The Lamp Oct-Nov 2023

An epic year and more to come. epage 12

Our collective spirit has delivered results.

When you have a voice, you make progress.

STRIKES WIN PRIVATE HOSPITAL RATIOS

THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

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CONTENTS

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Editorial Committee

Shaye Candish, NSWNMA General Secretary

Michael Whaites, NSWNMA Assistant General Secretary

O’Bray Smith, NSWNMA President

Michelle Cashman, Long Jetty Continuing Care

Richard Noort, Justice Health

Liz McCall, Byron Central Hospital

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Rachel Hughes, John Hunter Hospital

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VOLUME 80 NO. 5

OCTOBER / NOVEMBER 2023

12

8

ANNUAL CONFERENCE

An epic year and more to come

We have accomplished a great deal in the last 12 months, but there is much more to do, says NSWNMA General Secretary, Shaye Candish.

14

ANNUAL CONFERENCE

Our collective spirit has delivered results

We achieve change by working together, says NSWNMA Assistant Secretary, Michael Whaites.

18

ANNUAL CONFERENCE

Nurses and midwives understand the importance of having a voice

A Yes vote in the upcoming referendum will help improve Aboriginal and Torres Strait Islander health, ANMF Federal Secretary, Annie Butler, told Annual Conference.

20

ANNUAL CONFERENCE

‘When you have a voice, you make greater progress. When you don’t have a voice, you’re easily exploited’

There are echoes of trade unionism in what Aboriginal and Torres Strait Islanders are asking for in the Voice to Parliament.

24

PROFESSIONAL DAY COVID-19 takes ‘unprecedented’ toll on nurses

The COVID-19 pandemic has inflicted a “huge and unprecedented” level of mental health trauma on nurses worldwide, according to a report published by the International Council of

(ICN).

COVER STORY

Strikes win private hospital ratios

Nurses at two big private hospitals have won staffing ratios after sustained industrial action for a new enterprise agreement.

REGULARS

5 Editorial

6 Competition

6 Your letters

27 Professional Perspectives

28 Branch Beat

30 What’s on

32 Ask Shaye

36 News in brief

41 Crossword

45 Nursing Research Online and Professional Issues

46 Your Health & Wellbeing

Photographed by Sharon Hickey

AUSTRALIAN

FEDERATION FEDERAL

From

Candish

GENERAL SECRETARY

A voice for change

Annual conference was a time to celebrate the magnificent wins of the past year but also a time to prepare for the challenges

What a year it has been.

We have just completed our 78th Annual Conference with some standout moments including an electrifying presentation by ex-Socceroo Craig Foster, thoughtful presentations from academics Mary Chiarella and James Buchan and appearances by the Health Minister Ryan Park and the Premier Chris Minns.

Annual Conference also gave us the opportunity to look back over a year of historic industrial actions taken across the public and private sectors that has led to tremendous victories (see p8).

After more than a decade of campaigning for nurse-to-patient ratios, we finally secured a commitment from the government to introduce safe staffing ratios in five key areas of our public health sector award. This commitment has now been formalised in a Memorandum of Understanding.

In aged care we won a 15 per cent pay rise for all RNs, ENs and AiNs, whether on the award or an enterprise agreement after a long and heroic campaign by our members. There is now a legal requirement for an RN on duty 24/7.

We are on the cusp of further gains such as mandated care minutes and we are fighting for a role for nurses in their enforcement.

In private hospitals we have won minimum staffing ratios at major private hospitals including Sydney Adventist Hospital, St Vincent’s Health Australia and Chris O’Brien Lifehouse.

While it is appropriate to celebrate the great achievements of the last 12 months it is not a time to sit on our laurels.

We have achieved a lot but there is much more to do.

In his presentation to annual conference Professor James Buchan

outlined how the COVID-19 pandemic inflicted a “huge and unprecedented” level of health trauma on nurses worldwide. His report concluded that safe staffing was essential to rebuilding health care workforces struck by COVID-19.

In NSW, the incoming Labor government has inherited a health system with a depleted and exhausted workforce.

When the previous Coalition government was in office it denied that nurses and midwives were leaving in droves.

We now know that they failed to fund 1,100 nursing positions for more than 12 months and they hid that between 2021 and 2022, 7678 nurses left NSW Health.

This is our point of departure as we go forward.

BUILDING A CULTURE FOCUSED ON WINNING

In response, the Association is now developing our strategic plan to be launched in 2024. This will set the roadmap for the next few years, offering a clear, unified direction based on our shared set of goals and values.

Building our collective strength will be as important as ever. We want to see more nursing and midwifery leaders across the healthcare system and at decision-making tables.

We will need to analyse the economic climate and assess our options for securing better pay rises, superannuation changes and affordable housing while ensuring that our work on important social justice issues like climate action continues.

We will encourage all members to

engage on vital issues such as fair pay, decent, safe and respectful working conditions, and on how to improve leadership, educational and career opportunities for nurses and midwives across the state. Workforce strategies will be vital: developing professional and industrial solutions to attract and retain our workforce, and to advance our professions.

A HISTORIC MOMENT

I would like to acknowledge the passing of a historic motion at conference to appoint two Aboriginal and Torres Strait Islander positions to the Association’s Council. This will ensure that our work with Aboriginal and Torres Strait Islander members continues and they are represented and have an effective voice in their workplaces.

At our annual conference, just days after the date for the referendum on a Voice to Parliament was announced by the Prime Minister, Yes23 campaigner and MUA member Thomas Mayo and journalist Kerry O’Brien highlighted how a Voice will deliver practical change to help close the health gap (see p 20).

“The Voice will save money by getting better outcomes for every dollar spent and it will save lives,” Thomas said. In her address, ANMF federal secretary Annie Butler pointed out how nurses and midwives need to be listened to in our workplaces and how important it is to have a voice that is heard.

We agree, for us and for others.

And so the NSWNMA will proudly support the referendum to establish an indigenous Voice that is enshrined in the constitution. n

Building our collective strength will be as important as ever.

ahead.

THE LAMP has partnered with eNurse to give NSWNMA members a chance to WIN.

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YOUR LETTERS

Have your Say

LETTER OF THE MONTH

The Mater and St Vincent’s inspires

I attended the 78th Annual Conference of the NSWNMA and it was so inspiring. Meeting so many other nurses and midwives, with their own experiences and perceptions of their working environments, makes you reflect on your own.

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Nurses and midwives have been fighting so hard for ratios to be introduced into the public hospital system. Change is on the horizon; it’s exciting and it’s about time!

But with all this reform, many nurses in the private sector are left with one key question: What about us?

While at Annual Conference, I attended a breakout session with NSWNMA delegates from the Mater and St Vincent’s Private. They shared powerful insights into their own campaign of winning ratios at St Vincent’s Health Australia (SVHA).

Members spoke about what a ratios campaign looks like on the ground at a private hospital, the tactics involved, how to motivate members to get active, and what it takes to push through different forms of industrial action.

What a joy it was to hear how these members fostered a sense of solidarity and community across both sites, in the face of fierce opposition from SVHA management. How these members banded together to move in the right direction is inspiring.

The SVHA campaign really gives nurses and midwives in other private healthcare settings a huge glimmer of hope. Now is the time for us to take these learnings and spread this fight across other private workplaces.

Mary Corr, midwife

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

* Conditions Apply. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 October 2023 and closes 31 October 2023. The prize is drawn on 1 November 2023. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date. Scrubs prize to be redeemed by 30 November 2023. 10% storewide discount excludes 3M Littmann Stethoscopes and Kits.

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A historic moment for our union

At the NSWNMA 78th Annual Conference, history was made with the passing of two very important motions regarding Aboriginal and Torres Strait Islander members’ inclusion within the Association. These changes to the rules are an acknowledgment that Aboriginal and Torres Strait Islander members need to be heard and represented within leadership roles of the NSWNMA.

The first motion put forward to delegates at Annual Conference was for the establishment of a statewide Aboriginal and Torres Strait Islander Circle. The Circle will operate with the same function as a branch, comprised of Aboriginal and Torres Strait nurses and midwives from across the state. The Circle will host monthly meetings, allowing members to bring to the table any ideas, issues or concerns that are affecting any of our Aboriginal and Torres Strait Islander members and our communities, and will allow us to raise these ideas or concerns to the Association in a culturally safe environment for members.

The second history-making motion to pass was the endorsement of two dedicated councillor positions on the NSWNMA’s Council for Aboriginal and Torres Strait Islander members: one nurse and one midwife position. These two councillor positions are representatives of the Circle who will now be included at the table for Council, ensuring the implementation of policy as determined by Annual Conference and ensuring the deliverance of the rules and objectives of the NSWNMA.

As a proud Aboriginal woman and NSWNMA member, it brings me great joy to be involved in the creation of the NSWNMA Aboriginal and Torres Strait Islander Circle.

I would like to personally thank Shaye (Candish) and Michael (Whaites) for their ongoing support to the Circle and our members. I also want to extend a very big thank-you to all the delegates who attended Annual Conference and supported these two historic motions, making them the footprint for the progression and inclusion of Aboriginal and Torres Strait Islander members in the NSWNMA – now and forever walking together in union.

Vanessa Smith, RN

Pilliga drilling a threat to local health

The Pilliga Forest, located just south of Narrabri in northern NSW, is one of the most significant areas of remnant forest in inland NSW. It is also a very special place for the local Gomeroi people.

Gas giant Santos intends to develop a gas field in the Pilliga, drilling at least 850 gas wells that will fragment the northern section of the forest.

Groundwater resources used by agriculture and urban communities are almost certain of depletion and/or contamination, as has been observed in Coal Seam Gas (CSG) extraction areas in Queensland.

Santos has never had the interests of local gas consumers at heart; it pays no corporate taxes, and is part of an extractive industry that contributes virtually no state or federal royalties.

The CSG industry has long been associated with negative health outcomes for people who are forced to live and work in a gasfield environs.

Over the last few months, I have joined with the union contingent, including members of the NSWNMA, who have travelled to Coonabarabran to protest the Narrabri Gas Project. As a local, I have been touched by the solidarity of our movement and the members who travelled hundreds of kilometres to join with my community and with the Gomeroi people.

Having unionists from across the state and from the NSWNMA standing with us has empowered our resolve to continue our opposition to this ecological disaster that is just waiting to happen.

Jenny Donaldson, NM

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

Strikes win private hospital ratios

Nurses at two big private hospitals have won staffing ratios after sustained industrial action for a new enterprise agreement.

NSWNMA delegates at St Vincent’s Private Hospital in Darlinghurst, Sydney, and the Mater Hospital in North Sydney have described their winning campaign for staffing ratios as a great achievement.

