The Lamp September 2016

lamp THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 73 No.8 SEPTEMBER 2016

PATIENT AND WORK SAFETY: EVERYONE’S RESPONSIBLE BETTER OFF DEAD Print Post Approved: PP100007890

LIVING BEYOND DEMENTIA

WHEN ALCOHOL ISN’T FUN

COVER STORY

We do everything as if you are here You work hard caring for others; we work hard to care for you.

Your needs, your goals, your future.

You wouldn’t have it any other way. Neither would we.

Winner.

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firststatesuper.com.au | 1300 650 873 Consider 2 | T Hour E Lproduct A M P S disclosure E P T E M B Estatement R 2 0 1 6 before making a decision about First State Super. Call us or visit our website for a copy. FSS Trustee Corporation ABN 11 118 202 672 ASFL 293340 is the trustee of the First State Superannuation Scheme ABN 53 226 460 365.

CONTENTS

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

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

VOLUME 73 No.8 SEPTEMBER 2016

Hunter Office 8-14 Telford Street, Newcastle East NSW 2300

COVER STORY

12 | Our issues are recognised because we fight for them

Natalie Ellis RN and Stephanie Cummings RN PHOTOGRAPH: SHARON HICKEY

REGULARS 5 6 8 35 39 41 43 45 47 50

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

COVER STORY

16 | Healthcare’s perfect storm Health Minister Jillian Skinner thanked nurses for their contribution to the public health system, touched on the issue of violence in hospitals and said she did not think the demands on our health system would be met “by simply raising the budget”.

Health issues were critical in the federal election due in no small part to our campaigning capacity and the willingness of our members to defend their professions and the public health system, General Secretary Brett Holmes told the 71st NSWNMA annual conference.

COVER STORY

14 | We’re part of a bigger movement Our participation in the global union movement is valuable because many of the issues we all face daily have their genesis in global trends, says Judith Kiejda.

PROFESSIONAL DAY

22 | When you’re better off dead Andrew Denton watched his father endure a drawn-out and painful death. Now he wants nurses to support his quest to legalise assisted dying.

IN A TWO-NIGHT LUXURY GETAWAY AT COMPETITION

6 | Win a luxury 2 night getaway in the Blue Mountains

PROFESSIONAL DAY

24 | Living beyond dementia Kate Swaffer’s nursing career ended when she was diagnosed with dementia at 49. Now she is an internationally– regarded advocate for the right of people with dementia to remain engaged with their pre-diagnosis lives.

NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962 For all editorial enquiries letters and diary dates T 8595 1234 E lamp@nswnma.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017 Produced by Hester Communications T 9568 3148 Press Releases Send your press releases to: F 9662 1414 E gensec@nswnma.asn.au Editorial Committee • Brett Holmes, NSWNMA General Secretary • Judith Kiejda, NSWNMA Assistant General Secretary • Coral Levett, NSWNMA President • Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital • Michelle Cashman, Long Jetty Continuing Care • Richard Noort, Justice Health Advertising Danielle Nicholson T 8595 2139 or 0429 269 750 F 9662 1414 E dnicholson@nswnma.asn.au Information and Records Management Centre To find archived articles from The Lamp, or to borrow from the NSWNMA nursing and health collection, contact: Jeannette Bromfield, Coordinator T 8595 2175 E gensec@nswnma.asn.au The Lamp ISSN: 0047-3936 General disclaimer The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Privacy Privacy statement: The NSWNMA collects personal information from members in order to perform our role of representing their industrial and professional interests.

We place great emphasis on maintaining and enhancing the privacy and security of your personal information.

Personal information is protected under law and can only be released to someone else where the law requires or where you give permission. If you have concerns about your personal information please contact the NSWNMA office. If you are still not satisfied that your privacy is being maintained you can contact the Privacy Commission.

Subscriptions for 2016 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $30.

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

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Average Net Distribution per issue. The Lamp is independently under the AMAA's CAB Total Distribution Audit.

Yearly Audit for the period: 01/04/2015 - 31/03/2016

THE LAMP SEPTEMBER 2016 | 3

what’s ON

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EDUCATION@NSWNMA

ARE YOU MEETING YOUR CPD REQUIREMENTS? – ½ Day An essential ½ day workshop for all nurses and midwives to learn about CPD requirements and what’s involved in the process. n Wednesday 7 September, Coffs Harbour Members $40 | Non-members $85

LEGAL AND PROFESSIONAL ISSUES FOR NURSES AND MIDWIVES – ½ Day

Aged Care Nurses’ Forum

Learn about potential liability, disciplinary tribunals, NMC and HCCC complaints, Coroners Court and more. n Thursday 8 September, Coffs Harbour n Thursday 24 November, Gymea Members $40 | Non-members $85

Friday 14 octobEr

MENTAL HEALTH AND DRUG & ALCOHOL NURSES’ FORUM – 1 Day

For RN’s, EN’s and AIN’s in residential, community and hospital aged care settings, across private and public sectors. Hear from a range of speakers and network with colleagues from residential, community and hospital aged care settings, across private and public sectors.

