’s now going on in acute care in public hospitals may improve.

The nursing unit manager has a very complex role. I’m sure if you spoke to any nursing manager at Gosford Hospital and asked them what they would prefer to do, they would prefer to do exactly as you describe – talk to the nurse at the bedside and help them through the day, but their time doesn’t allow it. So we’ve created clinical nurse educator positions, which have a very important function, but sadly we don’t have enough of them.

Peg Hibbert, CNS, Aged Care/Rehab plus Emergency Medical Unit, Hornsby Hospital

Susan Henderson, NUM, Royal North Shore Hospital

I’m the branch president of the Nurses’ Association here, and I’m on the council of the Association, so people bring a lot of their problems to me. My role as their delegate is to try and assist.

I find it harder now to get anyone to make a decision or to find the person I should be directing that problem to.The majority of [problems] are workload issues.

Workloads are too high.Their skill mix on their ward on a dayto-day basis has changed incredibly over the past few years.We have the numbers but we don’t have the experience.

Over the past two years much of the human resources functions have been moved off the Royal North Shore site and centralised to support the Area Health Service functions.

This has led to a frustrating and protracted response in regard to HR issues.The reality is that it may take up to three months to be appointed into a position.There are delays in advertising, criminal record checks and communicating with the potential employees, and by the time the position can be offered the applicant may well have gone to another position.

22 THE LAMP MAY 2008

system is sick

SAVE UR SYSTEM

to the Garling inquiry about the deep problems encumbering the NSW Health System.

Jan Marie Tweedie, Acting Director of Nursing and Midwifery, Royal North Shore Hospital

Margo MacKenzie, Midwife, Mudgee Hospital

I think what happens after hours is a serious issue.We have noticed that a lot of our sick patients deteriorate after hours because people are not around to pick up the fact they are deteriorating and because of the lack of support after hours.They can’t get sufficient medical staff to do after-hours work.That then falls back on the nursing staff.We seem to run a service that caters to patients Monday to Friday, nine to five; yet the patients are here 24 hours a day and the nurses are here 24 hours a day, but they don’t have any support after hours.There is practically no allied health support after hours and on weekends.

There are lots of us here who are highly qualified. Most of us are 45 to 65 years old and not going to be here for that much longer and morale is getting down a bit. At the moment, our maternity unit is down three full-time equivalent midwives and we have been told we can have no holidays until next January.

Roz Norman, EN Special Grade, Tamworth Hospital

Jennifer Kiddle, 4th year RN, Mudgee Hospital

The shortage of nurses impacts in rural areas.

We have a lot of difficulty getting registered nurses to come out to the rural areas and this impacts greatly when you go to a ward area and find you have a second or a third year registered nurse who might be in charge of a ward on an evening shift who is struggling, who has no resources to call on, except her work colleagues, and who might be new graduates and enrolled nurses.

Sometimes those enrolled nurses are very experienced and unfortunately sometimes there is a heavy workload on them to give that experience over to the registered nurse and support them during a shift.

Currently new graduate nurses are attending shifts without the support of a suitably qualified preceptor to facilitate their introduction into a nurse care setting. It could result in the new graduate nurse not feeling confident in their decision-making skills and clinical competencies. Changes that could significantly impact on the success of the program are to make available more positions for nurse educators and education programs for registered nurses.

THE LAMP MAY 2008 23

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24 THE LAMP MAY 2008

HERE’S HOW YOU CAN WIN c cancel your payroll deductions and start paying your fees through direct debit and you will go in the lucky draw and/or c convince your colleagues to convert from payroll deductions to direct debit and you, and each of your colleagues who switch to direct debit, will go in the lucky draw and/or c sign up a new member using the direct debit method of paying their fees and you, and the new member, will go in the lucky draw.

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

s

A G E N D A

SAVE UR SYSTEM

Nurses hold system together g The public health system in NSW would all but collapse if it were not for the goodwill and dedication of nurses and midwives but they need to be rewarded if they are to remain, the NSWNA has told the Garling Inquiry.

T

he NSWNA presented a submission to the Garling Inquiry expressing the hope that the Inquiry will mark ‘a new era of very real and meaningful reform in the NSW public hospital system’.

The submission stresses that immediate action is required and that, to date, the responses to frequent systemic breakdowns have been too timid.

NSWNA General Secretary Brett Holmes said nurses hold the system together, but collectively they are close to breaking point.

‘Nurses and midwives routinely accept excessive workloads, unpaid overtime, poor support services and inadequate pay in order to maintain the most vital community service,’ he said.

‘Our members report there is a growing gap between the safe, high quality care they want to deliver and the

KEY RECOMMENDATIONS IN NSWNA SUBMISSION TO GARLING The NSWNA has recommended that: c

c

A body be established to oversee a process of real and meaningful consultation with the community with the express goal of enabling the community to make informed choices about the future of the public hospital sector in NSW; Nurse and midwife leadership positions be embedded at every level of management within the public health system;

c

Adequate funding be provided to ensure nurse and midwife staffing levels and skill mix are sufficient to meet the service demands of the acute hospital sector;

c

Greater flexibility in shift patterns to promote work environments that successfully retain nurses;

c

A review of the effectiveness of

existing policies and procedures in relation to bullying and harassment; c

An increase in the number of Clinical Nurse Educator positions so there is one CNE for every 40 direct care nursing staff, an increase of approximately 225 additional positions;

c

Adequate funding for administrative and clerical support;

c

All health staff, including management at all levels, undergo a process of education (including refreshers), in the National Patient Safety Education Framework to build a culture of patient safety.

The NSWNA submission to the Garling Inquiry can be downloaded from the NSWNA website: www.nswnurses.asn.au

realities of unsafe skill mix, excessive workloads and the constant pressure of cost-containment.’

The submission states that nurses are attracted to and remain in nursing because of the rewards gained from undertaking caring work in a professional manner, but this alone is not enough to ensure that nurses remain in the workforce.

‘Nurses expect remuneration levels and working conditions that recognise and value their contributions to patient care and the health of the community,’ said the NSWNA in its submission.

The NSWNA told the inquiry that its claim for a new pay and conditions agreement for public health system nurses and midwives in NSW provided the framework for a stronger and more sustainable nursing and midwifery workforce for the people of NSW. ‘The claim was crafted after a substantial process of consultation with our members and reflects their views on what is needed to fix the system.

Overwhelmingly, the message from our members has been they want an agreement that will provide a framework for improved safety, both for staff and patients, and better quality care.’

Brett Holmes said the claim had been designed to foster the creation of a nursing and midwifery workforce for the public health system, with the capacity to provide care of the standard required to meet the health needs of the people of NSW. ‘Nurses and midwives have told us they want meaningful recognition and fair pay for their increased workloads and responsibilities. They want better attraction and retention initiatives so there will be safer workplaces for staff and patients and they believe more experienced and specialist nurses are needed to support and supervise trainee and developing staff and maintain a culture of continuous improvement.’n THE LAMP MAY 2008 25

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A G E N D A

Who is running our hospitals? g Four years ago, John Menadue (former Chair of the NSW Health Council) said ‘no-one runs hospitals’. He argues that evidence in support of his proposition continues to mount with malfunction in many hospitals.

H

ealth ministers across Australia must be among the most frustrated people in the country. They keep pouring money into health to address the ‘hot button’ issues – often run to extract more money – but the crises keep bubbling up week after week.

A major problem we face, which not one health minister has yet acknowledged, is that we can’t have all that we want in health. Until we effectively and fairly manage the demand, no solution is possible. Band aids keep failing. Resources are limited. We have to ration or determine our priorities otherwise the powerful will continue to skew public resources in their favour, eg more money for waiting lists, while the needy, in areas such as Indigenous and mental health, are relegated to the end of the queue. When some hospitals try to prioritise their workload, their political masters tell them not to, for fear of a front page story.