Their employer, St Vincent’s Health Australia (SVHA), had earlier rejected ratios as “out of the question”. However, nurses at Sydney’s biggest private hospital, Sydney Adventist, had already set something of a precedent by winning ratios in 2022. Encouraged by this example, NSWNMA members employed by SVHA held their first strike at the end of 2022 and maintained a strong campaign that united nurses in industrial action across both the Mater and St Vincent’s Private. Nurses voted for industrial action in secret ballots and held five rounds of strikes at each hospital.

SVHA responded with an offer of three annual increases of 3.75 per cent, 3.25 per cent and 3.25 per cent, and inadequate ratios for a limited number of wards/units at night.

NSWNMA branches voted to reject the revised offer, but management insisted on putting it to a vote of all nursing staff.

The offer was overwhelmingly rejected by 76 per cent of nurses and midwives.

A HUGE ACHIEVEMENT

The NSWNMA then held a second ballot, which won strong endorsement for further industrial action.

This showed the SVHA executive that nurses were serious about getting a better deal.

SVHA then agreed to ratios throughout both hospitals, to improve staffing in all perioperative areas and an improved pay offer.

NSWNMA Branch secretary at the Mater Hospital, Deidre Duggan, described the win as “a huge achievement”.

“Initially, the executive was adamant they would never consider giving us ratios, so the outcome is a huge turnaround and it’s really exciting for us,” she said.

“It will make a huge difference for

our workplace, our patients and ourselves as individual nurses and midwives.

“It’ll be a much safer workplace and we will be in a much better position to support and educate the new grads coming through, because our workloads won’t be as heavy.

“Previous offers from management weren’t up to scratch – we just couldn’t accept them. But overall, we have done very well out of this campaign.

“Our ratios will be better than what the Sydney Adventist Hospital and the public system have.”

Deidre, a theatre nurse, said implementation of ACORN standards would increase theatre staffing to 3.5 nurses, with an additional nurse working across two theatres.

‘Initially the executive was adamant they would never consider giving us ratios, so the outcome is a huge turnaround and it’s really exciting for us.’

— Deidre Duggan, Mater Hospital NSWNMA branch secretary

STRONG UNION PRESENCE

“It will be easier to take meal breaks and theatres will run much more smoothly. Plus, we will have more time to teach new grads,” she said. “It’s a big step forward; our theatre staffing will be better than any other hospital in NSW.”

She said the Mater’s NSWNMA branch was now much stronger as a result of the campaign of industrial action, with about 90 per cent union coverage.

“Our campaign delivered new members, which in turn strengthened our campaign.

“The more members we had, the more people we could take out on strike, which gave us a greater impact.”

The NSWNMA had already raised its profile among SVHA nurses before the campaign for a new enterprise agreement got underway late last year.

The union acted to successfully recover incorrect payments and additional days off (ADOs) that had been abolished.

“Getting ADOs back for us was a big membership boost and during the campaign, nurses could see we were determined to make the hospital a better place to work,” Deidre said. n

Major gain for SVHA nurses

SVHA will employ more nurses to meet the following ratios in medical and surgery wards:

• 1 to 4, including the in-charge nurse on morning shifts

• 1 to 5, including the in-charge nurse on afternoon shifts

• 1 to 8 on night shifts.

Ratios will include 75 per cent RNs/RMs on most wards. SVHA have 10 months to recruit to the new ratios.

Theatre staffing will increase through the implementation of ACORN standards. There will be pay increases of 4 per cent from July 2023, 4 per cent from July 2024 and 3 per cent from July 2025. There is a $1000 one-off payment to full-time nurses and midwives with pro-rata payment for part-time and casual staff.

Strikes the first for a decade

The strikes at St Vincent’s Private and the Mater just before Christmas 2022, were the first by nurses at any NSW private hospital for more than 10 years.

Before members voted to strike, NSWNMA branches gauged the mood of staff by asking them to sign a form pledging to take action for ratios and fairer pay.

In just 10 days, members collected 1143 signed pledges, which they presented to hospital executives.

NURSES AND MIDWIVES FROM THE MATER AND ST VINCENT’S HOSPITALS GIVE THE THUMBS UP FOR THEIR NEW AGREEMENT WHICH INCLUDES RATIOS FOR THE FIRST TIME.

Ward reps a key to success

Members trusted NSWNMA ward representatives to convey their views and keep them informed.

The NSWNMA was able to run a strong campaign for ratios at St Vincent’s Private Hospital (SVPH) and the Mater Hospital because it built an extensive network of branch representatives in every department. Department reps served as links between members in individual departments, and branch executive members responsible for an entire hospital.

Grainne Murphy, Vice-President of the SVPH branch, said building trust between members and their department reps was a key factor in the campaign’s success.

“Members were not getting accurate information from the hospital executive about the enterprise agreement negotiations.

“However, they knew they could trust the information the union was giving them via the department reps.

“Members also trusted their department reps to present their views to the branch and to management.

“We listened to the members and what they wanted was ratios. Through our industrial action we got management to agree to ratios, despite them earlier saying to us that ratios would never happen.

“We got a pay rise significantly better than what SVHA was earlier prepared to pay.

“We also got the reinstatement of allowances that were taken away in previous years during negotiations with the former SVHA executive.

“These results have strengthened the branch because the members can clearly see what the union has

achieved for them.”

Grainne said department reps were now in a position to talk directly to new grads when they joined the hospital, and sign them up to join the NSWNMA.

The branch had also picked up new members from among long-serving nurses who earlier declined to join the union.

“They agreed to join us after seeing how hard the branch worked to get results for all the nursing staff.

“There is always friendly fire when you put yourself out there – you will get shot down.

“However, we knew we had to do it –and we did it for members and got a positive outcome.

“It was a long dispute but the members never weakened in their determination to get a good result.

“They were determined not to be pushed around.

“We had not had a strike for 30 years, but after we held the initial strike in December 2022 we became stronger, if anything, and more united.

“Members were angry and upset that management refused to seriously negotiate on ratios and what they offered us was totally inadequate.

“It was inferior to what nurses at Sydney Adventist Hospital had already achieved and it contained clauses that would have allowed management to renege on even these unsatisfactory ratios at any time without any explanation.”

Grainne said the union’s extensive mapping network of department reps made it a strong tool for the campaign.

She added that the hospital’s previous executive had eroded nurses’ working conditions.

“We want to build our relationship with the current executive, help them to recruit more staff and make the hospital a much better working environment.

“This new EBA is not perfect, but it will hopefully provide some reassurance to our members that we are going in the right direction to rebuild our once-positive culture.”

‘It was a long dispute, but the members never weakened in their determination to get a good result.’

— Grainne Murphy, NSWNMA branch St Vincent’s Private Hospital

Lifehouse nurses win ratios

Nurses at Chris O’Brien Lifehouse have overwhelmingly approved a new enterprise agreement (EA), including their first ever nurse-to-patient ratios.

Nurses at Lifehouse, a Sydney cancer treatment centre, voted 90 per cent in favour of the new EA, which includes a 10 per cent pay rise over three years.

Lifehouse is a private facility that partners with the neighbouring Royal Prince Alfred public hospital.

When negotiations started last year, Lifehouse offered just one improvement to the EA. Management later improved their offer, but it remained unacceptable and was rejected by a 68-per-cent majority in a secret ballot.

NSWNMA members then conducted a photo campaign in which one in four nurses had their photo taken with signs calling for fair pay and ratios.

Lifehouse took the unusual step of paying a 3 per cent increase during bargaining when it became clear they could not win majority support for the EA as it stood, but needed to address the pay issue.

Successful industrial campaigns for ratios at other private hospitals, and the election of a state Labor government committed to public sector ratios, further strengthened the position of Lifehouse nurses.

Ben Brady, a member of the NSWNMA EA bargaining committee, described the final deal as “a big step up from the original offer” of a 9 per cent pay increase over three years and no ratios.

Ben said early negotiations took place in an atmosphere with “a degree of apathy and poorly attended meetings”.

He added, “However, nurses’

Lifehouse Agreement –Main Features

• Shift-by-shift nurse-to-patient ratios to replace the nursinghours-per-patient-day system from January 2024.

• Medical/surgical wards – 1:4.8 excluding in-charge/NUM on morning shift; 1: 4.8 excluding incharge afternoon shift; 1:8 including in-charge night duty.

• ICU – 1:1 ventilated; 1:2 non-ventilated; 1:3 outlier ICU patients.

• Additional nurses based on acuity.

• Updated reference to ACORN standards.

morale improved as the campaign went on and more nurses came forward to join the union.”

He said the example set by private hospital nurses employed by St Vincent’s Health encouraged Lifehouse members to hold out for a better deal.

“We could see they were making headway with their campaign for ratios and pay. We looked at them in admiration and wanted to get something close to what they were achieving.

“With our new agreement we have effectively achieved the same ratios as St Vincent’s Private.” n

• AHMs, CNEs, CNCs, CNS2, NUMs and AiNs supernumerary to ratios, unless stated above.

• Skill mix of 75 per cent RNs to ENs.

• In-charge not to be allocated a patient load unless there are exceptional circumstances and it is clinically justified.

• Any ratios already superior to the above will be retained.

Pay

• 3 per cent from July 2023

• 4 per cent from July 2024 (a 1 per cent increase on the previous offer)

• $1000 bonus for permanents (pro rata for part timers)

‘Nurses’ morale improved as the campaign went on and more nurses came forward to join the union.’

— Ben Brady, EA bargaining committee member

An epic year and more to come

Nurses and midwives have achieved significant wins in the public health system, private hospitals and aged care over the last 12 months, and these gains have created opportunities for even more improvements, Shaye Candish told Annual Conference.

In the public sector, “after more than a decade of campaigning for nurseto-patient ratios, it was no small feat to finally secure a commitment, in the lead-up to the state election, to introduce safe staffing ratios in five key areas of our Public Health System Award”.

“Achieving this has been testament to the unwavering resolve of public sector nurses and midwives to keep fighting day and night for patient safety, better patient outcomes, safety in the workplace, more support in the workplace, long-lasting changes to workforce planning, and investment in the future workforce.”

But, she said, the NSWNMA remains “committed to fighting for as long as it takes to achieve our full Award claim, covering all specialty areas, as endorsed by public sector members”. The union will also continue to fight for better pay.

“The previous government’s arbitrary wages policy contributed to falling real wages, made it more difficult to attract and retain vital workers, and undermined wage growth across the broader labour market. These caps were also a violation of workers’ basic collective

We have accomplished a great deal in the last 12 months, but there is much more to do, says NSWNMA General Secretary, Shaye Candish.

‘ Our state government and the majority of employers need to understand that better conditions at work lead to better conditions of care.’

— NSWNMA General Secretary, Shaye Candish

bargaining rights, and we look forward to them being abandoned for good in NSW.”

GREAT RATIO WINS IN THE PRIVATE SECTOR

There have been terrific wins in the private sector too, Shaye said.