Hear from a range of interesting and informative speakers relevant to MHD&A nursing, network with colleagues and share experiences across the mental health and drug and alcohol arena. n Friday 9 September, Waterloo Members $30 | Non-members $50

Program:

MANAGING OVERTHINKING – 1 Day

Care of Bariatric Patients in Aged Care / Work, Health & Safety

n Monday 19 September, Parramatta Members $85 | Non-members $170

Perspectives of Culture Workshop Partners in Culturally Appropriate Care NSW and ACT

FOOT CARE FOR NURSES – 2 Days

Practical, Positive Tools in Getting People on Side

For RNs, ENs and AINs n Tuesday 20 & Wednesday 21 September, Tamworth Members $203 | Non-members $350

Leaders in Leading

Resolve, Protect, Improve Aged Care Complaints Commission (ACCC)

nswnma 50 o’dEa avEnuE watErloo 9am to 4pm Members $30 Non-Members $50 Lunch and refreshments provided

!

Register online

Attendance at Education@NSWNMA sessions may count towards Continuing Professional Development (CPD) hours

www.nswnma.asn.au/Education/

For enquiries call 8595 1234 (meTro) 1300 367 962 (rurAL) 4 | THE LAMP SEPTEMBER 2016

AGED CARE NURSES’ FORUM – 1 Day For RNs, ENs and AINs in residential, community and hospital aged care settings, across private and public sectors. Hear from a range of interesting and informative speakers relevant to aged care nursing and network with colleagues. n Friday 14 October, Waterloo Members $30 / Non-members $50

POLICY AND GUIDELINE WRITING FOR NURSES AND MIDWIVES – 1 Day n Thursday 24 November, Waterloo Members $85 / Non-members $170

Register online

WWW.NSWNMA.ASN.AU/ EDUCATION/ EDUCATION-CALENDAR

For enquiries contact NSWNMA Metro: 8595 1234 Rural: 1300 367 962

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

The state government needs to listen to the community The public clearly told our politicians during the federal election that they want the integrity of Medicare and the public health system to be maintained. It’s not clear that all politicians listened.

The NSWNMA’s 71st annual conference came only a few weeks after the federal election. It was an opportune moment to reflect on our work as a union over the past year and to look at the challenges going forward (see pp 12-21).

Medicare and health were the top issues that resonated with voters during the election and Prime Minister Malcolm Turnbull admitted that he underestimated the public’s concerns on health.

The NSWNMA has over many years warned about the creeping privatisation of our health system – and it often seemed like we were a lone voice in the wilderness doing so – but the passing of time and the actions of governments at both the state and federal levels have vindicated our claims.

The public clearly recognises the threat of privatisation to Medicare and public health and what that would mean to them in terms of health outcomes and the impact on the cost of living.

Governments have been disingenuous about the privatisation of health. They know it isn’t popular and they usually do it by stealth.

We need to be clear - privatisation is not simply defined by a government selling something to the private sector. It can be a longer, subtle process of shifting from universal ownership to individual responsibility with higher user pays charges set by the private sector.

Our annual conference gave us a chance to find out whether the Baird government had taken on board the lessons of the federal election campaign and the public’s concerns about health.

Apparently it hasn’t. In her address to conference the NSW Health Minister Jillian Skinner made it clear we can expect more privatisations of public hospitals with Maitland likely to be the next cab off the rank following the Northern Beaches Hospital.

The Baird government should take note that we will continue to fight for patient safety right up to the next state election and that we have the community on our side.

The Minister was also dismissive of the need for RNs in aged care facilities. She claims that there is no evidence that nursing home residents are better off or worse off without the requirement for an RN to be present in a nursing home.

We beg to differ and conference delegates made it very clear to the minister what they thought of her position.

There is a shortfall in the provision of expert care in aged care right across the country. We are concerned about the cost shifting that will occur from aged care into the public health system.

A review of the Poisons Act is now expected in 2017, we have grave concerns that the aged care industry will lobby the NSW Government to further water down the requirements for Registered and Enrolled Nurses to be involved in the administration of medication. We will continue to advocate strongly for resident safety.

At the conference I urged the Minister and her government to review their wages policy and reconstruct their thinking about how it negotiates with its workforce.

I pointed out to her that we want to progress nursing hours per patient day or ratios beyond where they’re currently stalled by the government’s wages

policy. The battle continues around enforceability of nursing hours per patient day. The view that they are maximums, not minimums will continue to be an issue for us.

Over the last year we have campaigned strongly on many issues and in doing so have shown our capacity and commitment to stand up for our professions, the public health system and aged care.

The Baird government should take note that we will continue to fight for patient safety right up to the next state election and that we have the community on our side.