Our present allocation of health 26 THE LAMP MAY 2008

resources is haphazard, secretive, costly and unjust. The hard issues about priorities are dodged. The hard questions are never really posed, and the health debate continues to be largely a private conversation between the minister, privileged doctors and special interests.

The public is excluded.

Nurses hold the system together but don’t have authority.

There is a particular design problem in all our hospitals, although I will focus on acute care in the 750 public hospitals in Australia. My proposition is that no one really runs these hospitals in the sense that we understand how a normal organisation should function. There is a major disconnect between corporate governance and clinical governance.

Doctors admit, treat and discharge patients. They largely see their roles as professionally autonomous. Their clinical

John Menadue

decisions drive both hospital inputs and outputs. Doctors manage the clinical demand and supply the clinical services.

Senior executives are ‘responsible’ for staffing and budgets, but don’t make the clinical decisions that affect outcomes and costs. They do not involve themselves, quite properly, in clinical decisions.

There are, of course, exceptions to this but they are at the margins and even where they exist in some hospitals, it is usually only in part of the hospital and often reliant on a few champions. The result is often that hospital budgets blow out and senior executives get the blame when clinicians are really making the decisions that determine expenditures and health outcomes. There is administrative confusion. Nurses hold the system together but don’t have authority.

Hospital boards are often political decorations or amalgams of interest groups. Most do not seriously concern themselves with clinical outcomes and particularly with quality and safety.

Ministers and CEOs of health departments often compound the governance confusion

by trying to micro-manage in response to media pressures. They mainly succeed in confusing their organisations even further, making senior executives gunshy in making decisions, and frustrating clinicians. The governance confusion is also worsened by the work pressures of unplanned admissions pouring in through emergency departments. (This is caused by a major problem in another part of the ‘system’ – the collapse of general practice at night, weekends, in outer suburban and rural areas.)

Hospitals in Australia have a life of their own with no clear lines of responsibility and accountability. They are large cottage industries. Only the good sense of people within hospitals prevents even more confusion. Governance is fundamentally flawed by the corporate and clinical divide.

Managers traditionally attempt to control and lead their hospitals (or other organisations) through hierarchical systems. The top level gives the orders and, by and large, the rest of the organisation follows. But this type of command and control, hierarchical system is ill equipped to deal with the key roles of clinicians dealing with very complex cases and employing highly technical skills. Clinicians rely on networks and not hierarchies to do their work.

Every organisation has disconnects.

There are time lags up and down the hierarchy; middle managers often build empires and, of course, the problem of disconnect in large organisations is greater because of the distance between the top and the bottom.

But the disconnect in hospitals is much more fundamental, principally because of the professional autonomy and clinical freedom which is highly prized

by clinicians. In hospitals, the skill and imagination is at the ‘bottom level’. Yet, while clinicians have very considerable power in clinical matters, they have very little organisational power and are consequently very frustrated. They literally make life and death decisions but often can’t sign a $50 petty cash voucher.

Where clinicians have been given some management autonomy and generated efficiency and cost-savings, the savings have often been taken away in the next budgetary round. Clinicians then lose their motivation.

work practices. This enhanced role for clinicians is essential despite the history of antagonism between managers and clinicians and past political opposition by some doctors to public health in any shape or form.

A robust program of hospital avoidance through large-scale building of primary health care clinics for all but the most acute cases would also relieve some of the pressures brought about by the disconnect between corporate and clinical governance in hospitals. A buy-in by clinicians in any health reform is critical,

Hospitals in Australia have a life of their own with no clear lines of responsibility and accountability.They are large cottage industries.

Attempts have been made to get around this disconnect by reinforcing the top/down hierarchical approach.

These attempts to overcome the organisational disconnect through strengthening the top of the organisation have only been partially successful and have often alienated even the bestintentioned clinicians.

Reform also needs to take a bottomup approach.

Those at the top of the hierarchy need to recognise the barriers to their top/down power. (Instinctively, they probably know it but don’t articulate it.)

Clinical communities need to recognise that they must play a much broader role in reforming and modernising hospitals.

Senior managers must recognise they cannot translate policy intentions into changed clinical practices. They must encourage clinicians to take on a much wider agenda including governance and

as the Rudd Government will find out. By clinical buy-in I do not mean AMA buy-in.

This disconnect between corporate and clinical governance is not an easy issue to fix. But before we can find a solution, we need first to acknowledge the problem. Money is clearly not solving our health problems. The solution must be in demand management and in design reform. We have outlived the design life of our present health delivery system.

Design reform will be resisted by the powerful vested interests that plague the health system, and the AMA and the private health insurance funds in particular, who want more and more money to fund the status quo. Leadership is necessary to win the public debate for design change.n This is an abridged version of a speech published by the Centre for Policy Development. The full version is available from http://cpd.org.au/sites/cpd/files/ JohnMenadueRACMA.pdf

Nurses helping care for children!

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28 THE LAMP MAY 2008

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I N D U S T R I A L

I S S U E S

Private hospital nurses’ protection countdown g With many Agreements expiring in September 2008, private hospital nurses should start thinking about improving pay and conditions in your next Agreement.

T

he way to get pay increases and improvements to conditions is through an agreement. This is the only way that nurses can win improved pay to keep pace with increases in the public hospital sector and also improve existing conditions.

According to NSWNA Assistant Secretary Judith Kiejda, private hospital nurses need to get organised and negotiate a new agreement with their employers to protect and advance their pay and conditions. Under the law there are two types of agreements – Union Collective Agreement (UCA) and Employee Collective Agreements. ‘A UCA provides the best protection because employees – supported by their union – negotiate collectively with management rather than having to fend for themselves against highly skilled negotiators,’ Judith said. ‘By working together employees have greater bargaining power. When combined

with the expert advice and negotiation skills of NSWNA officials, UCAs are proven to deliver the best pay rises and conditions which, in turn, allow nurses to better balance work and family life,’ said Judith. ‘Not only do UCAs produce the best outcomes for nurses, they also provide better access to the independent umpire, the Australian Industrial Relations Commission, which will act to enforce conditions if required.

‘The biggest advantage of a UCA was that we had someone with us who knew what was going on ... they knew how to effectively put our case to the hospital.’ ‘But beware of Employee Collective Agreements (ECA). Some employers may push for an ECA, which excludes genuine union involvement. These agreements can be the first step towards much larger pay and condition cuts once the union is out of the picture,’ she said.

The NSWNA has successfully negotiated several UCAs at private hospitals recently that deliver pay rises of up to 13% and improved conditions.

An Agreement at Dalcross Private Hospital delivers nurses a 7% pay rise over two years, plus significant improvements to conditions such as 12 weeks paid maternity leave, an education allowance for postgraduate study and professional acknowledgement of endorsed ENs. Committee member Heather Henderson said the gains under their UCA

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did not require nurses to trade off any existing conditions. ‘The biggest advantage of a UCA was that we had someone with us who knew what was going on ... they knew how to effectively put our case to the hospital,’ said Heather.

To achieve a strong UCA at your workplace: c Encourage workmates to join the NSWNA. The more members at

c

c

c

your workplace, the stronger your bargaining position. It’s easy for an employer to fob off one employee but much harder when you are united as a group. (See NSWNA’s ‘Sign up a New Member’ deal on page 32).

Form a workplace union committee to begin developing a list of issues you would like dealt with in an Agreement. Call the NSWNA office on 1300 367 962 to get tips on how to go about this.

Attend the ‘Your New Agreement in Private Hospitals’ workshop on 4 July at Newcastle and 11 July in Sydney.

Update your contact details with the NSWNA – particularly if you have moved workplaces or work in more than one place. Help the NSWNA keep you in the loop!n

ABN: 68 014 575 993 Locked Bag 3030 Burwood NSW 1850 Phone: 97457525 www.numsociety.com.au

Would you like to present to your peers any innovative projects or initiatives that you have implemented or are working on in your workplace?