“Thanks to the valiant efforts of members, we now have a commitment for minimum staffing ratios to be embedded in all wards, maternity, perioperative units, and the emergency department at Sydney Adventist Hospital (SAN), under a new enterprise agreement.

“Buoyed by the courage of their SAN comrades, and the high-profile public sector strikes, members embarked on historic protected industrial actions at St Vincent’s Private Hospital in Darlinghurst and The Mater Hospital in North Sydney over a seven-month period. “These led to an agreement that delivers ratios on most wards at St Vincent’s and the Mater, the improvement of staffing in all perioperative areas and improved wage increases over three years.”

(see pp 8–10)

HISTORIC ACHIEVEMENTS IN AGED CARE

In aged care, massive strides have been made thanks to the perseverance, determination, and a willingness to win by our courageous aged care members, Shaye said.

Members have won a 15 per cent pay rise in a work value case heard by the Fair Work Commission, which has flowed through to all registered nurses, enrolled nurses, and assistants in nursing. Importantly, she said, we convinced the federal government to commit funding for this pay increase to flow on to nurses on enterprise agreements too.

“This means, that for the first time in years, many aged care nurses will be earning wages competitive with the public and private hospital system. In some workplaces, aged care will even be paid more.

“In the May budget, the federal government announced a $11.3 billion taxpayer-funded commitment to cover the cost of the pay increase.”

Going forward, “we will be campaigning and lobbying for a worker voice to be developed into the legislation, undertaking a key regulatory role in this sector, through the enforcement of care minutes, which will be implemented from October this year”.

“We also achieved success in our campaign to secure a legal requirement for residential aged care facilities to have at least one registered nurse on duty, 24 hours a day, seven days a week.”

THE CHALLENGES OF COVID-19

During the pandemic our efforts to protect our members and patients led NSW Health to implement better PPE and fit testing, Shaye told conference.

This led to the NSWNMA winning the SafeWork Award for Outstanding Work Health and Safety support to members in the changed working environment due to COVID-19.

“Although the World Health Organization determined COVID19 is now an established and

ongoing health issue that no longer constitutes an international health emergency, its impacts are still being felt – particularly in the mental health and wellbeing of the workforce.

“Rather than pushing a destructive ‘individual resilience’ approach, which places the burden of a broken health system onto nurses or midwives, solutions-driven and system-wide reform is needed.

“We must see improvements in working conditions, as well as urgent investment in available services such as robust physical and mental health supports, more job control, and access to childcare.

“Our state government and the majority of employers need to understand that better conditions at work, lead to better conditions of care.” n

‘The NSWNMA remains committed to fighting for as long as it takes to achieve our full Award claim.’

— NSWNMA General Secretary, Shaye Candish

Our collective spirit has delivered results

We achieve change by working together, says NSWNMA Assistant Secretary, Michael Whaites.

The resolve of members and their willingness to take action over the last 12 months has made us a stronger union, Michael Whaites told Annual Conference.

“During last year’s Annual Conference, delegates endorsed the ongoing fight to win ratios and improved pay and conditions for public sector members. We continued our strike action, with our third and fourth statewide strikes occurring in September and November,” he said.

“These strikes not only saw thousands take action, but they were also a continuation of this union going from one that hadn’t taken action in 10 years, to holding four such strikes within one year.

“When members are united in their resolve to take action, we strike. That’s a fundamental foundation for any union, and one we have clearly rebuilt. We can now rely on this strength when it is right to do so.

“Those strikes built on our already strong public support, complemented by our media campaign. Where other unions’ continued strike action sees public support ebb and flow, ours only got stronger. Why? Because the work you do is respected by the public, it is relied upon by the public, and because our union brand is trusted by the public.”

This increased strength will be needed, he said, “in our pursuit for ratios, in the pursuit of higher wages and improved conditions, the fight for action on climate change and

affordable housing, and the fight for our professions”.

“A year on, we have stronger foundations on which we can build.”

THE FIGHT FOR BETTER PAY CONTINUES

Michael said the union is committed to a fight that will return public sector nurses and midwives to being the highest paid in the country.

“The 4 per cent provided by Labor was disappointing. We do not see

that as the conclusion of the fight for better pay. Far from it.

“We know the 4 per cent pay outcome for public sector members did not meet expectations; we hear the anger over this, and we welcome that the desire to fight remains. We are committed to that fight, but we only have the power to do so when a majority of members are willing, and when there is a reasonable expectation that taking action will deliver meaningful outcomes.”

‘ Last year we stood here in hope; this year will see (ratios) in your Award. The signing of the MOU confirms that.’

— NSWNMA Assistant Secretary, Michael Whaites

HOLDING LABOR AND THE MINISTRY TO ACCOUNT

Michael says that since Labor won the March state election, the Association has been holding Labor and the Ministry of Health to account to ensure the implementation of its Safe Staffing policy.

“We welcomed the announcement of the taskforce that will oversee the implementation – for the first time, and after more than ten years of fighting –which will see ratios implemented in NSW.

“Last year we stood here in hope; this year will see them in your Award. The signing of the MOU confirms that.

“Not as widely as we want, and not across as many workplaces as is needed, but getting ratios into five areas represents a significant start – one we will not let go and one you should be proud of.”

Michael acknowledged that Labor has inherited a mess from the previous Coalition government.

“The previous government denied nurses and midwives were leaving the system in droves. They failed to fund 1100 nursing positions for more than 12 months, and they hid that between 2021 and 2022, 7678 nurses left NSW Health.

“After the first round of ratios are implemented, the union will be better placed to plan our longer-term ratios campaign goals,” he said.

“That campaign will need to be one that maintains dialogue with the ALP, but also holds them to account; one that allows them a path to deliver reform, but also ensures they do not take us for granted.” n

A period of renewal

The NSWNMA Council’s breadth of voices gives depth to our collective decisions, says President O’Bray Smith.

In the last 12 months we have welcomed three new members to the NSWNMA Council, O’Bray said in her report to Annual Conference.

“All three new councillors have joined your council to provide valuable nursing and midwifery voices to the decisions made at the executive level.”

O’Bray pointed out how the council – composed of working nurses and midwives – contributes to the oversight and day-to-day management of the union.

“We have advocated for and helped develop a member survey to review member satisfaction.

“The council will continue to ensure resolutions are not just on paper, but are also part of our everyday practice in the Association.”

This, she said, includes practical changes, such as moving to hybrid vehicles, participating in ethical investments, and implementing rule changes to give a greater voice to our Aboriginal and Torres Strait Islander members, to name just a few.

“I want every member to know that the resolutions you pass at your branch meetings are key to help us steer the Association. “We thank you for placing your trust in us to manage your Association. We relish the opportunity to oversee the implementation of our strategic plan, and to be able to represent you in a fair and altruistic manner.”

‘The previous government hid that between 2021 and 2022, 7678 nurses left NSW Health.’

— NSWNMA Assistant Secretary, Michael Whaites

‘I want every member to know that the resolutions you pass at your branch meetings are key to help us steer the Association.’

— NSWNMA Council President, O’Bray Smith

Park hails safe staffing agreement

NSW health minister hopes the government/union MOU will boost recruitment and retention.

NSW health minister, Ryan Park, has described the memorandum of understanding (MOU) between the state government and the NSWNMA on the implementation of safe staffing levels in public hospitals as the start of the greatest change to hospital staffing in 15 years.

The MOU sets out an agreement for both parties to work together to develop a process and timeframe to implement safe staffing levels, which will be included in the Public Health System Nurses’ and Midwives’ (State) Award.

The MOU also includes principles concerning data sharing and access to information.

Mr Park told the NSWNMA Annual Conference that staffing reform would take a staged approach, starting with emergency departments.

He hoped it would lead to “greater recruitment, retention and enjoyment for staff right across your whole system”.

“It is beginning the journey of changing the way our hospitals are properly staffed, so we’ve got transparency in staffing, so we’ve got certainty in staffing, and so you can come to work knowing there will be enough people on your shift.

“What keeps me up at night is not projects running late or equipment not working – though they are important – (rather) it is the challenges we face around

the workforce.

“It’s not just about recruiting junior nurses – yes, they are important –but we also have to keep the ones we have.

“Part of my determination to see safe staffing rolled out as quickly as possible (and yes, I know there’s going to be bumps along the road) is to make sure the workforce have the confidence that we are focused on them.

“To say this has been a challenging process is an understatement. You have to remember we have a

bureaucracy that has worked for 12 years under a Coalition government, and it takes time.”

RETENTION IS PARAMOUNT

Mr Park said he had been making unannounced visits to hospitals at least once a week at different hours of the day, to speak with staff and find out what was happening first hand.

“It is an opportunity to see how the system is happening in real time and to learn, question, debate, argue and agitate back with NSW Health about what I see and learn.

‘What keeps me up at night is … the challenges we face around the workforce.’

— NSW health minister, Ryan Park

“This week I had a couple of hours with your state council, going through questions and issues they raised with me on your behalf.

“I want to thank them for that time … Engaging with the workforce is something more than just ticking the box; it is something I believe in deeply and something I’m committed to, and I can’t do my job without it.

“I need to see the concerns, the challenges and, to be quite frank, the problems that you face, and get them fixed.”

He said he was “acutely aware” that nurses were leaving the NSW system to take more attractive jobs north and south of the state border.

He added, “One of the reasons I’m so committed to safe staffing is because I think it is also a retention policy.”

He pointed to the state government’s creation of a Special Commission of Inquiry into healthcare funding.

He said he was determined the inquiry would result in the return of money to the workforce and service delivery. In answering a question from the floor following his speech, Mr Park said he was not happy with the implementation and rollout of the Rural Health Workforce Incentive Scheme and had made this clear to the recently appointed Deputy Secretary for Regional Health, Luke Sloan. The NSW Government recently doubled its cash incentive for healthcare workers in rural areas to $20,000, saying the previous offer of up to $10,000 had failed to fill critical gaps in the rural health workforce. n

Healthcare reform is top of my agenda, says Minns

Premier Chris Minns said the MOU between the NSWNMA and the NSW Ministry of Health on safe hospital staffing was signed after “long but warm” discussions between NSWNMA officials and the government.

He told the NSWNMA Annual Conference the MOU was a first step to making safe staffing a reality across all current Nursing Hours Per Patient Day wards, all emergency departments and intensive care units, all Multipurpose Services and D hospitals, and maternity services.

“I want to extend a big thank-you to the Association for your collaboration, your good-faith negotiations and your passionate dedication of behalf of your members,” he said.

“Our society is stronger and more resilient when we put people first and that is what your union does every single day.”

He said there could be no “quick fixes” after 12 years of underinvestment in frontline essential services.

“We were elected in March to rebuild the health and education sectors in New South Wales and to reinvest in the workforce.

“We believe we’ve hit the ground running and made significant policy changes compared to the previous government.