NEW ROLE FOR THE AUSTRALIAN NURSING AND MIDWIFERY FEDERATION NSW BRANCH (ANMF NSW BRANCH) As a result of changes made in the Work Choices Federal Legislation (now the Fair Work Act), NSWNMA staff who require a Right of Entry to Federal workplaces will become employees of the ANMF NSW Branch. ANMF NSW Branch will become the Federally Registered Union that will be the sole bargaining agent for nurses and midwives in all enterprise agreements in the Private and Aged Care Sectors. ANMF NSW Branch is also now registered under the NSW Industrial Relations Legislation.

All members of the NSWNMA are also members of the ANMF NSW Branch and will not experience any change in their membership or services but will see a higher visibility of the name of ANMF NSW in their workplaces. As Branch Secretary of the ANMF NSW I will be making sure that the harmonious relationship between the two unions continues as it has for the last three decades.

THE LAMP SEPTEMBER 2016 | 5

COVER STORY

YOUR LETTERS

WIN A TWO-NIGHT LUXURY GETAWAY AT LE TTE R OF THE MONTH

Professional day inspires

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WIN! The Lamp is offering NSWNMA members the chance to win two night’s luxury accommodation (Sunday to Thursday) in your own private Bush Suite along with breakfast, lunch and dinner daily valued at $1,898.

To enter, simply provide your name, address and membership number and email your entry with the subject: Spicers Sangoma Retreat to lamp@nswnma.asn.au *Conditions apply. Rooms subject to availability. Prize must be redeemed by 31 March 2017 and is valid for stays Sunday to Thursday nights (not valid during NSW School Holidays or Public Holidays).

Beverages are not included in the prize. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 September 2016 and closes 30 September 2016. The prize is drawn on 1 October 2016. If a redraw is required for an unclaimed prize it must be held up to 3 6 | the T Horiginal E L Adraw M Pdate.

S ENSW P T EPermit M B Eno: R LTPM/16/00329 2016 months from

Once again I have been incredibly impressed by the quality of the NSWNMA Professional Day speakers.

Of particular note was Kate Swaffer.

Her talk was both moving and inspiring, as she spoke of her own experience, putting a face and voice to the enormous challenges facing people as they ‘live beyond dementia’ and ways in which we can support them - often just by the language we use.

Andrew Denton with his talk ‘Better Off Dead’ also delivered an incredibly important message, calling on nurses to support the voluntary euthanasia movement and stating his belief that it is only through our support that legislation allowing this human right will become a reality. His detailed and thorough investigation of the guidelines, process and safeguards instituted by other countries that allow voluntary euthanasia was reassuring and enlightening.

In the past 12 months I have held the hand of both my mother and a very dear friend as they passed from this life. Both had excellent palliative care but both had come to a point where death was a welcome relief and given the choice, they would have embraced it sooner.

As nurses, many of us have borne witness to the unbearable suffering the dying process can engender, regardless of our level of care.

I hope Andrew’s session will encourage discussion, debate and ultimately support for an individual’s right to choose to die, especially when being alive, is no longer living.

Jane Cooper RN, Corrimal

Marriage equality plebiscite is relevant to our care I had the great pleasure of moving the motion at annual conference asking delegates to allow our Association to help support the ‘yes’ vote for the marriage equality plebiscite. There was a resounding YES from the delegates, which filled my heart with pride. There seemed to be an understanding that we are advocates for all our patients and have a need to stand up for them when they are faced with inequalities.

Earlier this year Elise was knocked down outside her daughter’s childcare centre, Lara received the call to say her partner was in the ED. Lara and Elise were in a relationship for 10 years and had two children together. I don’t think the politics behind their love was important to them back then, I don’t think they realised a piece of paper would affect their experience at a tragic time.

24 hours after the call, life support was turned off, a wife left to mourn and also left with a mountain of paperwork that denied her rights and her status. This is not a fair system. I don’t want to work in a system that makes tragic life events harder for my patients. I don’t think a death certificate should only recognise a husband and wife. I don’t think a mother should have to fight for her rights as a parent just because she was not the birth mother. It is for these reasons I will be standing up to support the ‘YES’ vote if a marriage equality plebiscite is called.

However I am amazed speaking to many people I know who won’t be working on the campaign as they are fearful of retaliation,

YOUR LETTERS

bullying and smear mongering from the ‘other side’. I never thought twice about standing up for this as I believe it is the right thing to do. If we get a plebiscite I think it important we do our part, as this is an issue that affects our patients and our community.

I would ask that other members help with this campaign and also turn up to vote on the day. Why? To help advocate for justice and equality for all our patients and because as Lara says:”Love is love and that should be enough, life is hard enough”.

O’Bray Smith RN MUM, Belmore Medical cannabis and epilepsy As a Clinical Nurse Consultant at Epilepsy Action Australia, working with individuals and families living with epilepsy who want to or currently utilise medicinal cannabis products to manage their or their child’s epilepsy, I sought to learn about medicinal cannabis to better meet their needs. This led me to San Francisco to attend a Virginia Nursing Board accredited Cannabis Nurse Training Program and a scientific medical cannabis conference.