Abstracts to be submitted by 25 July 2008 PLEASE CONTACT: Prescilla Luzon: luzonp@email.cs.nsw.gov.au : ph 97676622 Samantha Faithfull: sfaithfull@stvincents.com.au : ph 83822463 Sheila Ryan: sheila_ryan@wsahs.nsw.gov.au : ph 98456128 2:43:13 PM THE 17/4/08 LAMP MAY 2008 29

30 THE LAMP MAY 2008

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I N D U S T R I A L

I S S U E S

AWAs dead but nurses still not secure g AWAs have been banned by Kevin Rudd, but nasty loopholes remain as WorkChoices winds back.

T

he Rudd Government’s Workplace Transition Bill may have passed into law but elements of WorkChoices still remain, meaning that some nurses employed at private workplaces are still not secure in their jobs.

Assistant General Secretary Judith Kiejda said one of the ugliest features of WorkChoices was the Transmission of Business rules, which mean that one year after a business changes hands the awards or agreements cease to apply. ‘From that time the only legally enforceable conditions are the five minimum standards in the Act,’ she said.

It’s a nasty loophole that won't be changed until the bulk of the WorkChoices laws are removed on 1 January 2010. It means that nurses working in facilities that have been sold are left with no legal safety net if their employer decides it wants to cut their conditions back to the minimum. Aged care industry workers are very much exposed to this part of the law because there is so much restructuring of the industry going on. For example, large companies like Principal, Riviera

‘Today we declare Australian Workplace Agreements to be dead and buried. And today, with this legislation, we begin the process of burying the rest of the WorkChoices omnibus once and for all.’

Kevin Rudd, 19 March 2008

and Conform have sites that have changed hands in 2007 and 2008.

‘With aged care companies regularly changing hands, more and more members will be faced with this issue and we’ll be looking to the government to address this.

There is a real need for some mechanism to bring employers to the bargaining table without having to resort to industrial action.’

Meanwhile, the government’s to-do list is also growing, starting with the Australian Industrial Relations Commission’s onerous task of reviewing 4300 federal awards in time for the 2010 commencement of Labor’s new Fair Work Australia commission – judiciallyempowered IR body designed to replace the plethora of current bodies including the AIRC, WorkChoices agencies, the Fair Pay Commission, the Workplace Authority, the Workplace Ombudsman and the Australian Building and Construction Commission.

The besieged Workplace Authority is currently swamped by a backlog of 138,000 AWAs requiring the scrutiny of its now infamous fairness test.

The government has also issued a discussion paper prior to drafting 10 new minimum employment standards and has commenced consultation with unions and business groups on how to provide unfair dismissal protection for workers in workplaces with less than 100 employees.

ACTU President Sharan Burrow said the passing of the bill was an historic day in the campaign to restore workers’ rights, describing the ill-fated AWAs as a LiberalNational means to attack workers’ rights and drive down pay and conditions.

‘A recent Senate Report confirmed that thousands of Australian workers lost pay and conditions under WorkChoices’ AWAs through the loss of public holiday pay, annual leave loading, shift allowances, overtime pay, penalty rates, redundancy pay and other conditions,’ said Ms Burrow.

‘Unions now call on employers to respect the will of the Australian people and allow workers to get off a lower paid or substandard WorkChoices AWA and go onto a union collective agreement that properly protects their wages, conditions and rights.’n

It’s funny how an election changes things …

A

n end to AWAs and a roll back of WorkChoices isn’t the only consequence of last year’s federal election.

Leading employer groups are now working with unions in a search for innovative thinking and creative solutions in order to end Australia’s skills crisis.

The National Skills Policy Collaboration brings together the Australian Council of Trade Unions, Australian Industry Group, Australian Education Union Dusseldorp Skills Forum and Group Training Australia.

It will be conducting a roundtable in coming months to communicate the plan and to engage with other stakeholders.

The group has released a ten-point plan to improve the quality and capacity of Australia’s workforce. This includes: c Renewed focus on apprenticeship completions; c A long-term strategy to improve Australia’s investment in education and training; c Skill infrastructure partnerships between public and private sectors;

c

Lifting Year 12 or certificate III completion rates; c A national vision and consensus on the future of TAFE; c A review of the traineeship program.

President of the ACTU, Sharan Burrow, said there was a need to look at fundamental reform. ‘Australia has a generational opportunity to turn around the skills crisis. Reforms undertaken today will set us up for a new wave of productivity improvement and prosperity,’ she said.n THE LAMP MAY 2008 31

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W O R K L O A D S

Byron workload dispute heats up g NSWNA takes NCAHS to IR Commission.

T

he NSWNA has taken the North Coast Area Health Service (NCAHS) to the NSW Industrial Relations Commission, following the continued refusal by the AHS to appoint a full-time ward clerk at Byron District Hospital.

‘We’re at breaking point. I’m a nurse not an accountant!’

The case for more clerical support was endorsed by the hospital’s Reasonable Workloads Committee and network general manager, yet NCAHS continues to reject, refute or simply ignore the growing evidence that there is a clerical workload problem.

NSWNA Assistant General Secretary Judith Kiejda said the health system’s

growing dependence on databases had increased the amount of paperwork nurses were required to complete each shift. ‘This increased paperwork burden is posing excessive pressure on nurse workloads,’ she said.

‘Nurses cannot do what they are trained to do if they have to be responsible for so much data entry and administration in Members of the NSWNA Byron District Hospital hospitals. We understand some branch are ready for industrial action. clerical work is necessary but all these new responsibilities are taking the most talented of our on us, not to mention complex new nurses away from patient care,’ computer systems with no IT support. said Judith.

We’ve been at breaking point. I’m a nurse Nurse Unit Manager Liz McCall said not an accountant!,’ she said. nurses were fed up with the strain of Documents show the NCAHS excessive workloads and the failure of the regularly uses staffing comparisons NCAHS to respond to their concerns. from one hospital to justify rejections of ‘Its just a matter of time before enhanced staffing requests at another. something gives,’ said Liz. ‘We have had ‘To say that other facilities are in payroll, HR and recruitment dumped a similar position does not make the

Night shift shortfalls at Grafton g NSWNA demands more RN and clerical support for Grafton ED.

T NSWNA Grafton Base Hospital Branch President Gwen Simpson 32 THE LAMP MAY 2008

he NSWNA and Grafton Base Hospital Branch are continuing a determined campaign to get adequate night-duty staffing for the hospital’s busy emergency department.

Management of North Coast Area Health Service (NCAHS) has repeatedly refused nurses’ requests for a Night Duty RN and Ward Clerk.

NSWNA has been attempting to negotiate with the NCAHS about the Grafton ED workload issue since January and is now considering industrial action.

NSWNA General Secretary Brett Holmes said there was a clear need for a Night Duty RN and a Night Duty Ward Clerk.

‘Night-duty nurses at Grafton are

using meal breaks to cover gaping holes in the roster and are so swamped by clerical duties that one nurse is often left working in isolation when patients present for assessment and treatment,’ said Brett.

‘If nothing is achieved soon we may need to consider industrial action.’

‘Nurses are spending considerably more time with administrative duties at night – duties that must be done before they can provide patient care. Using nursing staff for these administrative tasks

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situation right – it just means that many managers are struggling under the increasing clerical/IT workload.

Byron is not the only facility without adequate clerical support either in the ward or ED,’ said Liz. ‘We have been incredibly reasonable. Until now we have accepted the increased clerical and IT workload but let’s face it, we have basically been absorbing the cost of downsizing in other NCAHS departments,’ said Liz. ‘The time and stress related to this dispute weighs heavily on nursing staff.’n

If you are planning to retire in the next one to two years, ask yourself these questions:

• Do you know how the Better Super changes will affect your plans?

• Are you maximising your defined benefit superannuation?

• How are you going to replace your pay packet in retirement?

Need answers? creates unnecessary risks for patients, extra stress for nurses, and is a waste of their skills and talents.