“On the top of our list is repairing and reforming our healthcare system, and the only way we’re going to do that is in unison with our essential workers and, of course, their elected representatives, in particular the Nurses and Midwives.” n

One of the reasons why I'm so committed to safe staffing is because I think it is also a retention policy.

‘Our society is stronger and more resilient when we put people first and that is what your union does every single day.’ — Premier Chris Minns

Nurses and midwives understand the importance of having a voice

A Yes vote in the upcoming referendum will help improve Aboriginal and Torres Strait Islander health, ANMF Federal Secretary, Annie Butler, told Annual Conference.

The upcoming Voice to Parliament referendum is hugely important for nurses and midwives, whose number one priority is improving the health and delivery of care for all communities across the country, ANMF Federal Secretary, Annie Butler, told delegates to the NSWNMA Annual Conference.

Annie, who attended Prime Minister Albanese’s announcement of the referendum date in South Australia in her role as ACTU Vice President, noted that from a health perspective, there are “none so disadvantaged as Aboriginal and Torres Strait Islander peoples”.

“Before 1788, there were more than 2000 generations of healthy babies, healthy children, healthy people, healthy communities. From 1788, it’s only taken seven or eight generations to completely destroy that. And that’s principally because Aboriginal and Torres Strait Islander peoples have had decisions made about them, without them.

“The Voice to Parliament finally gives Aboriginal and Torres Strait Islander peoples the opportunity to have a say in anything that involves them, so we can finally address the deep disparities we have across our country.”

Nurses and midwives understand how you need to be listened to in your workplaces and how important it is to have a voice that’s heard, she

said. “I think for us … there is no other option but to vote yes. And I’ll be voting yes on 14 October.”

‘Nurses and midwives understand how you need to be listened to in your workplaces and how important it is to have a voice that’s heard.’

— ANMF Federal Secretary, Annie Butler

PROGRESS IN AGED CARE

Annie also reminded delegates of the significant positive changes implemented in the health sector since the 2022 election of the federal Labor government, but also of the work that still needs to be done.

In October last year, for example, the government passed legislation requiring registered nurses 24/7 in every nursing home, and put in place mandated care minutes. Most recent figures show that “86 per cent of all nursing homes across the country” now have an RN 24/7, she said.

“We know it can be done, and when employers say ‘Oh, we can’t find the staff’, or ‘There’s a shortage; we can’t get registered nurses’… that’s the wrong question. Instead of ‘We can’t do this’, they should be asking ‘How can we do this?’”

Mandated care hours don’t come into force until 1 October this year, but employers have been funded for that increase since October 2022. “We have to keep fighting and keep working to get it done.”

Annie told delegates that we now have a federal government that is “prepared to at least listen and

Aged care reforms have immediate impact

New data shows that only a month after the implementation of 24/7 reforms, RNs are now on-site in aged care homes 98 per cent of the time.

have a genuine discussion” about what reforms are needed. She noted how she represented the ANMF at the Jobs and Skills summit held in Parliament House in 2022, being one of 100 people invited. “I can’t imagine that ever happening in the previous 10 years, so the doors are definitely starting to open.”

Another positive change is “the removal of red tape and allowing nurse practitioners to work more effectively”. Annie added: “It’s legislatively complicated, so it’s going to take a little while to achieve.”

There is also a “scope of practice review” underway. Federal health minister Mark Butler (no relation) “describes this as unleashing the potential of the health professionals,” Annie Butler said, “which just means getting everybody working to their full scope of practice.”

Another priority issue for the ANMF is making it easier for nurses and midwives to return to work after leaving the profession. “We are currently working with the Nursing and Midwifery Board of Australia (NMBA) on adjustments to getting back on the register and the ‘recency of practice’ standard.” n

In August, the federal Department of Health and Aged Care released the first month of data from 95 per cent of facilities regarding 24/7 nursing:

• On average, there is an RN onsite in aged care homes 98 per cent of the time.

• On average, there is an RN on-site in aged care homes for 23.5 hours a day.

• 86 per cent of facilities now have a nurse on-site 24/7.

• The majority of the remaining homes are very close to 24/7 coverage.

Star Ratings now show that more residential aged care homes are at four and five stars and fewer are at one and two stars compared to when Star Ratings were first introduced in December 2022.

“Data from across our aged care reforms continue to demonstrate a positive trajectory, which we are confident will lift the standard of care in the aged care system even further with the introduction of mandatory care minutes targets on 1 October,” said Minister for Aged Care, Anika Wells. n

‘I think for us…there is no other option but to vote yes. And I'll be voting yes on October 14th.’

The upcoming referendum for a Voice to Parliament has come about after Aboriginal and Torres Strait Islander peoples held an extensive series of 13 regional dialogues that culminated in 250 representatives developing the Uluru Statement from the Heart in 2017.

Thomas Mayo, one of the Uluru Statement’s signatories and Assistant National Secretary of the Maritime Union of Australia, compared the consensus work in the dialogues by First Nations people from across the country and at Uluru, to union delegates working together.

“When you have a voice, you make greater progress. When you don’t have a voice, you’re easily exploited and ignored,” Mayo told the NSWNMA Annual Conference.

“So, we decided, looking at the history, when Indigenous people have had a voice, we made great progress. And when it’s taken away, the gap widens in life expectancy and all those other measures that we have failed to close.”

Throughout Australian history, groups such as the Australian Aboriginal Progressive Association in the 1920s and the Australian Aborigines’ League in the 1930s made

progress for Indigenous people, “but what is in common is that they were all silenced”, said Mayo, a Kaurareg Aboriginal and Kalkalgal, Erubamle Torres Strait Islander.

‘When you have a voice, you make greater progress. When you don’t have a voice, you’re easily exploited’

There are echoes of trade unionism in what Aboriginal and Torres Strait Islanders are asking for in the Voice to Parliament.

‘If we can’t take this important proposal forward, it will be devastating. The whole world will look at us and wonder what a backward country we are.’

— Thomas Mayo

Later governments formed Indigenous bodies that were constantly dissolved and replaced by new organisations: the Whitlam government established the National Aboriginal Consultative Committee, which was then abolished by Malcolm Fraser, who formed the National Aboriginal Conference (NAC), which in turn was replaced by Bob Hawke with the Aboriginal and Torres Strait Islander Commission.

“Howard came in and got rid of that one, and that’s when we saw the gap widening,” Mayo said. “We couldn’t ignore those lessons from the past. Our voice is always taken away. So, we must enshrine it in the Constitution to see that it can consistently improve policies, programs and laws that affect our lives.”

PAST GOVERNMENT APPROACHES HAVE FAILED

Speaking alongside Mayo at the conference was Kerry O’Brien, journalist and former adviser to Gough Whitlam. With Mayo, he is co-author of the bestselling The

Voice to Parliament Handbook.

O’Brien said the failures of past government approaches to Indigenous communities have been the result of “fly-in fly-out bureaucrats” who “would drop in, like cargo cultists from the sky”.

“They would have their pens, and they’d write copious notes. And they’d ask very learned questions, and they’d nod a lot. And they might even make some promises, and then they’d go away, in many cases, never to be heard from again, or when the policy outcome came back, it had nothing to do with the advice that was given to them.”

In contrast, O’Brien said, establishing a Voice will involve Indigenous representatives from around the country who will consult with their communities about policy that affects them and take their views to Canberra. Their advice would go to the relevant departments and Ministers to be considered by the cabinet.

But the Voice won’t have the power to “dictate to the Parliament or government”, O’Brien added. The Voice’s power will come from “the strength and the quality and the integrity of their arguments. But they will also have the moral and political authority that will be vested in them, by us with this referendum”.

O’Brien said referendums don’t happen often, but we shouldn’t “build a kind of mystique” around the Constitution as an unchangeable document.

The Constitution “has immense significance to us as a nation because it is the rulebook by which our democracy is framed through legislation in Parliament”, he said.

O’Brien pointed out that if the proposition is approved, future parliaments will have the power to legislate how the Voice is assembled and details such as the number of delegates and how often it meets. There is much is at stake with this vote, Thomas Mayo says.

“If we can’t take this important

proposal forward, it will be devastating. We won’t be closing the gap because nothing else has worked.

“The whole world will look at us and wonder what a backward country we are.” n

Historic motions passed

The NSWNMA 78th Annual Conference passed a historic motion to appoint two Aboriginal and Torres Strait Islander positions – one for a nurse and one for a midwife – to the Association’s Council, and the formation of a dedicated Members Circle for Aboriginal and Torres Strait Islander members.

NSWNMA Assistant Secretary Michael Whaites said the motions came about after consultation with Indigenous members.

“Together we spoke of our shared desire for a voice within the union and a seat at the decision-making table,” he said. “This has been endorsed by conference.” n

Find out more:

‘The Voice’s power will come from the strength and the quality and the integrity of their arguments.’

— Kerry O’Brien

COVID-19 takes ‘unprecedented’ toll on nurses

The ICN report said multiple studies in different countries show COVID-induced anxiety, stress, depression, burnout, psychological distress and PTSD have affected between 40 to 80 per cent of nurses.

Nurses in intensive care and coronary care have suffered the worst impact, according to the report titled Recover to Rebuild: Investing in the nursing workforce for health system effectiveness.

A co-author of the report, Scottish professor James Buchan, addressed the NSWNMA Annual Conference in Sydney in August.

He said the emotional toll on nurses was “immense”, with poor work/life balance, “moral injury” and a feeling of not being listened to.

International surveys showed over 20 per cent of nurses said they intended to leave the profession.

“We are now beginning to see real evidence of (nurse) leaving rates growing post-pandemic,” said Professor Buchan, who is affiliated with the World Health Organization Collaborating Centre at the University of Technology Sydney.

“The National Health Service in England has more than 40,000 registered nurse vacancies, which is about 10 per cent – so one in 10 posts in the NHS is not filled. The retention rates are reducing and the turnover rates are increasing.”

WRONG EMPHASIS ON RESILIENCE

He said health organisations had failed to adequately protect and prevent harm to nurses, and had also wrongly emphasised a need for individual nurses to be resilient.

“We can’t just focus on emphasising resilience of individuals; we have to be looking at organisations’ duty of care, and their ability to reflect and respond to the growing concerns that are clearly there,” he said.

The incidence of industrial disputes and strikes in the health sector was

The COVID-19 pandemic has inflicted a “huge and unprecedented” level of mental health trauma on nurses worldwide, according to a report.

‘We can’t just focus on emphasising resilience of individuals; we have to be looking at organisations’ duty of care, and their ability to reflect and respond to the growing concerns that are clearly there.’

— Professor James Buchan

up by 60 per cent internationally. Strikes were a reaction to a failure to protect individual nurses from harm, historical undervaluing and funding, and concerns about patient safety.

“Governments and employers say they cannot afford to give pay rises and better conditions. The reality is, it is much more expensive to continue with the status quo.”