Epilepsy Action Australia has taken a proactive role in advocating for safe, legal and affordable access to medicinal cannabis-based products in Australia. As a national non-profit organisation we are working to improve understanding of and response to epilepsy in the community; increase the knowledge and skills of people supporting those with epilepsy; and enhance individual and family capacity to self-manage their epilepsy through access to specialised epilepsy courses, resources and a team of Epilepsy Nurse Educators.

Scientific and media interest in medicinal cannabis has grown exponentially over the last five years, directly attributed to those pioneer researchers and families who have shared their experiences, advocated for legal safe access and the re-introduction of cannabis-based therapies for the treatment of epilepsy and other health conditions. Although there are many conventional treatment options and anti-epileptic drugs (AED) on the market, approximately a third of people with epilepsy are either unable to tolerate the adverse effects of AED or have intractable epilepsy that is resistant to conventional medications.

Reports of children with medication-resistant epilepsy achieving seizure freedom or meeting developmental milestones never thought possible have saturated social media channels, fanning the interest of scientists, doctors and others living with epilepsy.

Public opinion and consumer demand for medicinal cannabis

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have rapidly outpaced legislative, scientific and medical developments and it is with this in mind that researchers and politicians have been racing to address this treatment gap.

As a nurse and consumer advocate, it has been of great interest that Epilepsy Action Australia has actively sought to understand and represent consumers in the research and clinical trial sectors, engaging with stakeholders and consumers to gauge the changing tide of opinion and willingness to participate in trials and contribute to the body of knowledge of consumer wants and needs. A recent community survey conducted by Epilepsy Action and analysed by the Lambert Initiative researchers at Sydney University indicated that 66% of participants (n649) were willing to participate in medicinal cannabis trials with 68% of parent/guardian respondents (n367) indicating they were ‘willing to try anything’ in a bid to ease their child’s seizures. To further understand these and other findings, the Lambert Initiative has launched the PELICAN study, which involves interviewing NSW parents of children aged 0-16 years with epilepsy to better understand how medicinal cannabis products are being used to treat childhood epilepsy.

Recent regulatory changes mean NSW doctors can now legally prescribe cannabis-based medicines to support patient submissions to the Commonwealth Therapeutic Goods Administration (TGA) Special Access Scheme (SAS) for unapproved cannabisbased medicines. It is important to note that applications for artisan cannabis-based products have been declined. The first Australian family to go through TGA SAS process for cannabisbased medicines, in Queensland, are eagerly awaiting the arrival of cannabis-based medicines to treat their son’s epilepsy and brain tumour after an 11-month process.

The NSW government recently launched the compassionate access program to a pharmaceutical-grade cannabidiol (CBD) product, Epidiolex, for 40 NSW children with intractable epilepsy. Premier Baird stated that the government aims to expand these numbers in the near future. Initially announced in 2015, the Sydney Children’s Hospital Randwick cannabidivarin (CBDV) trials will focus on a small number of children with severe epilepsy. No doubt selection will be difficult as requests for inclusion in the trial will outnumber positions available.

There are adult studies proposed, however news of these studies will be released closer to the time of recruitment.

I believe nurses will drive patient education and implore all nurses to learn about the endocannabinoid system and the medicinal uses of cannabis.

Lisa Todd CNC, West Pennant Hills

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

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

Letters may be edited for clarity and space. Anonymous letters will not be published.

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THE LAMP SEPTEMBER 2016 | 7

NEWS IN BRIEF

Britain

British wages fall 10% since GFC

annual conference

Patient & work safety: everyone’s responsible

NSW Nurses and Midwives’ Association gratefully acknowledges the sponsorship provided by the following companies for our Annual Conference held at Rosehill Gardens, 20 – 22 July 2016 First State Super Teachers Health Fund HESTA Super Fund ME Bank Mercure Hotel Sydney Chifley Financial Services Pty Ltd Commonwealth Bank Fuji Xerox Australia Pty Ltd Hester Communications Offset Alpine Printing Phil Gilbert Motor Group Scott and Broad/Clark Pacific Telstra The Association also thanks the following companies for their contribution and assistance Bexters Soda Crystals Cetaphil • DB Health • DU’IT Ferndale Mints • Hamilton Lindt & Sprungli

8 | THE LAMP SEPTEMBER 2016

A report by the Trade Union Congress shows that real earnings have declined by 10.4% since the Global Financial Crisis began in 2007, leaving Britain equal bottom in a league table of wages growth in OECD economies.

Using Organisation for Economic Cooperation and Development (OECD) data the TUC found that over the same 2007-2015 period, real wages grew in Poland by 23%, in Germany by 14%, and in France by 11%. Across the OECD, real wages increased by an average of 6.7%.

Real hourly wages in Britain were more than 25% below where they would have been if wage growth had continued at the rate observed during 2000-07.