‘The NCAHS’s only concession has been to divert night phone calls from the ED.’ According to Branch President Gwen Simpson, nurses are already overloaded and the lack of clerical staff is causing enormous stress.

‘Nurses in the ED are constantly being taken away from patient care to do clerical work. With the increasing clerical demands on nurses today, especially in the ED, 24-hour support is vital,’ she said.

‘If nothing is achieved soon we may need to consider industrial action.’

Following a determined Reasonable Workload campaign by the local branch of the NSWNA, the NCAHS has provided extra clinical staff to relieve day-time workload pressure at Grafton but is so far stonewalling discussion regarding the night shift clerical and clinical workloads.n

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THE LAMP MAY 2008 33

OU L U FAB

TS AVAILABLE NOW R I H S T IGN A P M S CA

BE PART OF THE 2008 NSWNA CAMPAIGN FOR FAIR PAY AND CONDITIONS It’s going to be a tough campaign. To win we need members to get involved. Show your support for the NSWNA pay and conditions claim by wearing the new campaign shirt.

You can order your shirt individually or through a bulk order from your workplace.

All we need is a cheque or credit card details and a delivery address.

34 THE LAMP MAY 2008 Authorised by Brett Holmes, General Secretary, NSWNA

T-SHIRT ORDER FORM NAME

WORKPLACE

ADDRESS POSTCODE

HOME

MOBILE

PRICE: $10 EACH plus postage & handling $5 PLEASE SEND ME:

TOTAL AMOUNT DUE $

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PLEASE RETURN TO CAMPAIGNS TEAM: MAIL: NSWNA, PO Box 40, Camperdown NSW 1450 • EMAIL: gginty@nswnurses.asn.au • FAX: (02) 9550-3667

s

OCCUPATIONAL HEALTH AND SAFETY

Will a national OHS system lower the bar? g NSW’s hard-won protection for workers is under threat of dilution in the push to ‘harmonise’ Australia’s OHS systems.

T

he push towards a nationally consistent OHS system will accelerate following the agreement of a new timetable at the recent Council of Australian Governments’ (COAG) meeting in Adelaide.

The original timetable, that would have seen work start next year and finish by 2012, has been fast-tracked by COAG’s Business Regulation and Competition Working Group (BRCWG), which intends to establish an intergovernmental agreement by May 2008, with model legislation to be developed and submitted to the Workplace Relations Minister’s Council by September 2009.

Minister for Employment and Workplace Relations, Julia Gillard, ad The Lamp May.ai 27/3/08 announcedQWRMS the review in April, allowing

only until the end of May for research and consultation with key stakeholders. The review panel will then invite submissions.

According to NSWNA General Secretary Brett Holmes, the union is committed to maintaining current standards and is currently providing comment to Unions NSW and the ACTU – its primarily concern at this stage is the time allocated to undertake the work.

workplace accidents and, in 2005, the lowest recorded workplace fatality rate in NSW for 18 years.

‘During the past three years, the Iemma Government has been under increasing pressure from the Federal Government to downgrade its OHS laws in an almost underhanded attempt to create a national system.

‘Throughout that process the NSWNA

‘NSW currently has the highest OHS standards in Australia, which is reflected in a clear downward trend in workplace accidents and fatalities’ ‘The timeframe appears far too tight.

We can’t see how the review panel can possibly undertake genuine national consultation or deliver well-considered OHS legislation on that schedule,’ said Brett.

‘The NSWNA has no objection to a uniformed approach to OHS in itself, but is concerned that “harmonisation” will be in a downward direction rather than the bar being raised by the other states.’

Brett said NSW currently had the highest OHS standards in Australia, which 2:13:26 PM is reflected in a clear downward trend in

has actively advocated against any lowering of NSW’s OHS standards, particularly changes that reduce employees’ protections and employers’ responsibility for their workers,’ he said.

The NSW government has indicated it will not stand in the way of the talks, agreeing at a meeting of workplace relations ministers in February to start work on a national review of OHS laws to develop model legislation, including the duties of employers and employees and their defences.n UGP_15084

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Q & A

ASK

JUDITH

WHEN IT COMES TO YOUR RIGHTS AND ENTITLEMENTS AT WORK, NSWNA ASSISTANT GENERAL SECRETARY JUDITH KIEJDA HAS THE ANSWERS.

No more WorkChoices When is WorkChoices going?

The new Labor Federal Government has passed transitional legislation that now stops employers making any new AWAs, or individual contracts. Some employers who were already offering AWAs last year can still offer individual contracts called Individual Transitional Employment Agreements (ITEA) until January 2010, but only under very limited conditions.

For almost all private sector organisations employing nurses, individual contracts can no longer be offered.

More substantial changes to the laws are expected in the second half of 2008, which are expected to change the way bargaining over wages and conditions of employment is conducted.

Still need to negotiate Agreements I thought that with WorkChoices going I wouldn’t need an agreement any more?

The Rudd Government has committed to keeping an award system in place to maintain 20 minimum conditions

of employment and to maintain a minimum wage.

However, employer-based collective bargaining is the way that wages and conditions will be set for the majority of the workforce. Awards and minimum standards will be just a safety net of 20 conditions, and we will not be able to

You will still need an agreement to thoroughly include and protect all your conditions of employment and to deliver fair pay rises. make significant advances such as those made through ‘work value’ cases under the NSW laws that covered all aged care nurses until 2006. These laws no longer cover most aged care and private sectoremployed nurses.

You will still need an agreement to thoroughly include and protect all your conditions of employment and to deliver fair pay rises.

Next pay rise under Nursing Homes Award I am covered by the Nursing Homes Award. When will the next pay increase be?

The last increase through the Australian Fair Pay Commission (AFPC) was paid in October 2007 and was around $10 per week for a full-time employee.

The AFPC may increase minimum pay rates to take effect in June or July 2008. However, these increases do not take the place of a Union Collective Agreement, which is the only way you can ensure continuing improvements to pay and conditions.

Union Collective Agreements now cover more than one third of aged care nurses in NSW and typically include 3.5% or 4% per year increases in wages and allowances. Talk to your NSWNA organiser about how staff at your workplace can get active to negotiate a Union Collective Agreement for your workplace.n

THE LAMP MAY 2008 37

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L I F E S T Y L E

Then She Found Me g Then She Found Me shows that having a baby is not child’s play. It’s an enjoyable chick flick with a message, says Maggie Roden

T

hen She Found Me, a film based on a book of the same name written by Elinor Lipman, portrays the very complicated journey of a woman’s desire to conceive a child. The actor, Helen Hunt, not only directs this film but plays the leading role of April Ebner, the newly married, then single again, 39year-old who is keen to have a child.

April, a dedicated preschool teacher, marries her long-time friend Ben (Mathew Broderick), who after less than a year realises, for him, the marriage is

a mistake. April turns to the family of her adoptive mother, an ailing dominant Jewish woman and her brother, who notso-gently encourages April to adopt.

Her adoptive mother then dies, leaving room for April’s biological mother, Bernice Graves (Bette Midler), to assume the role of mother. Bernice is a glamorous, quirky and larger-than-life character with a daytime talk show and an aversion to telling the truth. This leads to some intense scenes about the emotional battle of giving up a child for adoption.

Throughout all this emotional

Review by Maggie Roden, RN, Lismore Base Hospital The Lamp’s rating

turmoil there is room for a blossoming romance between April and one of her student’s parents – a very dishevelled Frank (Colin Firth), a new divorcee who, of course, has some trust issues of his own.

Personally, I am a follower of arthouse, foreign and Australian films and try to avoid the Hollywood Blockbusters.