Professor Buchan said safe staffing was essential to rebuilding healthcare workforces severely affected by COVID-19.

“You need some sort of system in place where nurses can be confident that when they turn up at work, they are going to be in a safe working environment and patients will be safe.

“The second key point, I think, is having career structures with decent pay and the ability for nurses to progress up a career ladder if they wish.

“Australia needs to significantly increase the opportunities for nurse practitioners and other nurses.”

ETHICS OF FOREIGN RECRUITMENT

Professor Buchan said high-income countries such as Australia, the US and UK had failed to educate enough nurses of their own and were increasingly relying on international recruitment as a quick fix.

“There are serious ethical issues and health consequences when nurses are being actively recruited from countries that have too few nurses already.

“I’ve heard stories of a complete intensive care unit of nurses from Uganda moving en bloc to the UK … I’ve heard stories of Fiji losing a lot of its nurses (to Australia) and again, those cannot easily be replaced.”

Professor Buchan was asked if Australians had the right to dissuade nurses and midwives in poor countries from moving to Australia. to enjoy better working conditions that would benefit themselves and their families.

“We don’t have any right … the preeminent right should be that of the individual to move, assuming they’re free to do so and they have the right qualifications,” he replied.

He added, however, that governments

Four steps to rebuild health services

The ICN report says solutions to rebuild health care workforces degraded by the pandemic include:

• adequate staffing levels

• attractive working conditions and pay, and career opportunities

• support for respite, health and wellbeing

• full participation in development and implementation of healthsystem rebuild strategies.

of low-income countries had sometimes paid for nurse training on the proviso that nurses would work in their local health system for a period of time.

“That is not always being respected by recruiters, so it’s something we need to be monitoring.

“What we need to do beyond that is have bilateral agreements between recruiting countries and those we are recruiting from, to be clear that the nurses who move will get fair and equitable treatment – as that’s not always happening.”

If poor countries were being negatively impacted by international recruitment, then countries receiving migrant nurses needed to work with poor countries to improve their healthcare systems, he said.

RECRUITMENT ‘RED LIST’

He pointed to the World Health Organization code of practice on international recruitment, which includes a “Red List” of about 50 countries that should not be targeted for “active”

international recruitment.

“The phrase ‘active recruitment’ gives a bit of an out in terms of how do you demonstrate the recruitment was active?

“Last year, the UK recruited about 6500 nurses from Red List countries … whether or not that was active recruitment or somehow all those 6,500 nurses made all the effort themselves is open to question.”

He said India and the Philippines were by far the biggest source countries for active recruitment.

“However, in both those countries most nurses pay for their own training and they do that with the intention of moving to earn more in other countries.

“So that dynamic is somewhat different, but in the Philippines there are concerns about their ability to meet their own healthcare demands post-COVID, when there are more Filipino nurses working in other countries than there are in the Philippines.” n

‘Governments and employers say they cannot afford to give pay rises and better conditions. The reality is, it is much more expensive to continue with the status quo.’

— Professor James Buchan

Medals for nurse leaders

Nurses and midwives prominent in the Australia Day Honours list.

Named in the 2023 Australia Day Honours list were Jennifer Collins, the union’s state president from 1992–1998, and Susan Pearce, who was a NSWNMA organiser and manager for almost nine years.

Jennifer, who retired as a Department of Veterans Affairs Deputy Commissioner (NSW and the ACT) in 2017, was commended for “significant service to veterans and their families, and to nursing”.

Susan, who is Secretary of NSW Health and a former NSW Chief Nurse, led the state’s COVID-19 Emergency Operations Centre health response during the pandemic. She was commended for “significant service to public health administration and governance”.

Susan told The Lamp she did high school work experience at a hospital and “never conceived of being anything else other than a nurse. I liked the idea of caring for people and I still do so – that’s always been in me.”

She became an Association branch official while nursing at Broken Hill. “I’ve always loathed unfairness and tried throughout my life, whether personally or professionally, to address things I could see were unfair,” she said.

“That probably attracted me to the union and the role unions play in advocating for staff as a collective.”

She agreed her background as a nurse

and Association officer undoubtedly helped her in her role as head of the state’s operational response to COVID-19.

Skills learned while working systematically through “very difficult problems, dealing with difficult situations, dealing with people when they were distressed or upset” stood her in good stead for a top health role during a period of crisis.

“A lot of nursing leaders stood up during the course of the pandemic … many of our senior nurses led the operational response to the pandemic and did a magnificent job of it.”

A UNIQUE PRIVILEGE

Susan has no hesitation in recommending nursing as a career; NSW Health employed a record number of newly graduated nurses and midwives this year and her own daughter has just started nursing.

“I think the beauty of the profession is the breadth and depth of it … You can really make of it anything you want to be, and I don’t think any of that has changed since I started nursing.”

Nurses and midwives have “the unique privilege of being with people during some of their most difficult and vulnerable times, as well as happy times. Dealing with people in those situations and forming those relationships sticks with you and you remember them forever.”

Jennifer Collins started her nursing career at Cooma Hospital in 1974, undertook general training at

‘I think the beauty of the profession is the breadth and depth of it…You can really make of it anything you want to be.’

— Susan Pearce, Secretary of NSW Health

Concord Repatriation General Hospital, and then commenced midwifery training at Westmead Hospital.

“I was shocked that many of the nurses’ conditions that were in place at Concord did not exist at Westmead,” she told The Lamp. “This injustice motivated me to be active at a local and state level to ensure nurses were not disadvantaged regardless of where they worked.” Jennifer became a union delegate and branch secretary, a member of state council, and state and national president.

“The union taught me about advocacy and being willing to call out things such as inequity and social injustice. It also taught me that if we stand together we can achieve great things.”

In the Department of Veterans Affairs she led major reforms in service delivery for widows and families of ADF personnel, and the development and implementation of a support program for wounded, injured or ill veterans.

In retirement, she chairs the boards of management of the Kokoda Track Memorial Walkway and War Widows Guild.

“My role is to ensure the stories of our veterans and families are not forgotten and also to advocate for families to ensure they receive the necessary support,” she said. ” n

Recognition of our profession

Three NSW nurses and two midwives were recognised in the 2023 King’s Birthday Honours list.

Joanne Gray was received as a member of the Order of Australia (AM) “for significant service to education, and to the midwifery profession”.

Joanne is the current Acting Deputy ViceChancellor, Education and Students, at the University of Technology Sydney (UTS), as well as the President of the Australian College of Midwives.

Dr Nicky Leap was also received as a Member of the Order of Australia “for significant service to midwifery as a clinician and educator”.

Dr Leap is Adjunct Professor of Midwifery at UTS, and was involved in the development of the university’s Bachelor of Midwifery program. She has served in the Midwifery Practice Committee of the NSW Nurses and Midwives’ Association, and was the Association’s Midwife of the Year in 2006.

Rose-Marie Radley was received as a member of the Order of Australia “for significant service to community health, and to the nursing profession”. She had been a former Director of Nursing at the Sydney Adventist Hospital, as well as having been the Lead Nursing Officer at Open Heart International’s first visitation program to the Solomon Islands.

Elizabeth Grist was awarded a Medal of the Order of Australia (OAM) for her “service to community health, and to nursing and midwifery”. She has been the Executive Director of Clinical Services Nursing and Midwifery for Hunter New England Local Health District since 2015.

Natalie Shiel was also awarded a Medal of the Order of Australia for “for service to nursing”.

Natalie is the Director of Nursing, COVID-19 Vaccination and Screening Program, for the Sydney Local Health District (SLHD).

‘The union taught me about advocacy and being willing to call out things such as inequity and social injustice.’

— Jennifer Collins, Chair, Kokoda Track Memorial Walkway and Chair, War Widows Guild

Update your details and win

Have you recently moved house or changed jobs?

Changed your classification or email?

Are you a dual-registered nurse/midwife?

Let us know now!

Log on to online.nswnma.asn.au

Update your details

Go into the draw to WIN A TWO-NIGHT WEEKEND STAY AT WILDES BOUTIQUE HOTEL, KANGAROO VALLEY for two adults including:

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Everyone who uses our online portal from 1 April 2023 – 30 March 2024 to update their details will automatically be entered in the draw to win.

*The winner must be a financial member of the NSWNMA. Prize valid until 30 December 2024 and excludes stays over long weekend and school holiday peak periods. Booking and stay conditions may apply.

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

Professional Perspectives

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

Support at a coronial inquest

There was an unexpected and unexplained death at work that was reported to the coroner. I was on duty at the time. What do I do? Can the NSWNMA help me?

Your membership with the NSWNMA provides you with legal representation for coronial inquests. Please call to speak to one of our legal officers, who will advise and support you through the process with the police, provide a statement to the coroner, prepare you to give evidence in court, and represent you at the Coroners Court if you are a party of sufficient interest. Even if you are required to appear as a witness only, the NSWNMA will provide advice and support to you during the coronial process. When there is an unexpected death there is also a Root Cause Analysis (RCA) or Serious Adverse Event Review (SAER) process. There may even be a fact-finding or Managing Complaints and Concerns about Clinicians (MCCC) process. This can be overwhelming. The NSWNMA member rights centre

can provide support, so please reach out.

Sometimes while the coronial and employer investigations are happening there can be a complaint to the Health Care Complaints Commission (HCCC). If this occurs the NSWNMA can advise, assist and represent you at the HCCC and also at the Nursing and Midwifery Council (NMC).

Rules around recency of practice

I am taking a career break. What do I need to do to ensure I maintain my registration?

Nurses and midwives are required to maintain recency of practice by ensuring they have completed a minimum of 450 hours of practice within the last five (5) years for each registration they hold. These hours of practice do not need to be continuous, as long as the hours are accumulated over the previous five-year period.

As per the Nursing and Midwifery Board of Australia (NMBA’s) definition of practice, this applies for both clinical and non-clinical practice roles for nurses and midwives: “Practice means any role, whether

remunerated or not, in which the individual uses their skills and knowledge as a health practitioner in their profession. Practice in this context is not restricted to the provision of direct clinical care. It also includes using professional knowledge (working) in a direct non-clinical relationship with clients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that impact on the safe, effective delivery of services in the profession”. You are also required to maintain a minimum of 20 hours of CPD for each current registration you hold, annually, for the registration period of 1 June to 31 May.

For more information visit: https://www. nursingmidwiferyboard. gov.au/codes-guidelinesstatements/faq/recency-ofpractice.aspx

Branch

Beat

Branch Beat with NSWNMA Assistant General Secretary Michael Whaites

Government funding decisions can mean life or death for nonmetropolitan hospitals – even when allocations are a tiny part of the NSW Health budget

Take the recent decision to scale back redevelopment of Muswellbrook District Hospital in the Upper Hunter region.

The previous government allocated $45 million for the job. That equates to 1.6 per cent of the $2.8 billion budgeted for NSW Health capital works in 2022-23.