Britain’s fall was equalled only by Greece in a list of 29 countries in the OECD. The TUC general secretary, Frances O’Grady told the Guardian that the figures highlighted the strains on household finances even before the vote for Brexit.

“Wages fell off the cliff after the financial crisis, and have barely begun to recover,” she said. “People cannot afford another hit to their pay packets. Working people must not foot the bill for a Brexit downturn in the way they did for the bankers’ crash.”

The TUC research is consistent with an analysis by the Bank of England’s chief economist, Andy Haldane.

He found that “the majority of UK households have faced a lost decade of income” and pointed out that half of all UK households have seen no material recovery in their real disposable incomes since around 2005.

“WAGES FELL OFF THE CLIFF AFTER THE FINANCIAL CRISIS, AND HAVE BARELY BEGUN TO RECOVER. WORKING PEOPLE MUST NOT FOOT THE BILL FOR A BREXIT DOWNTURN IN THE WAY THEY DID FOR THE BANKERS’ CRASH.”

NEWS IN BRIEF

Australia

Australia

High court challenge to Border Force gag

Health inequality high in poor areas

The group Doctors for Refugees is to launch a high court challenge to the Border Force Act and will argue the law prevents clinicians speaking out over child abuse and mistreatment of asylum seekers in detention centres.

The Border Force Act contains provisions that threaten detention centre staff with two years’ jail for disclosing information about conditions they observe in the centres. Clinicians risk criminal charges for reporting children at risk of physical or psychological harm.

“If doctors stand by and allow people [in detention centres] to walk through raw sewage, just to get to the meal area, they’re failing their patients and their profession,” Dr Barri Phatarfod, the group’s convenor told the Sydney Morning Herald.

“If doctors and nurses remain silent about women and young children having showers in view of male guards, they’re not fulfilling their professional responsibilities.”

Dr Phatarfod said clinicians were being “forced into silence about serious issues they witness”.

She said that clinicians often say things like ‘I don’t want to end up in court for months and months’ or ‘I’ve got a young family and I’ve got concerns about going public’.

The Fitzroy Legal Service will prosecute the High Court challenge. A lawyer from the service Meghan Fitzgerald said the case would “determine whether doctors and nurses are allowed to advocate in the interests of their patients”.

“THE CASE WILL DETERMINE WHETHER DOCTORS AND NURSES ARE ALLOWED TO ADVOCATE IN THE INTERESTS OF THEIR PATIENTS.” World

Chinese breakthrough on climate change Economists have hailed a downturn in Chinese coal consumption as a milestone in the fight against climate change.

The global battle against climate change has passed a historic turning point with China’s huge coal burning finally having peaked, reports the Guardian.

China’s coal consumption peaked in 2014 and has since then been in decline.

The economists argue in a new report (published in National Geoscience journal) that this can now be seen as a permanent trend, not a blip, due to major shifts in the Chinese economy and a crackdown on pollution.

“I think it is a real turning point,” said Lord Nicholas Stern, an eminent climate economist at the London School of Economics who co-authored the report.

“I think historians really will see [the coal peak of] 2014 as a very important event in the history of the climate and economy of the world.”

The UN’s climate chief, Patricia Espinosa, welcomed the analysis.

“It underlines how ambitious and deliberate policies to shift away from highly polluting fuels to cleaner energy sources can deliver global climate benefits and national improvements in health and indeed in people’s lives,” she said.

Chinese coal production fell 9.7% in the first half of 2016 compared to 2015. The previous year had seen a 5.8% decline. Coal burning fell 3.7% in 2015.

Stern said there are a series of deep and long-term transformations taking place in China, which means the nation’s falling coal use is now a permanent trend. One is the falling rate of economic growth from 9-10% to about 6% and the transformation of the Chinese economy away from heavy industry and towards more hi-tech and service sectors, which are much less dependent on energy. There is also a serious focus on improving energy efficiency.

“It underlines how ambitious and deliberate policies to shift away from highly polluting fuels to cleaner energy sources can deliver global climate benefits and national improvements in health and indeed in people’s lives.”

Where you live has a major impact on your chances of being admitted to hospital for preventable illnesses, a Grattan Institute report has found.

The report – The Perils of Place: Identifying Hotspots of Health Inequalities – found 38 communities in Queensland and 25 in Victoria had hospital admission rates 50% higher than the average for those states.

The report found that hotspots tended to be more remote, have populations of lower socioeconomic status and have a higher proportion of Indigenous people.

In both Queensland and Victoria, low socioeconomic status areas were two and a half times more likely to be persistent hotspots than all areas, on average, and about 10 times more likely than high socioeconomic status areas.

The report proposed health inequalities be addressed by trying preventive interventions in high priority areas, monitoring results and then rolling out solutions and funding nationally.

The report estimated that if preventable admissions in hotspots were reduced to average levels in the two states studied, direct savings would be at least $10m or $15m a year.