However, I did enjoy the film and felt that it did accurately identify some of the real issues facing many contemporary women about having children later in life. The story manages to avoid the

C O M P E T I T I O N

WIN A WEEKEND OF DELIGHTS Last month The Lamp forgot to include entry details for our wonderful Weekend of Delights getaway competition to Batemans Bay and Eurobodalla on the enchanting NSW South Coast. We apologise to our loyal readers and competition junkies and promise it was a simple faux pas and had nearly nothing to do with any desires, latent or 38 THE LAMP MAY 2008

otherwise, to disappear down the Princes Hwy on a worry-free weekend ourselves.

Anyway, in case you’ve forgotten, the winner gets two nights accommodation for two in a fully self-contained, two-bedroom villa at the Coachhouse Marina Resort in Batemans Bay with a unique Creature Comforts Package including a cruise on

C O M P E T I T I O N typical Hollywood plastic-beauty crap and, in doing so, leaves the actors free to play their roles realistically.

In a sentence I would describe this movie as a chick flick with a message. Enjoy!n

GIVEAWAY The Lamp has 100 double passes to give away to see previews of Then She Found Me. To enter, email lamp@nswnurses.asn.au with your name, membership number, address and contact number. First entries win!

Our reviewers & tipsters receive a delightful ABC Classics CD – for uplifting enjoyment!

Gifts so good, you won’t want to give them away. There is an ABC Shop near you. For locations visit abcshop.com.au or call 1300 360 111.

Ask about our rewards program.

WIN A RELAXING ESCAPE

TO LAKE MACQUARIE The Lamp is offering members the chance to win a wonderful fourday escape for two to beautiful Lake Macquarie.

Situated between the Central Coast and Newcastle, Lake Macquarie offers a delightful chance to relax and unwind. At 24km long it is one of the largest coastal saltwater lakes in Australia – four times the size of Sydney Harbour – and offers an incredible range of water activities or the chance to relax at local cafés and just admire the views.

Courtesy of Hunter Tourism, this month’s winner gets two weeknights up at the Kemeys Mountain Hideaway, and the weekend down on Lake Macquarie at the Comfort Inn. Kemeys is located in the Watagan Mountains and includes a king bedroom suite with private lounge, a cosy wood fire and double spa bath plus a three-course, candlelit dinner for two.

The Comfort Inn is situated near the shores of Lake Macquarie and boasts an outdoor hot tub, saltwater pool and barbecue area. The prize includes a complimentary bottle of champagne, cheese platter and gift on arrival, a fully cooked breakfast the next morning plus a seafood platter (or three course meal) and wine on the second night.

In case its just all too relaxing, we’ve included a heartstopping, high-speed jet boat experience courtesy of Jetbuzz and a one-day kayak hire for two courtesy of Lake Macquarie Kayaks & Camping.

To enter, write your name, address and membership number on the back of an envelope and send it to: Lake Macquarie Escape Competition PO Box 40, Camperdown NSW 1450 To find out more about Lake Macquarie and the region, go to: www.huntertourism.com; or call 02 4978 4000.

AT EUROBODALLA

Competition closes 31 May 2008.

the magnificent Clyde River courtesy of Merinda Cruises, a Family Pass to Mogo Zoo and a three-course dinner for two at the Coachhouse Rockwall Restaurant.

To enter, just write your name, address and membership number on the back of an envelope and post it to: Eurobodalla Weekend of Delights Competition PO Box 40, Camperdown, NSW 1450 Competition closes 31 May 2008.

THE LAMP MAY 2008 39

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N O T I C E

Summary of NSWNA Financial Report for the Year Ended 31 December 2007

T

he financial report of the New South Wales Nurses’ Association has been audited in accordance with the provisions of the Industrial Relations Act 1991, and the following summary is provided for members in accordance with Section 517 (2) of the Act, as applied by section 282(3) of the Industrial Relations Act, 1996.

A copy of the Financial Report, including the Independent Audit Report, will be supplied free of charge to members upon request.

Certificates required to be given under the Act by the Accounting Officer and the Committee of Management have been completed in accordance with the provisions of the Act and contain no qualifications.

INFORMATION TO BE PROVIDED TO MEMBERS OR REGISTRAR

INCOME STATEMENT FOR THE YEAR ENDING 31 DECEMBER 2007 Income Membership Subscriptions

5,019,767

4,707,187

2,657,313

1,909,651

26,560,966

24,335,230

(24,747,015)

(18,092,674)

1,813,951

6,242,556

SURPLUS FOR THE YEAR

In accordance with the requirements of the Industrial Relations Act 1991 [NSW], the attention of members is drawn to the provisions of Subsections (1) and (2) of Section 512 which read as follows: 1. A member of an organisation, or the Industrial Registrar, may apply to the organisation for a specified prescribed information in relation to the organisation.

2. An organisation shall, on application made under Sub-section (1) by a member of the organisation or a Registrar, make the specified information available to the member or Registrar in the manner, and within the time, as prescribed by the regulations.

($) 17,718,392

Other Income

Less total expenditure

2006

($) 18,883,886

NursePower Fund Subscriptions

TOTAL INCOME

2007

BALANCE SHEET AS AT 31 DECEMBER 2007 2007 ($)

2006 ($)

26,564,633

25,512,639

4,351,177

5,436,964

Non-Current Assets

27,362,289

24,916,545

AUDITOR’S CERTIFICATE

TOTAL ASSETS

31,713,466

30,353,509

We certify that the above Summary of the Financial Report is a fair and accurate summary of the Report, Accounts and Statements of the New South Wales Nurses’ Association for the year ended 31 December 2007. Our Independent Audit Report to the members dated 1 April 2008 on the Financial Report did not contain any particulars of any deficiency, failure or shortcoming as referred to in the Industrial Relations Act 1991 [NSW], as applied by Section 282 of the Industrial Relations Act, 1996.

Current Liabilities

2,318,540

4,488,734

Non-Current Liabilities

2,830,293

352,136

TOTAL LIABILITIES

5,148,833

4,840,870

26,564,633

25,512,639

DALEY & CO Chartered Accountants 98 Kembla Street Wollongong NSW 2500

ML Gleeson Registered Company Auditor 1 April 2008

ACCUMULATED FUNDS Represented by: Current Assets

NET ASSETS

A copy of the Financial Report, including the Independent Audit Report, may be found on the Members page of the website www.nswnurses.asn.au or can be obtained upon written application to: Brett Holmes, General Secretary, NSW Nurses’ Association, PO Box 40, NSW 1450.

Liability limited by a scheme approved under Professional Standards Legislation.

Avis offers Nurses a free day* plus upgrade* Rent a Group A (e.g. Hyundai Getz) through to Group D (e.g. Mitsubishi Lancer) with Avis in Australia for 4 or more days (including a Saturday night) and receive the 4th day free* of the time and kilometre charges. Plus, receive a one car group upgrade* up to a maximum Group E (e.g. Holden Commodore).

Visit www.avis.com.au or call Avis on 136 333 and include coupon number TPPA026.

Offer valid on rentals commenced prior to 31 July 2008.

Travelling to an unfamiliar city?

Add Avis’ portable GPS to your rental. *Subject to vehicle availability. An advance reservation is required. Cannot be used in conjunction with any other offer or coupon. Contact Avis for full terms and conditions.

W.T.H. Pty. Limited - ACN 000 165 855 - Avis Licensee. CT6833

THE LAMP MAY 2008 41

s

WHERE TO GET THIS MONTH’S NEW RELEASES

L I F E S T Y L E

Book me Lifestyle Medicine

by Garry Egger, Andrew Binns and Stephen Rossner, McGraw-Hill Australia, RRP $65.00 : ISBN 9780070138179 Lifestyle Medicine examines the causes, measurement, and management of a range of modern health problems with predominantly lifestyle-based causations.

This practical book extends from disease prevention to modifying risk factors and rehabilitation. It is an invaluable resource for general practitioners, practice nurses and clinicians but it should also be read by anyone who cares about their health.