The redevelopment has completed Stage 2 but NSW Health says $45M will no longer cover all of Stage 3 due to rising construction costs. Rather than find extra money, the revised plans scrap new operating suites and a new sterilisation department and downsize the new inpatient unit and maternity unit.

Hospital upgrades in other regional towns such as Glen Innes, Gunnedah and Moree are also being scaled back due to rising construction costs.

The ministry’s about-face had left Muswellbrook hospital’s future hanging by a thread but it also galvanised the local NSWNMA branch into action. Branch Beat reports on how Muswellbrook branch is battling to save the hospital that has served the people of the Upper Hunter for more than a century.

Strike vote gets a rethink on hospital rebuild

Muswellbrook nurses were “devastated” to learn that vital elements of their Stage 3 upgrade would no longer proceed, said Peggy Smith, NSWNMA branch vice president and delegate.

“Our old building is very run down; the door of our patient bathroom fell off its hinges with a patient inside the other day,”  she said.

“No money has been spent on repairs because the building was supposedly about to be upgraded.”

Peggy said the existing theatre does not meet accreditation standards and only received accreditation in 2019 on the understanding it was being upgraded.

Accreditation is due again in December 2023 and some surgeons have said they might stop working there due to the infection risk.

“We know that if the theatre had to stop for a few months over

compliance issues we probably would not be able to get the  surgeons back.”

The scaling back of renovations follows the loss of Muswellbrook Hospital’s aged care facility and closure of the maternity in-patient unit in recent years.

“Increasingly our patients are being funnelled to metropolitan areas away from their families,” Peggy said.

“There’s a total lack of equity between metropolitan and regional areas. We only have one train up and back to Newcastle each day to see a specialist at John Hunter Hospital.

“It’s too hard for some people to get to appointments, their condition deteriorates and they end up presenting back to us with acute consequences of delayed treatment.”

Seeking members’ views

On learning the upgrade had been scaled down, Peggy and other branch officials spoke to as many staff members as possible to get their views.

“People wanted to do something but weren’t sure what,” she said.

“We sent a protest email to Health Minister Ryan Park. His office advised us to keep talking to NSW Health Infrastructure.

“We sought advice from our NSWNMA officials who offered their full support. They recommended calling a branch meeting to get members views and see how many were willing to take action.

“The meeting was one of the biggest turnouts we’ve ever had. We got strong feedback from members who voted for a one-hour stopwork meeting.”

The branch had already built a strong foundation for action with around 95 per cent union membership across the hospital.

“We are always recruiting new people; when a new staff member joins the hospital everybody talks to them about making sure they are part of the union,” Peggy said.

“We have our own private Facebook group where we share information and everybody chats on it. We aim to make new members feel welcome and involved with the union.

“A high branch membership means you get broad feedback from every section of your facility and lots of different ideas and opinions. It is a strong basis of support when you're trying to run a campaign.”

“We have our own private Facebook group where we share information and everybody chats on it.”

Two days after voting for a stopwork meeting the branch was contacted by Minister Ryan Park who offered a meeting with his chief of staff Matt McLean and representatives of the Treasurer and Health Infrastructure – providing the branch called off its stoppage.

Keeping the community informed

Branch officials consulted with members on shift that day before deciding to accept the offer and convert the stoppage to a lunchtime community rally, in order to keep the public informed and onside.

Meanwhile, Peggy contacted the local newspaper, radio and television station to publicise the rally. She and theatre nurse Kathryn Black also met with local Nationals MP Dave Layzell.

He and Muswellbrook mayor Steve Reynolds were among over 50 people who attended the community rally.

“The community was quite outraged that we were possibly losing yet another service,” Peggy said.

The meeting with the minister’s chief of staff Matt McLean coincided with the NSWNMA national conference in Sydney, so the branch was able to send three delegates –  Alex Stevenson, Kayla Collins and Peggy.

Peggy said they received a sympathetic hearing and were promised $100,000 to ensure the theatre  could meet accreditation standards in December.

Several days later, McLean advised that Health Infrastructure had commenced an independent architectural review of the project.

“They are going to share with us a few different plans and get staff feedback on them,” Peggy said.

“They also agreed to further community consultation once a new master plan is completed.

“The battle is not over but we have gained some concessions while we continue our campaign.” n

MUSWELLBROOK DELEGATES – KAYLA COLLINS (FRONT) WITH ALEX STEVENSON (LEFT) AND PEGGY SMITH

PROFESSIONAL EDUCATION

Face-to-face CPD Education Opportunities

Surry Hills

Mental Health and Drug & Alcohol Nurses Seminar

Friday 13 October, 9am-4pm, 6 CPD Hours

Waterloo

Effective Management of Consumer Consultation and Complaints

Tuesday 17 October, 9am-3pm, 5 CPD Hours

Environmental Sustainability Seminar (rescheduled date)

Friday 3 November, 9am-4pm, 6 CPD Hours

Child and Family Health Seminar

Friday 10 November, 9am-4pm, 6 CPD Hours

SURRY HILLS

Law, Ethics and Professional Standards in nursing and midwifery

Thursday 23 November, 9am-4pm, 6 CPD Hours

West Ryde

Dementia Management Training

Friday 27 October, 9am-5pm, 7 CPD Hours

Wagga Wagga

Nursing and Midwifery

Professional Roadshow

Friday 17 November, 9am-4pm, 6 CPD Hours

Wollongong

Medications: How we do it better Tuesday 28 November, 9am-4pm, 6 CPD Hours

Newcastle

Clinical Communication and Documentation

Thursday 19 October, 9am-4pm, 6 CPD Hours

Please note: 2 working days’ notice is required for course cancellations. Read the full Education Cancellation, Refund and Catering Policy available on the Association’s website prior to registering for courses. bit.ly/educationNSWNMA

Mental Health and Drug & Alcohol Nurses Seminar

NEW VENUE!

Rydges Sydney Central Albion St, Surry Hills

Friday 13 October, 9am-4pm, 6 CPD Hours

Cost: Members $75 / Non-members $150

Keynote Speakers:

• The Hon Emily Suvaal, MLC – Consumer, Registered Nurse, Unionist, Legislator

• Richard Lakeman, Empathy Masterclass –Responding therapeutically to people who express disturbing beliefs (more information on the masterclass in the program).

Program:

• The role of nurses and midwives in supporting family resilience and child mental health;

• Co-morbidity complexities for mental health and drug & alcohol nurses;

• Medically Supervised Injecting Centre.

Note: On-site parking is available at a cost of $30 for the day. Rydges Sydney Central is also a short 5 minute walk from Central Station and is easily accessible via other public transport options.

Scan QR to register online now

Specialty Seminars

Register via bit.ly/educationNSWNMA

TIME: start at 9am and conclude around 4pm. COST (per seminar): Members $75 • Non-Members $150

Lunch and refreshments will be provided You will receive a CPD certificate of attendance

SURRY HILLS

Mental Health and Drug & Alcohol Nurses Seminar

Friday 13 October

Hear from a range of speakers, network with colleagues, from residential, community & hospital areas, across mental health and D&A sectors.

WAGGA WAGGA Nursing and Midwifery Roadshow

Friday 17 November

The NSWNMA is bringing an exciting and interesting education day to Wagga Wagga! Come and hear from speakers covering a range of nursing and midwifery topics.

Environmental Sustainability Seminar

WATERLOO Environmental Sustainability Seminar

Friday 3 November

Hear from a range of speakers, network with like-minded colleagues, from residential, community and hospital settings, across private and public sectors.

Child and Family Health Seminar

Friday 10 November

Hear from a range of speakers, network with colleagues, from residential, community and hospital settings, across private and public sectors.

FREE WEBINAR SERIES

Reconnecting with your purpose

Thursdays commencing

Friday 3 November

Program:

• Climate change is a health emergency –the Climate and Health Alliance

• Gas-free healthy homes

• Mental Health and Climate Change

• Too hot to work? How mandatory pandemic protocols impacted occupational heat exposure

• Introduction to sustainability in healthcare services

• Ministry of Health – Climate Risk and Net Zero Unit REGISTER NOW

19 October, 10-11am

What are your career goals? What are you passionate about? In this 3-part series, Sam Eddy will help you create an intention, and vision and set goals aligned to your life purpose, without all the pressure:

Part 1: Your current life reality & core values

Part 2: Bringing your new future to life

Part 3: Goal setting, planning & taking action while staying aligned to your purpose.

Ask Shaye

Annual leave in a medical centre

I’ve just started a job at a local medical centre, how many weeks of annual leave should I get?

When working for a smaller private employer you’ll generally be covered by the Nurses Award 2020. The Award provides for 5 weeks of annual leave as a standard. However your employer can pay you a higher rate of pay and then provide four weeks of annual leave instead. The first step is for you to look at your contract or letter of offer and see if there’s any mention of annual leave. If annual leave is not mentioned or you’re still unsure, this is a great question to take to bring to us and we can give you specific advice.

In-charge allowance

In my unit, we have a team leader for all three shifts but only the morning and evening shift receive the in-charge allowance? Is this right?

The allowance is paid when the NUM of a ward is away, so it’s often paid for afternoon and night shift if the NUM is not at work. However a Team Leader may also be paid the allowance where the NUM is at work and the nurse in-charge is delegated and performs the ‘day-to-day’ clinical management of the unit. Practically, if a team leader is allocating patients, handling escalations and questions from staff and generally running the clinical work of the unit, then they should receive an in-charge allowance.

If you believe that you may qualify for this allowance and aren’t being paid it, you should contact the Association for a further discussion.

Employer requests for medical info

I’ve had knee surgery in the past and have some difficulty bending over or kneeling. I work in the public system and have been asked to get a medical certificate to show I can keep working. Is that allowed?

Employers have a right to request medical evidence from you if they have reasonable questions about your ability to perform the requirements of your job or if there are safety concerns because of your health.

However, a request by an employer for medical information should be specific and confined to the concerns they’ve raised. In this example, it’s probably reasonable for the employer to ask you for medical information or doctor certificates about your knees and how your injury affects movement and mobility. It would likely not be reasonable, though, to ask you for information about psychologist appointments or blood pressure medication.

If you have been asked for medical information from your employer and are concerned that the request is not reasonable you should contact the Association for assistance.

Classification following parental leave

If I take parental leave for a year, will I have to take a lower classification job when I return?

No, if you return from parental leave after having a child you are entitled to return to the position which you left when you commenced parental leave. If the job no longer exists, you should be employed in the same or a similar position to the one you left before taking parental leave. This right is set out in s 66 of the Industrial Relations Act 1996 for public sector workers and in s 84 of the Fair Work Act 2009 for private sector workers.

Personal leave at Ramsay

I work for Ramsay and have to take my elderly grandfather to hospital unexpectedly. What sort of leave should I take?