“Indirect savings should be significantly larger,” it said. “Government and primary health networks must ensure that all communities get a fair go.

“Improving the health of people in these priority places will, in the longrun, improve wellbeing and opportunity, social cohesion and inclusion, workforce participation and productivity, and reduce health system costs.”

“HEALTH INEQUALITY HOTSPOTS TENDED TO BE MORE REMOTE, HAVE POPULATIONS OF LOWER SOCIOECONOMIC STATUS AND HAVE A HIGHER PROPORTION OF INDIGENOUS PEOPLE.” THE LAMP SEPTEMBER 2016 | 9

NEWS COVERINSTORY BRIEF

Australia

Stop privatising says ACCC chief

Britain

Hidden gene risks skin cancer It’s not just pale redheads who need to be careful in the sun.

People can carry a hidden red hair gene that raises their risk of sun-related skin cancer, according to new research reported by BBC News (July).

Around 25% of UK adults have one version of the gene called MC1R which increases their risk of malignant melanoma.

A new study found that patients who had at least one copy of a genetic variant of MC1R had 42% more sun-associated mutations in their cancers than individuals without these variations. This was equivalent to the impact of an additional 21 years in the sun.

The researchers say that people with two copies of the gene will have ginger hair, freckles and pale skin and probably know to take extra care in the sun. Those with one copy may not realise they are at risk.

The researchers looked at more than 400 tumour samples from patients who had been diagnosed with melanoma.

Lead researcher Dr David Adams, from the Wellcome Trust Sanger Institute, said the findings reinforced the message that people need to be sun aware.

“All people, not just pale redheads, should be careful in the sun.

“It has been known for a while that a person with red hair has an increased likelihood of developing skin cancer, but this is the first time that the gene has been proven to be associated with skin cancers with more mutations.

“Unexpectedly, we also showed that people with only a single copy of the gene variant still have a much higher number of tumour mutations than the rest of the population.”

“PEOPLE WITH TWO COPIES OF THE GENE WILL HAVE GINGER HAIR, FRECKLES AND PALE SKIN AND PROBABLY KNOW TO TAKE EXTRA CARE IN THE SUN. THOSE WITH ONE COPY MAY NOT REALISE THEY ARE AT RISK.” 10 | THE LAMP SEPTEMBER 2016

Privatisation has damaged the Australian economy says the chairman of the Australian Competition and Consumer Commission (ACCC).

In a startling admission the ACCC chief Rod Sims admitted he had reversed his thinking on the value of privatisation.

“I’ve been a very strong advocate of privatisation for probably 30 years,” he told the Melbourne Economic Forum.

“I’m now almost at the point of opposing privatisation because it’s been done to boost proceeds, it’s been done to boost asset sales and I think it’s severely damaging our economy.”

Sims said privatising ports were examples where monopolies had been created without suitable regulation to control how much they could then charge users.

The ACCC recently launched legal action against Medibank Private for concealing changes to health insurance policies to boost profits ahead of privatisation.

Billions of dollars have been wasted in the vocational education sector since it was opened up to the private sector and deregulating the electricity market and selling poles and wires in Queensland and NSW had seen power prices almost double there over five years, he said.

“When you meet people in the street and they say ‘I don’t want privatisation because it boosts prices’ and you dismiss them ... recent examples suggest they’re right.”

A drastic change in policy was necessary he said.

“I think a sharp uppercut is necessary and that’s why I’m saying: stop the privatisation,” he said.

PUBLIC SERVICES INTERNATIONAL, THE NSWNMA AND OTHER PUBLIC SECTOR UNIONS HAVE ORGANISED THE PEOPLE’S INQUIRY INTO PRIVATISATION. WE WANT TO HEAR YOUR VIEW ABOUT THE STATE OF AUSTRALIA’S VITAL PUBLIC SERVICES. GO TO www.peoplesinquiry.org.au and make a submission.

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NEWS IN BRIEF

Australia

Indigenous suicide rate “a national disgrace” Indigenous suicide rates in the Kimberley are seven times higher than for other Australians.

A report, published in the Medical Journal of Australia found that 102 of the 125 people who took their lives in the Kimberley between 2005 and 2014 identified as an Aboriginal or Torres Strait Islander.

That meant the age-adjusted Indigenous suicide rate in the Kimberley was 74 in every 100,000, more than three times the national Indigenous suicide rate of 21.4 in every 100,000 and seven times the national nonIndigenous suicide rate of 10.3 in every 100,000.

The clinical director of the Kimberley mental health and drug service, Dr Murray Chapman, told the Guardian the reasons for the high suicide rate were complex but there was an apparent “clustering” effect, where each suicide in Aboriginal communities increased the risk of more occurring.

“If you are in a community where you are constantly going to funerals of people who have died from suicide there is never any time to recover.

There is this constant build up of grief that just makes the situation worse.”

The National Aboriginal Community Controlled Health Care Organisation chairman Matthew Cook said the suicide figures were “a national disgrace”.