Contemporary Nursing: Issues, Trends and Management (4th edition)

by Barbara Cherry and Susan R. Jacob, Mosby Elsevier Health Sciences, RRP $68.00 : ISBN 9780323052177 Contemporary Nursing: Issues, Trends and Management begins with the evolution of nursing and discusses nursing licensure and certification, work place advocacy, emergency preparedness, health policy and budgeting issues facing nurses. The authors have reorganised the content by combining similar topics to avoid redundancy and ensure more cohesiveness throughout all the chapters. This edition is fully revised and updated, giving readers the most practical, balanced preparation for the issues, trends, and management topics you’ll encounter in practice.

These books are all available on order through the publisher or your local bookshop. Members of the NSWNA can borrow any of these books and more from our Records and Information Centre.

For borrowing information, contact Jeannette Bromfield, 8595 2175, jbromfield@nswnurses.asn.au or Cathy Matias, 8595 2121, cmatias@nswnurses.asn.au Reviews by NSWNA librarian, Jeannette Bromfield.

Psychology for Nurses and the Caring Professions (3rd edition)

by Jan Walker, Sheila Payne, Paula Smith and Nikki Jarrett, McGraw-Hill Australia, RRP $70.00 : ISBN: 9780335223862 Psychology for Nurses and the Caring Professions has been comprehensively updated to include new notional concepts and contemporary research. It provides clear, concise descriptions of psychological theories, research-based evidence and practical examples of applications across the lifespan in different health and social care settings. This text is essential reading for students undertaking pre- and post-qualifying diploma or degree level courses in nursing and health care, including nurses, midwives, occupational therapists, physiotherapists and radiographers.

Core Curriculum for Transplant Nurses

by Linda Ohler and Sandra Cupples, Mosby (available through Elsevier Australia), RRP $100.00 : ISBN 9780323044110 The Core Curriculum for Transplant Nurses provides transplant and critical care nurses guidance in caring for solid organ transplant recipients. The focus of this book is the critical care aspects of transplantation, including pre-transplant candidates awaiting a new heart, liver or lungs while in

SPECIAL INTEREST TITLE

Staring at the Sun: Overcoming the Dread of Death

by Irvin D. Yalom, Scribe Publishing Pty Ltd, RRP $29.95 : ISBN 9781921215667 In his book, Staring at the Sun, Dr Yalom helps us recognise that the fear of death is at the heart of much of our day-to-day anxiety. He writes that once we confront our own mortality, we can be inspired to rearrange our priorities, communicate more deeply with those we love, appreciate more keenly the beauty of life, and increase our willingness to take the risks necessary for personal fulfilment.

the intensive care unit. There are separate chapters on topics that affect all organs such as immunology, infections, pharmaceutical agents and patient education.

Clinical Companion: Medical-Surgical Nursing

by Gayle McKenzie and Tanya Porter, Mosby (available through Elsevier Australia), RRP A$39.95 • NZ$47.00 : ISBN 9780729538404 Clinical Companion MedicalSurgical Nursing is a userfriendly, quick-find handbook to common situations student nurses will face during their clinical placement. The text outlines each body system and covers concepts relating to the role of the nurse. Each chapter covers simple anatomy and physiology, common conditions, common treatments and pharmacology.n

PUBLISHER’S WEBSITES • Scribe Publishing: www.scribepublications.com.au • McGraw-Hill: www.mcgraw-hill.com.au • Elsevier Australia: www.elsevier.com.au

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42 THE LAMP MAY 2008 Schlanger Advert1.indd 2

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THE LAMP MAY 2008 43

Are you a Nursing leader?

Are you a Nursing leader?

Are you interested in learning more about the COAG media release for additional training places & its application to the nursing sector?

Do you want to hear from innovative organisations partnering in providing Skills Set Training in a broad and diverse range of EN work roles?

Do you want to link your recruitment, performance management and training to the Australian Quality Training Standards?

If you answered yes to just one of these questions and you are in the Community Services or Health Industries then you need to join us on 26 June 2008 in the first of a series of Nursing Forums at the Powerhouse Museum, Darling Harbour, Sydney.

(Registration from 8.00am, Opening Address 9.00am â&#x20AC;&#x201C; Close 4.30pm)

We will focus on: Workforce Development, Skill Set Training, Successful Recruitment and Retention Strategies through Nationally Accredited Training and much much more!

To view the program and to register online visit our website www.cshisc.com.au Or contact Linda Coggiola 02 9270 6628 or Lisa Woodward 02 9270 6626 for more information

2008

Australiaâ&#x20AC;&#x2122;s premier Aged & Health Care Expo for CEOs, Managers, Clinicians, Health Professionals, Carers & Staff.

Free attendance, register on line now at: www.totalagedservices.com.au For all enquiries regarding exhibiting at or attending Carex 2008, contact: Wayne Woff (Manager, Total Aged Services) 03 9571 5606 / 0422 484 209 E: office@totalagedservices.com.au www.totalagedservices.com.au melbourne

sydney

brisbane

adelaide

April 16 & 17

May 28 & 29

July 9 & 10

November

Proudly sponsored by:

44 THE LAMP MAY 2008

Proudly supported by:

ITOR EXHIB ES PLAC G SELLIN FAST

s

N U R S I N G

O N L I N E

Nurses’ crucial role in primary care ore and more governments, policy-makers and corporations are realising that the most efficient and cost-efficient ways to make a sustained difference in our health and wellbeing are happening in the primary care sector. This renewed interest in the primary care sector presents new opportunities for nurses and midwives as well as challenges to the traditional hospital-focus of nursing preparation. This month Nursing Online presents a preview of important research that has been published recently by the Australian Primary Health Care Research Institute.

M

Review of Primary and Community Care Nursing

A Systematic Review of Chronic Disease Management

By Keleher, H., Parker, R., Abdulwadud, O., Francis, K., Segal, Dalziel, K. Health care reform is driven by ageing populations and increasing levels of chronic and complex illness, reduction in access to general practitioners and workforce shortages.

There is also pressure to improve accessibility of services to underserved groups and communities.

Strengthening the role of primary health care and prevention to enhance individual and population health outcomes is important to address the rise in chronic and preventable conditions.

Nurses are becoming increasingly central to the delivery of primary health care in Australia. Nurses working in primary health care can help address workforce shortages, improve access to health care and contribute to the management of chronic conditions and illness prevention.

By Zwar N, Harris M, Griffiths R, Roland M, Dennis S, Powell Davies G, Hasan I Worldwide, chronic disease is on the rise, placing an increasing burden on those affected, their carers and the health system.

In Australia many chronic diseases are predominantly managed in primary health care and there is a need to understand how to do this more effectively.

A systematic review was conducted on chronic disease management in primary health care using the Chronic Care Model (CCM) as the conceptual framework.

Among the key findings are that selfmanagement support, in particular, patient education and motivational counselling, improve physiological measures of disease as well other patient outcomes and that a multidisciplinary team-approach is effective in improving physiological measures of disease and health care professional’s adherence to disease management guidelines.

c www.anu.edu.au/aphcri/Domain/

Workforce/Keleher_25_final.pdf

c www.anu.edu.au/aphcri/Domain/

ChronicDiseaseMgmt/Approved_ 25_Zwar.pdf

Optimising Skill Mix in the Primary Health Care Workforce for the Care of Older Australians: A Systematic Review

By Zwar, N., Dennis, S., Griffiths, R., Perkins, D., May, J., Hasan, I., Sibbald, B., Caplan, G. & Harris, M. Australia has an ageing population resulting in demand for extensive and comprehensive care of chronic disease.

Equipping the primary health care workforce to meet this demand has forced policy makers to consider if re-moulding the workforce skill mix is a solution to meeting the health care needs of older Australians in the community.

We conducted a systematic literature review to identify what sort of skill-mix changes in the primary care workforce could be successfully implemented to meet the health care needs of older Australians.

Key findings included that task substitution between doctors and nurses improves health professionals’ adherence to guidelines and patients’ physiological measures of disease.