Leave entitlements can be different from employer to employer so it’s good to check your own enterprise agreement or Award. Taking care of a family member is a valid reason to take paid personal leave (often known as sick leave). In the Ramsay Agreement, a grandparent qualifies as a family member and so you are absolutely entitled to take a day of paid personal leave to help him attend an unexpected hospital visit.

thank you

The NSW Nurses & Midwives’ Association gratefully acknowledge and thank our sponsors

The Association would also like to thank the following organisations for their contribution and support:

• DU’IT Skincare

• Ferndale JILA mints

• Dermal Therapy

• Lindt & Sprungli

• The Happy Snack Company

CHILD & FAMILY HEALTH REFERENCE GROUP

Are you a member of the NSWNMA?

The NSW Nurses and Midwives’ Association is seeking members to join the Child and Family Health Reference Group. The group meet a minimum of four times a year to discuss current issues and challenges in the sector. Meetings are held via Zoom to allow members to be involved regardless of geographical location.

Current NSWNMA members working in child and family health are invited to join.

Being a member of the Child & Family Health Reference Group gives you the opportunity to:

be a voice for the issues impacting those working in the sector

provide feedback to the Association

assist in the development and reviewing of related policies

be a link between members and the Association

THE NSWNMA MEMBERS’ REWARD SYSTEM

Recruitment incentive scheme

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

HOW THE SCHEME WORKS

$20

E-GIFTE-GIFT CARD

Once you have recruited 4 new members you will be entitled to an $80 e-gift card. For every new member you sign up after that, you will receive a $20 e-gift card.

Digital gift cards are emailed to recruiters at the end of financial year and valid for 3 years. Gift cards are not deemed to be income for the purposes of taxation.

What you get with your FREE membership!

Unlimited year-round access to worldwide properties at the industry’s lowest prices. Access to ubookdirect’s optimized algorithm that swiftly sorts hotels based on the day’s best deals.

If you find a better rate on another popular online travel site, just contact us and we will negotiate a better rate. Highly discounted flash sales in Peak and Holiday seasons. Handpicked packages with value-add inclusions.

Industry super funds outperform for-profit funds in 2023

The industry watchdog, Australian Prudential Regulation Authority (APRA), has savaged the big for-profit funds in its super performance test.

Not-for-profit industry super funds, including HESTA, dominate the top 10 performing super funds for 2022–23, according to SuperRatings.

“A rebounding share market has delivered Australia’s six bestperforming funds double-digit returns in the past financial year, while the top 10 delivered an average return of 9.5 per cent,” reported the New Daily.

“That’s a sizeable turnaround from the 3.4 per cent loss reported a year ago as the share market suffered a COVID-19 hangover amid soaring inflation and the start of interest rate hikes.”

Meanwhile, APRA has released the results of the 2023 superannuation performance test.

The annual test is designed to improve outcomes for members by assessing long-term performance against benchmarks.

ACTU Assistant Secretary Joseph Mitchell said the results “once again illustrate the significant and persistent underperformance of forprofit super funds”.

“Ninety-eight per cent of products that failed the performance test were from a for-profit or nonindustry fund,” he said.

“Industry super funds consistently perform better and are governed better.

“The banking royal commission showed working people are

often sold into choice products by for-profit providers and it is important that they have a clear understanding of the performance of their retirement savings demonstrated through performance testing.”

CROSSWORD SOLUTION

‘Industry super funds consistently perform better and are governed better.’

— ACTU Assistant Secretary Joseph Mitchell

WORLD Global health organisations call for ban on nuclear weapons

A joint editorial published in 11 of the world’s leading medical and health journals said the health community has a crucial role to play in efforts to reduce the risk of nuclear war.

The editorial said “current nuclear arms control and nonproliferation efforts are inadequate to protect the world’s population against the threat of nuclear war by design, error, or miscalculation”.

It calls on health professionals to “alert the public and our leaders to this major danger to public health and the essential life support systems of the planet”.

It points out the modernisation of nuclear arsenals could increase risks of nuclear catastrophe. For example, hypersonic missiles decrease the time available to distinguish between an attack and a false alarm, increasing the likelihood of rapid escalation.

“Once a nuclear weapon is detonated, escalation to all-out nuclear war could occur rapidly. The prevention of any use of nuclear weapons is therefore an urgent public health priority and fundamental steps must also be taken to address the root cause of the problem – by abolishing nuclear weapons,” it said.

The editorial said three immediate steps are required from nucleararmed states and their allies: first, adopt a no-first-use policy; second, take their nuclear weapons off hair-trigger alert; and third, urge all states involved in current conflicts to pledge publicly and unequivocally they will not use nuclear weapons in these conflicts.

https://www.mja.com.au/journal/2023/219/5/

UNITED STATES New spike in US suicides – CDC

The suicide rate in the United States returned to a near-record high in 2021, reversing two years of decline, according to a recent report released by the US Centers for Disease Control and Prevention (CDC).

The study showed that suicide was the eleventh leading cause of death nationwide, with more than 14 deaths for every 100,000 people.

The death rate has increased 32 per cent over the past two decades, and the 4 per cent jump between 2020 and 2021 was the sharpest annual increase in that timeframe.

Suicide was the second leading cause of death for people aged 10 to 34, and fifth for people aged 35 to 54.

The suicide death rate was four times higher among men than women in 2021, the CDC data showed.

Rates were highest among American Indian people – about twice as high as average for men and three times as high for women – and rates spiked about 17 per cent between 2020 and 2021.

A companion report by the CDC showed that in recent years, adolescents were the age group most likely to visit the emergency department for suicidal thoughts.

Children are facing increasing mental health challenges, with significant shares of both teen girls (57 per cent) and boys (29 per cent) saying they felt persistently sad or hopeless in 2021. Nearly 1 in 3 teen girls said they seriously considered attempting suicide, the CDC survey found.

‘Suicide was the second leading cause of death for people aged 10 to 34 in the US.’

ACTU sets up inquiry into price gouging

Professor Allan Fels AO, former head of the Australian Competition and Consumer Commission (ACCC), will chair an inquiry into price gouging. While Australian households are experiencing a significant decline in living standards as prices rise, corporate profits and executive bonuses are skyrocketing, claims the ACTU.

The ACTU has commissioned Prof. Fels to convene and chair an “Inquiry into Price Gouging and Unfair Pricing Practices” to examine the cause and effects of price gouging on Australian working people.

Recent OECD research has demonstrated that in Australia, corporate profits have been a major driver of inflation.

Supermarket chains have been among the worst offenders.

Leading economists have blamed supermarket greed and a lack of competition for rising grocery prices. Coles recently announced $1.098 billion in total profits for the last financial year. The two retail behemoths Coles and Woolworths control two thirds of Australia’s supermarket sector, “creating a chokehold over the prices we pay for essentials at the tills”, said the ACTU.

Origin Energy, one of Australians biggest energy providers, recently announced a surge in profits by a whopping 83.5 per cent. Origin’s gross profit on gas nearly doubled, and nearly tripled on electricity.

ACTU Secretary, Sally McManus, said the inquiry will take public submissions, as well as submissions by experts and organisations concerned with the potential impacts of price gouging.

“It’s only right we take a look to see

Report a rip-off!

Share your story of corporate price gouging at: https://reportaripoff. australianunions.org.au/

UNITED STATES

From show business to no business

Screenwriters and actors have taken on the Hollywood corporations in a fight that has ramifications beyond tinsel town.

The 160,000 members of SAG-AFTRA, Hollywood’s largest union, authorised a strike in July.

The Writers Guild of America (WGA) has been on strike since early May. It is the first time unions representing both US writers and actors have been on strike at the same time since 1960.

The writers and actors are calling for higher wages and improved compensation in the streaming TV era, and safeguards around the use of artificial intelligence (AI).

Performers see their jobs as especially vulnerable to new technology, with generative AI able to replicate facial expressions, body movement and voice with alarming accuracy.

Although series budgets are increasing, that increase is not being reflected in the share of the money coming to performers. Residuals (payments for the re-use of their work) are also much smaller on streamers compared to broadcast TV rates.

While writers and actors have been reduced to gig workers on low wages and in insecure work, Hollywood executives have been earning a fortune.

Eight Hollywood CEOs made nearly $800 million, while pay for TV writers has fallen by 23 per cent over the last decade, according to Bernie Sanders.

“Organised labour has been under attack for quite some time, and our negotiations set a tone for what a worker will tolerate from a corporation,” said Brigitte Muñoz-Liebowitz, a TV writer for HBO Max.

We’re setting an example for what American workers should tolerate.’

—TV writer Brigitte Muñoz-Liebowitz

AUSTRALIA

Nurses mark Vietnam war anniversary

Australians who worked as civilian nurses in wartime Vietnam were in Canberra in August for a commemoration to mark the 50th anniversary of the end of Australia's involvement in the Vietnam War.

In 1967, 26-year-old nurse Dorothy “Dot” Angell joined other staff from The Alfred Hospital in Melbourne in signing up to work in south Vietnam.

Under contract to the Australian Government, the team was sent to work at a civilian hospital.

“I think we thought we were going to another Alfred hospital, with all the facilities, all the equipment, et cetera,” Dot told the ABC’s 7.30 program.

“And what we found were the hospital conditions in a rural area, so we had wards that had dirt floors ... We were short of everything.”

Dot’s patients included children who had lost limbs to land mines, or had been burnt with napalm dropped by US aircraft.

After four frantic months, Dot’s team flew home to Australia. But the transition home was difficult.

“She was startled by loud noises and flew into inexplicable rages. It took her four years to realise she was suffering from post-traumatic stress,” the ABC reported.

Dot and other civilian medical staff suffered similar health problems to the returned service personnel, but were denied the same level of subsidised health care because they were not deployed as part of the military.

It took decades of lobbying for the civilian nurses to finally be given access to the Veterans Gold Card in 2020.

Five factors hold back women in retirement

New research by Aware Super has found Australia’s national gender pay gap of 13 per cent will equate to a $93,000 deficit in the superannuation balances of women when compared to Australian men at retirement.

The report identifies five factors that work against women in the education years, during career selection, with regards to pay equity in the workplace and promotion, with development opportunities for women throughout their careers, and due to a greater burden in domestic caring responsibilities.

Aware CEO Deanne Stewart said the fund’s Hold the Door report would help Australian women, their partners and their employers to understand the gender retirement gap is a direct consequence of the five closed doors experienced by women over the decades of their working lives.

“Equal pay for women and men has been a legal requirement in Australia since 1969. In reality though, as Hold the Door shows us, the persistent gender pay gap –and subsequent gap at retirement, is as much about how we educate our young people, how we help teenagers plan for their future careers, and how we support employees with caring responsibilities, as it is about rates of pay,” she said.

‘We had wards that had dirt floors. We were short of everything.’