He said in any other country these statistics would be a cause of national shame and soul searching.

“It is time there was a full royal commission into failings in the system that are driving so many people in our communities to such levels of despair that suicide is the only answer,” he said.

“IF YOU ARE IN A COMMUNITY WHERE YOU ARE CONSTANTLY GOING TO ATTEND FUNERALS OF PEOPLE WHO HAVE DIED FROM SUICIDE THERE IS NEVER ANY TIME TO RECOVER. THERE IS THIS CONSTANT BUILD UP OF GRIEF THAT JUST MAKES THE SITUATION WORSE.”

Britain

Air pollution furrows the brow Air pollution is now rivaling sun damage as the primary cause of wrinkles and skin ageing say researchers.

Prof Jean Krutmann, director at the Leibniz Research Institute for Environmental Medicine in Germany, told the Guardian: “UV [damage from the sun] was really the topic in skin protection for the last 20-30 years. Now I think air pollution has the potential to keep us busy for the next few decades.”

“UV EXPOSURE, NUTRITION AND SMOKING CONTRIBUTE TO AGEING BUT AT LEAST FOR THE PIGMENT SPOTS ON THE CHEEKS, IT SEEMS AIR POLLUTION IS THE MAJOR DRIVER.” Air pollution in urban areas, much of which comes from traffic, includes tiny particles called PMs, nitrogen dioxide (NO2) and chemicals such as polycyclic aromatic hydrocarbons (PAHs).

“What is very clear is that PMs are a problem for skin,” said Krutmann.

He says NO2 also increases ageing: people in both Germany and China had age spots on their cheeks increase by 25% with a relatively small increase in pollution – 10 microgrammes of NO2 per cubic metre.

Krutmann said other factors, such as UV exposure, nutrition and smoking contribute to ageing: “But what we can say is that, at least for the pigment spots on the cheeks, it seems air pollution is the major driver.”

“It is not a problem that is limited to China or India – we have it in Paris, in London, wherever you have larger urban agglomerations you have it,” he said. “In Europe everywhere is so densely populated and the particles are being distributed by the wind, so it is very difficult to escape from the problem.”

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THE LAMP SEPTEMBER 2016 | 11

COVER STORY

Our issues are recognised because we fight for them Health issues were critical in the federal election due in no small part to our campaigning capacity and the willingness of our members to defend their professions and the public health system, General Secretary Brett Holmes told the 71st NSWNMA annual conference.

Medicare, public hospitals, aged care, privatisation and penalty rates were key issues in the federal election and were made so by years of campaigning by nurses and midwives, Brett Holmes told annual conference.

“Medicare became the issue of the campaign. Medicare and health were the top issues that resonated with voters,” he said.

Brett says grassroots campaigning was crucial to our issues receiving the recognition and support they did and would continue to be “an essential part of growing and strengthening our union and our capacity to influence”.

“It needs involvement from everyone if we want to change the status quo,” he said.

Brett says the commitment of members in the election campaign to highlight health issues clearly paid off.

The NSWNMA: • campaigned in 12 electorates • secured commitments from 23 Greens and ALP candidates on all our issues • organised over 50 activities including MP visits, street stalls, leafleting at pre-poll booths and train stations and door knocking •m ade over 2,000 persuasion phone calls to undecided members.

OUR RN 24/7 CAMPAIGN HAS ENGAGED THE COMMUNITY In his overview of the union’s activities during the last year Brett said aged care has been and will continue to be a major focus for the NSWNMA despite the state government abandoning its responsibility for the welfare of older Australians.

12 | THE LAMP SEPTEMBER 2016

Earlier Jillian Skinner had bluntly told the conference that the government would stand by its decision to ignore public opinion and abandon the legal requirement to have a registered nurse on duty around the clock in nursing homes.

“This disappointing decision means the issue will now have to be resolved by the Commonwealth as the State has absolved itself of this important responsibility and could create a knock-on effect destabilising the entire skilled staff structure,” Brett said.

Although Minister Skinner has promised to put the issue on the COAG Health Ministers agenda Brett said he had little confidence that the issue would be resolved at the federal level.

“They won’t want to make changes to what will be another cost shifting exercise. The federal government’s decision to slash $1.2 billion in funding from the budget for nursing home residents with complex health care needs is also an area of concern.”

Brett said the fate of RNs in aged care was a touchstone issue for the union with consequences for the delivery of care in the public health system.

“My prediction is that combined with federal cuts to funding of complex care we will see ever increasing numbers of aged care residents needing transfer to emergency departments and longer hospital stays.”

“The Aged Care Guild commissioned Access Economics to analyse the real cost impact and they estimated the costs to be $3-4 billion. We fear both revisions are a recipe for disaster in NSW, promoting a dangerous model of care that leaves minimally trained staff at Certificate three level to manage patients with complex care needs in residential aged care.”