The tasks that could be successfully substituted from doctors to nurses include case-management using guidelines, proactive patient follow-up, general patient consultation and support, care planning and goal setting, and patient self-management education.

Nurse enhancement improves patients’ adherence to treatment, their quality of life and their functional status. The enhanced nursing roles that are likely to produce positive results include general patient consultations, patient home visits and support, care planning and goal settings, and patient self-management education.n c www.anu.edu.au/aphcri/Domain/

Workforce/Zwar_25_final.pdf THE LAMP MAY 2008 45

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(URRY ÂŹ%NROLMENTSÂŹSTILLÂŹBEINGÂŹACCEPTED !PPLICANTSÂŹ OTHERÂŹ THANÂŹ THOSEÂŹ SEEKINGÂŹ .37ÂŹ (EALTHÂŹ FUNDEDÂŹ PLACESÂŹ FORÂŹ THESEÂŹ COURSESÂŹ HAVEÂŹ UNTILÂŹÂŹ ÂŹ-AYÂŹ ÂŹTOÂŹSUBMITÂŹTHEIRÂŹAPPLICATIONS ÂŹ4HEÂŹCOURSESÂŹRUNÂŹFROMÂŹ*ULYÂŹ ÂŹnÂŹ*UNEÂŹ #ONTACTÂŹTHEÂŹ#USTOMERÂŹ3ERVICEÂŹ#ENTREÂŹORÂŹSEEÂŹOURÂŹWEBSITEÂŹFORÂŹMOREÂŹINFORMATION ÂŹ$OWNLOADÂŹANÂŹ APPLICATIONÂŹFORMÂŹATÂŹWWW NURSING EDU AU !PPS

Aged care textbook Aged Care in Australia: a guide for aged care workers is a contemporary textbook developed by TAFE NSW which is contextualised to the Australian aged care industry.

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Topics covered Growing older Healthy ageing Aged care services Working in aged care How the body ages Common health conditions Communication skills Occupational health and safety Personal care Social and emotional needs Documentation Disability awareness Working in the community Medication awareness

Aged Care in Australia a guide for aged care workers

CRoSSWoRD Test your knowledge in this month’s nursing crossword.

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Tiredness, exhaustion (7) State of deep unconsciousness (4) Endured (8) Leaders, bosses (6) People unable to move their arms and legs (13) Baby, new…. (4) Mutually, jointly (8) Large veins returning blood to the right atrium (4,4) Where the cervical vertebrae are found (4) Disorder of the lining of the uterus (13) Relating to the teeth (6) Tools, equipment (8) Collective data of a patient, …. history (4) Relating to the skull (7)

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A fever, especially in malaria (4) The common cold (9) The cancer ward (8) Getting older (5) Lack of a particular vitamin or mineral (10) Someone with a drug dependency (6) Impolite (4) Body that administers a state or nation (10) Part of the mouth and throat prone to infections (7) Knee caps (8) One of the two upper chambers of the heart (6) The sinuses are located behind this (4) Relating to the eye (5) Bone of the arm (4)

Solution page 49 THE LAMP MAY 2008 47

DIARY DATES Conferences, seminars, meetings SYDNEY, HUNTER & ILLAWARRA Hospital Bed Management Conference 7–8 May, Crowne Plaza, Darling Harbour.

Contact: 9080 4081 Mothers Day Classic 2008 11 May, 7–10.30am, The Domain or Parramatta Park.

Contact: 8296 0363 or email awand@membersequity.com.au Web: www.mothersdayclassic.org International Nurses’ Day 2008 ’Delivering Quality, Serving Communities: Nurses Leading Primary Health Care’ 12 May

‘How Drugs Work‘ refresher study days for nurses 20–21 May, Comfort Inn Cambridge Cost: $352. Contact: (03) 9375 7311 Cardiovascular CT at Concord Conf.

23–25 May, Grand Pavilion, Rosehill Gardens Event Centre.

Contact: Tara Montgomery, 9518 7725, or email taram@conexion.com.au Web: www.cctatconcord.com Surgical Symposium 23 May, Lowenthal Auditorium, Westmead Hospital. Cost $99 incl. GST. Contact: Dee Macguire, 9845 5555 pg 08968/ Amanda O’Regan, 9845 5555 pg 27028

2008 ACSA National Community Care Conference 14–16 May, Sydney Convention Centre Contact: ACS Events, 8754 0400, or email events@agedservices.asn.au

WorkCover: One day manual handling conference 27 May, 9am–4:30pm, Taronga Zoo Ctr, Bradley’s Head Rd, Mosman. Cost: $45pp (incl. lunch, morning and afternoon tea) Contact: Vicki Dunn, 4321 5225 or email irg@workcover.nsw.gov.au

SWAHS 2nd Annual Stroke Professional Development Day 16 May, Blacktown Hospital, 9am–4.30pm. Cost: free.

Contact: Camelia Burdusel, 9881 7061, Camelia_Burdusel@wsahs.nsw.gov.au

Rural Health Directorate Southern Hospitals Network SESIAHS – One day Respiratory Nursing Course 28 & 29 May, Nowra Showground Contact: Tod Adams, 4423 9705, Tod.Adams@sesiahs.health.nsw.gov.au

Australian Dermatology Nurses’ Association 7th National Conference 16–17 May, Darling Harbour Convention Ctr. Contact: Jan Riley, 6682 5145, janslrd@ netspace.net.au/ kamslrd@netspace.net.au

CAREX 2008 (Sydney) 28–29 May, 9.30am–4pm, Rosehill Racecourse. Free admission & free workshops.

Contact: Wayne Woff, (03) 9571 5606, www.totalagedservices.com.au

Laser Safety Seminar – LSO training 16–17 May, Royal Newcastle Centre, Rankin Park.

Cost: $330.

Contact: Neridah Thomson, 4922 3425/ Neridah.Thomson@hnehealth.nsw.gov.au

’Nurses Who Care – Dare’ Conference 29 May, Kerry Packer Educ. Ctr, RPA Hosp.

Contact: Lynn Jones, 9515 7278, jonesl@email.cs.nsw.gov.au

ACAT Special Interest Group 19 June , 21 Aug, 16 Oct, and 4 Dec, Bankstown Hospital, 1–3pm Contact: Wendy Oliver, 9722 7300, Wendy.oliver@sswahs.nsw.gov.au Clinical Nurse Consultants Association Development Day 20 June, The Burwood RSL Club Contact: CNCAN office, 9745 9614 or email cncan@nursing.aust.edu.au Prince of Wales Private Hospital Neurosurgery Conference 21 June, Crowne Plaza Coogee Beach Cost $99. Contact: Naomi Byrnes, 9650 4458, Naomi.Byrnes@healthscope.com.au Renal Society of Australasia (RSA) National Conference 26–28 June, Sydney Convention Centre Contact: anna.lee@sesiahs.health.nsw. gov.au, www.rsa2008.com ’Bones on the Beach’ Wollongong Orthopaedic Conference 5 July. Cost: $88 early bird.

Contact: Fiona Roberts, 4222 5390, fiona.roberts@sesiahs.nsw.gov.au Enrolled Nurse Professional Day 26 July, Wyong Hospital, 9am–3.30pm Contact: Jenny Sullivan, 0400 426 353/ Jolan Bogsanyi, 0419 487 822 by 18 July

63rd NSWNA Annual Conference 6–8 August, AJC Randwick Racecourse.

Contact: NSWNA, 8595 1234 ATCA/TNA 2008 National Conference Bridging The Gap 8 Aug, Sydney Convention & Exhibition Ctr Contact: www.tna.asn.au Natural Therapies & Natural Hlth Expo 21–22 Aug, Wharf 8, Sydney Contact: info@naturaltherapyexpo.com.au/ www.naturaltherapyexpo.com.au 2008 Discharge Planning Association ’Critical Actions‘ 24 October, Rydges Hotel, North Sydney.