— Dorothy “Dot” Angell

Welcome to

The new online CPD portal

Access to online CPD

FREE for NSWNMA members and student members

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

FEATURING

FREE access to over 200 CPD modules online

Highly visual and interactive modules you can do at your own pace

New modules added regularly

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

for NSWNMA members LOGGING ON

nswnma.info/ilearn

MEMBERS

users create a ONE-TIME login to Member Central

receive access to hundreds of FREE CPD hours

CROSSWORD test your Knowledge

ACROSS

The highest court in a state (5.7.5)

10. The chief protein occurring in the white of egg (9)

11. Either of two large superficial veins of the legs (7)

12. Glucose utilisation index (1.1.1)

13. Not high (3)

14. Legs (5)

15. A brief sleep (3)

16. Sharpened (5)

17. Persons connected by blood or marriage (9)

18. A gland that secretes sebum for lubricating hair and skin (9.8)

23. Intramuscular (1.1)

24. Symbol for kinematic viscosity (2)

25. A trough use in mining (3)

26. Perception of sudden and transient bright spots of light in the absence of

light stimuli (7)

27. Tibial (7)

29. Vengeance, payback (7)

31. Incisive bone (12)

32. Positive electrodes (6)

33. An epidemic infectious disease caused by several different viruses (12.5)

DOWN

1. Dyspnea (9.2.6)

2. Morbid fear of small skin parasites, small particles, often resulting in preoccupation with itching (11)

3. Unborn, in utero (9)

4. Unpleasing tune (11)

5. Tineas (9)

6. A notation representing the pitch and duration of a musical sound (7.4)

7. Imitator (7)

8. Admitting of no doubt or misunderstanding; clear and unambiguous (11)

9. Cooley's anaemia (12.5)

19. Capital of The Netherlands (9)

20. A device that supplies electrical energy (9)

21. A vascular channel that transports lymph (9)

22. A garland of flowers worn around the neck (3)

27. The gray matter of the brain and other parts of the nervous system (7)

28. The pinna, or external ear (7)

30. A nursing qualification (1.1)

The NSWNMA is committed to protecting the interests of nurses and midwives by purchasing a range of insurances to cover members.

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

Professional Indemnity Insurance* provides legal representation and protection for members when required.

Make sure your membership remains financial at all times in order to access the insurance and other benefits provided by the NSWNMA.

Looking for funding to further your studies in 2024?

The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships. Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT.

You must currently be registered with the Nursing and Midwifery Board of Australia and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last 12 months of which must have been spent in NSW or the ACT.

Details of eligibility and the scholarships available (which include study projects either within Australia or overseas), and application forms are available from: www.nswnma.asn.au/education

Administration Liaison, Lions Nurses’ Scholarship Foundation 50 O’Dea Avenue Waterloo NSW 2017 or contact Matt West on 1300 367 962 or education@nswnma.asn.au

The challenges of shiftwork were a key theme underpinning a number of resolutions brought to our recent Annual Conference. And for good reason too. This month, nursing research online looks at the latest evidence regarding the impact of shiftwork on nurses’ health and wellbeing.

Systematic review of shiftwork and nurses’ health

D Rosa, S Terzoni, F Dellafiore, A Destrebecq, Occupational Medicine, Volume 69, Issue 4, June 2019, Pages 237–243

Shiftwork and night-time work involve a greater risk of cardiovascular and metabolic diseases compared to daytime work, due to desynchronisation of circadian rhythms.

Therefore, it represents a negative risk factor for workers’ health, because natural defences of the human body are reduced overnight. It is necessary to consider that a reduction in attention levels and vigilance at night-time, combined with sleep deprivation and a sense of tiredness, reduce work efficiency and increase the likelihood of errors and injuries.

Nurses are one of the most studied populations in terms of shiftwork. Shiftwork encompasses a number of risks for nursing staff, leading to psychological and physiological problems, increased risk of errors and decreased quality of work. Many studies have investigated both psychological and physiological problems caused by shiftwork, but results are often fragmented.

The aim of this study is to describe and critically analyse the effects of shiftwork and desynchronisation of circadian rhythms on nurses’ health.

https://doi.org/10.1093/occmed/ kqz063

Fatigue in new registered nurses: A 12-month cross-lagged analysis of its association with work motivation, engagement, sickness absence, and turnover intention

Stephanie Austen et al,

Journal of Nursing Management

28(3) January 2020

In Canada, as in many countries, a continuing priority for health organisations is the recruitment of motivated and competent nurses. However, nurse retention is a problem, as 17.5 per cent of new registered nurses quit their first job within one year of starting work and between 33 to 62 per cent will change position or leave the occupation within five years of employment. A longstanding question for researchers, health managers and practitioners is, why do some new nurses stay in their position while others leave?

Fatigue reflects an overwhelming sense of tiredness attributable to physical and psychological demands, which can be alleviated by rest periods during and following work shifts. Nurses traditionally work 8-hour shifts, but in many countries they work longer shifts lasting 12 hours or more.

Shiftworking, long hours, unplanned overtime and inadequate breaks to rest and recuperate between work periods are some examples of factors that can exacerbate the fatigue experience of nurses during and following work. If not relieved, fatigue may result in detrimental consequences including lower work engagement, higher sickness absence, and turnover intention. In a context of shortage, it is important to examine how fatigue can impact the career of new nurses.

https://doi.org/10.1111/jonm.12962

Work-schedule characteristics and fatigue among rotating-shift nurses in a hospital setting: An integrative review

Ari Min et al,

Journal of Nursing Management 27(5) February 2019

Approximately a fifth of the worldwide workforce is involved in shiftwork. As in some other occupations (e.g. police, military), shiftwork in many healthcare settings is necessary and imperative to ensure continuity of care.

In nursing, typical working hours (i.e. 9 a.m. to 5 p.m., Monday to Friday) are uncommon, and 24-hour coverage is crucial to ensure patient safety and continuity of care. The common characteristics of shiftwork in nursing are rotating work hours, long work hours (more than 13 hours per day or 40 hours per week), consecutive workdays with insufficient rest between shifts, and mandatory overtime.

Nursing work is both physically and mentally laborious. Performance decline is reported during the last hours of work shifts. In addition, for nurses who experience rotating work schedules, long work hours, and circadian rhythm adjustments to night shifts, fatigue becomes unavoidable and carrying out optimal nursing tasks is a challenge.

The Institute of Medicine (IOM), Joint Commission International (JCI) and many professional nursing organisations have emphasised the importance of reducing work-related fatigue among nurses as a priority issue. For example, several states began regulating nurses’ mandatory overtime and shift lengths, with limited resting time between shifts introduced in 2002, and the ANA supported the state legislation for these regulations. However, nurses continue to report moderate to high levels of fatigue.

https://doi.org/10.1111/jonm.12756

health+wellbeing

Navigating the grief of loss and change

All of us will experience grief and loss at some point in our life. Grief is a highly individual experience, and it comes with no rule book.

Living with loss – something we all go through

All of us will experience grief and loss at some point in our life. Feelings that accompany grief are often painful and confusing. Grief and loss are most often assumed to be related to the death of someone we care about, but we also need to talk about a different type of loss: “Living loss”.

Living loss is a type of grief we experience in the aftermath of losing something significant in our life. It can be equally difficult as grieving a death.

Because these losses may not be as obvious to those around us, support might not be offered as readily as if we lost a loved one to death. The

experience can turn into what is known as “disenfranchised grief”, compounding our feelings of loss.

TYPES OF LOSS

The types of living loss you might experience can be broken into four broad categories:

• Relationships

• Health

• Finances

• Professional

Sometimes, these losses can be so paralysing they upturn our lives, leaving us questioning our sense of self and who we are in the world. Many of you may have experienced a living loss as a result of changes that occurred through the pandemic. The lives of nurses

and midwives were altered in unpredictable and frightening ways.

The effects of grief and loss

It is important to know that grief is a healthy and normal response to significant change or important loss. Grief is different for everyone and can change over time. Grief can have a profound impact on your life and impact you physically, emotionally, spiritually, mentally, and behaviourally.

Reactions to grief are many and varied. Common reactions to grief include:

• anxiety

• shock

• panic

• anger

• change in values and beliefs

• loneliness

• helplessness

• guilt

• sleep disturbances

• changes to focus and concentration and

• changes to appetite.

Grieving is a painful and challenging process. How it presents depends on many factors, such as your personality, coping style, and the type of loss.

The grief-and-loss cycle

The cycle of grief is messy and nonlinear and doesn’t always occur in order. Exploring the stages of grief and loss can help you understand and contextualise where you are in your grieving process and the emotions you feel.

SHOCK

Shock can be intense and sometimes paralysing. You may feel numb and detached from your feelings.

DENIAL:

Disbelief it has occurred. You may feel unable to face the truth.

ANGER AND FRUSTRATION

Anger that the loss occurred may be directed inward at yourself, the world, or other people.

DEPRESSION

Feelings of fatigue and extremely low energy and motivation, sometimes coupled with feelings of intense sadness, negativity or emptiness.

TESTING

Figuring out what the new situation means for your life through experimentation with finding ways to help facilitate the change.

ACCEPTANCE

This doesn’t mean being okay with what happened, but is an acceptance of the new reality.

INTEGRATION

Finding a new way of being in the world, such as a reorganisation of roles and forming new relationships.

There is no set time for how long the process of grieving will or should last. It is normal to cycle through the different phases of grief.

Coping with grief and loss

Although grief can feel neverending and debilitating for some, you can find strength and mobilise resources to heal. Over time, it’s possible to live with grief and cope with its effects. Engaging in selfcare practices, reaching out for support, practising self-compassion and finding new ways to manage at work can help you to cope better with grief and loss.

Adopting self-care practices

We have an incredible ability to help ourselves. By taking especially good care of ourselves, we can learn strategies to cope with our difficult emotions. Focusing on simple approaches can be most supportive in a period of grief and loss. Good nutrition, sleep, a regular exercise routine and proper rest can go a long way in healing from grief. Especially in challenging times, these essential practices become even more important.

Useful strategies for dealing with grief are:

• journaling

• playing or listening to music

• expressing or creating something

• being in nature

• seeking guidance.

Managing your grief at work

It can feel overwhelming to try to maintain a busy job as a nurse or midwife while also grieving a loss. You may have low motivation, find it hard to concentrate, feel distracted or anxious, or have difficulty attending to tasks the way you did before. However, some people find that being at work can be an effective way to bring stability and structure to their lives.

Communicating to others about how you are feeling can help you to get support. Speak to your manager, let them know what’s happening for you and make a plan together for how they can best support you. It might be that you need extra time off, to temporarily reduce your hours, or modify your duties. If you’re not sure how to start this conversation, give Nurse and Midwife Support a call on 1800 667 877 or by email: www.nmsupport. org.au/support and we’ll help you plan what you want to say.

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

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