Contact: Margaret Blackwell, abacus@ abacusevents.com

INTERSTATE AND OVERSEAS 5th Biennial National Medicines Symposium, Canberra 14–16 May, National Convention Ctr Contact: www.nps.org.au HESTA Australia Nursing Awards 15 May, Melbourne Info: www.hestanursingawards.com Australian College of Operating Room Nurses (ACORN) Conference Between the Flags 21–24 May, Gold Coast Convention Ctr, Queensland. Contact: www.acorn.org.au

HIV, Sexual Health & Viral Hepatitis Course for Nurses RCNA Nursing & Health Expo NSW 16–20 June, 8.30am–4.30pm, RNSH 18 May, 10am–3pm, Rosehill Gardens.

Cost: $550 / $250 for NSCCAH staff Cost: Gold coin donation.

Contact: Carol Martin, 9926 7414 ContinentalTravelNurse.ai 7/3/08 10:51:46 AM Contact: 1800 061 660/ www.rcna.org.au cmartin@nsccahs.health.nsw.gov.au

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Diary Dates Diary Dates is a free service for members. Please send the diary dates details, in the same format used here – event, date, venue, contact details, via email, fax, mail and the web before the 5th of the month prior, for example: 5th of August for September Lamp.

Send information to: Editorial Enquiries Email: lamp@nswnurses.asn.au Fax: 9550 3667 PO Box 40 Camperdown NSW 1450 Please double-check all information sent is correct. The Lamp cannot guarantee that the issue will always be mailed in time for the listed event.

ANF Vic Branch: ’No Lifting’ Expo 4 June, Hotel Ibis Melbourne Contact: (03) 9275 9333 11th Case Management Society of Australia National Conference 12–13 June, Sofitel, Melbourne.

Contact: (03) 9658-2399 or email cmsa@cmsa.org.au CAREX 2008 – Aged Care Expo.

9–10 July, Brisbane.

Contact: Wayne Woff, (03) 9571 5606 th

8 International Conference on Grief & Bereavement in Contemporary Society 15–18 July, The Sebel, Albert Park, Melbourne.

Full registration: $850 Contact: (03) 9265 2100/ conference@ grief.org.auwww.icgb08.com th

10 National Congress of Aboriginal & Torres Strait Islander Nurses (CATSIN) 10–12 September, Mercure Grosvenor Hotel, Adelaide, SA. Contact: Susan Day, (02) 8850-8317 Royal College of Nursing Australia Annual Conference 2008 25–27 September, Sheraton Perth, WA. Contact: (02) 6283 3400 34th Annual International Conference of the Australian College of Mental Health Nurses 6–10 October, The Sebel, Melbourne.

Info: AST Management, (07) 5528 2501

Reunions Western Suburbs Hosp. Trained Nurses Assoc. Reunion & Luncheon 31 May, 12 noon, Ryde-Eastwood Leagues Club.

Contact: Lesley Potter, 9349 8387, catch63@bigpond.net.au Liverpool Hospital 50th birthday 26 July, 11:30am, Cabravale Diggers Exservicemens Club, Canley Vale Cost: $35.

Contact: Margaret Favelle, 9605 1733 or email margfav@hotmail.com

Due to high demands on the page, some dates too close to publication or too far in the future may be cut.

Only Diary Dates with an advised date and contact person will be published.

Diary Dates are also on the web – www.nswnurses.asn.au Special Interest Groups Special Interest Groups is now part of Diary Dates. If you are a special interest group, you now must send information about your event as above.

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

Prince Henry Hospital Little Bay 1964 July PTS 1 Aug. Venue: TBA. Contact: Maxine Cook, mcook@smbs.com.au/ Cherrylyn McCarthy, cmccarth@chcs.com.au Scott Memorial Hosp. Scone Reunion 4 Oct, 6.30 for 7pm start, Scone Bowling Club. Cost $25pp. RSVP by 12 Sept. Contact: Jan McPhee, 6545 1690/ Leigh Schalk, 6540 2100 Mater Hospital 30 & 40 Year Reunion 26 Oct. Venue: TBA. Contact: Christine Kirby (30-year reunion), 0414 550 419/ ckirby@nswnurses.asn.au or Patricia Purcell (40-year reunion), 0416 259 845, patricia@ppms.net.au Sydney Hospital group 78/2 Seeking interest in 30 years reunion Contact: Carolyn Moir 93461418 cmoir@bcs.org.au

Social Events Illawarra International Nurses’ Day Formal Ball 9 May, 6pm – midnight, Fraternity Club, Fairymeadow. Cost: $85pp.

Info: Glen Barrington, 0402 000 841, glen. barrington@sesiahs.health.nsw.gov.au NSWNA Family Fun Day at Luna Park 2008 for International Nurses’ Day 10 May. Classic unlimited rides for $29pp for NSWNA members.

Contact: Luna Park, 9033 7600

Other notices The Heart Foundation, Heart Week 08 4–10 May Contact: www.heartfoundation.com.au

Crossword solution

EXPRESSIONS OF INTEREST SOUGHT FOR

REMOTE AREA NURSES/ HEALTH CENTRE MANAGERS Department of Health and Community Services Central Australia Remote Health – Alice Springs Region Nurse 4 ($70,598-$75,846)+ Benefits. Free accommodation Nurse 5 ($77,742-$81,006)+ Benefits. Free accomodation Exciting Opportunities exist for Registered Nurses and Midwives to work in Central Australia and the Barkly area in the diverse and challenging field of Remote Area Nursing. We are seeking motivated, professional nurses from a variety of backgrounds to join some of our 25 community based health centre teams. Experienced Remote Area Nurses are also sought for upcoming vacancies as Health Centre Managers.

Central Australian Remote Health provides comprehensive Primary Health Care Services through a dynamic multidisciplinary team approach that includes Nursing, Aboriginal Health Workers, Medical, Specialist and Allied Health services.

The Health Centre teams range in size from 1 Remote Area Nurse to teams of 5 remote area nurses delivering health services which reflect: • Child Maternal and Women’s Health • Men’s Health • Acute Care Management • Chronic Disease Management • Program development • A Primary Health Care Context of educational, promotional and preventative activities.

An induction program will be available on commencement of employment including access to Professional Development opportunities relevant to remote area practice. Applicants must have a genuine interest in Indigenous Health with a focus on Primary Health Care and are highly motivated, mature, flexible and adaptable.

ENQUIRIES SHOULD BE DIRECTED to the Nursing Coordinator, Central Australia Remote Health on 8951 7586 or email shella.hall@nt.gov.au or the Nursing and Midwifery Recruitment officer THE LAMP MAY 2008 49 FREECALL1800000648

Nurses Wanted in NSW 10 Reasons To Nurse with Drake Medox 1.

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Call Drake Medox on 02 9273 0539 and ask for Vanessa Hardy or email vhardy@au.drakeintl.com

w w w . d r a k e i n t l . c o m / m e d o x

Great legal advice for Nurses Maurice Blackburn are proud to be the lawyers for the New South Wales Nurses’ Association.

Free legal advice#

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Conditions apply

Call the Association information line on 1300 367 962.

Maurice Blackburn has offices in: Sydney T (02) 9261 1488

Newcastle T (02) 4953 9500

New offices in: Parramatta T (02) 9806 7222

Canberra T (02) 6248 9122

Visiting Offices Camperdown T (02) 9261 1488

Wollongong T (02) 9261 1488

Appointments for regional members can also be arranged.

www.mauriceblackburn.com.au 50 THE LAMP MAY 2008

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THE LAMP MAY 2008 51

Low home loan rate for members

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You’re a member, and we look after you. With a Members Equity Bank home loan, you’ll pay less in fees - no fees to apply, no account-keeping fees, no fees to split or top-up your loan, no phone and internet banking fees and free redraw. That’s a much better deal.

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52 THE LAMP MAY 2008