Beth Mohle

Celebrating the success of ratios

“CAMPAIGNING IS AN ESSENTIAL PART OF GROWING AND STRENGTHENING OUR UNION AND OUR CAPACITY TO INFLUENCE.” — NSWNMA General Secretary, Brett Holmes

An honoured guest at this year’s annual conference was Beth Mohle, Secretary of the Queensland Nurses Union. The QNU recently had a massive victory in its public heath system when minimum nurse to patient ratios became enshrined in law.

Brett said the Association should take inspiration from the recent successes of our colleagues in Queensland and Victoria in having ratios guaranteed by law.

He said the Association was focused on building on past ratio wins in NSW and was proud to have introduced a claim for ratios for the first time in aged care during the past year.

“We made history in aged care this year when our claim for ratios in Opal delivered us an enforcable staffing arrangement. We will be trying the same at Bupa.”

Brett flagged a testing campaign next year to have ratios improved in the public health sector and put the government on notice that nurses and midwives would not compromise on patient safety.

“We must be clear in our resolve: either the government changes the way we operate and meets our demands to keep our patients safe, or we change the government at the next state election.”

The ongoing fight for a better profession and a better health system These are some of the issues the NSWNMA campaigned strongly on during the year: • RNs in aged care 24/7 • Save Medicare • Hands off disability services • Build a better future campaign with the ACTU • ‘If you don’t care, we can’t care’ federal election campaign • Save our weekend penalty rates (undertaken with other unions) • Paid parental leave • China free trade (Chafta) agreement • Trade and tax justice THE LAMP SEPTEMBER 2016 | 13

COVER STORY COVER STORY

We’re part of a bigger movement Our participation in the global union movement is valuable because many of the issues we all face daily have their genesis in global trends, says Judith Kiejda.

The health system and nursing and midwifery do not exist in a vacuum and we need to understand how they connect with other political and economic currents if we are to be effective advocates for patient safety, says NSWNMA Assistant General Secretary Judith Kiejda.

“We can’t get enough staff in any sector or appropriate health funding to provide the care we know our patients need but at the same time trillions of dollars are lost in amoral tax avoidance by big business,” she told the union’s annual conference.

“Governments are drafting free trade agreements that we know will undermine our professions due to deskilling and deregulation.

“And privatisation of public health services is not in the best interests of the community as we clearly saw in the recent election.”

Judith said the NSWNMA had campaigned hard over many years against 14 | THE LAMP SEPTEMBER 2016

privatisation and that hard work was being rewarded with a push back from the public over the loss of public services – particularly Medicare and public health.

“People hate privatisation because it takes away from the public their right to have a say in those services. Unfortunately people don’t often realise that until it’s too late.

“The proposed TPP trade agreement – which looks like it’s being signed by both major parties – articulates that once you privatise an entity it cannot be put back in public hands even if it fails! This is serious business and warrants our close scrutiny.”

WE’RE GOOD INTERNATIONAL NURSING CITIZENS Judith said our participation in international bodies like Global Nurses United allowed the NSWNMA to draw support from and to give support to the other 13 partner countries.

The GNU had four pillars to its work:

nurse to patient ratios in all health care settings, universal healthcare as a right for all, tax reform to allow appropriate health funding and resisting the privatisation of any public health services.

“These are even more relevant today than it was when we first formed several years ago. Canada and Australia’s health systems are constantly under attack but thankfully the citizens of both countries have pushed back,” she said.

Judith said our affiliation with Public Services International became closer and stronger this year with the appointment of Michael Whaites, a NSWNMA officer, as the Secretary for PSI (Oceania).

Michael will divide his time between the NSWNMA and PSI and provide a link between the two.

PROUD AFFILIATES OF THE ACTU AND UNIONS NSW The NSWNMA is not just a key player at the international level but also

the national level with our affiliation to the Australian Council of Trade Unions, said Judith. The Australian Nursing and Midwifery Federation is now the biggest union in the country with more than 250,000 members.

“The recent federal election saw the ACTU’s campaign to Build A Better Future be front and center.

“This campaign was not just for the election – it’s an ongoing campaign to ensure that Australia is the country that our children and grandchildren can inherit with the values that are the mark of a decent society.

“It will continue to be about the quality of health, education, workers’ rights, public services and a fair go for all. If that’s the sort of country you want to live in make sure you are a part of this campaign.”

During the election our union ran a very effective issues-based campaign on health broadly with a specific focus in the NSW marginal seats.

“Our campaign allowed the public to

make informed choices about their vote and gave them real information about the current status of our health system.

“It shows that in any campaign if you attract the attention of the public to issues that ultimately effect them they will listen and make appropriate choices.”

Judith said Unions NSW – of which she was recently elected President – was also an excellent vehicle for members to make a difference in their local communities.

“Over the last few years Unions NSW has established a number of Local Union Community Councils (LUCCs) in a number of metropolitan, urban and regional areas and these groups were pivotal to the success of health and education as issues in the recent election.

“They are a group of local people who work together for issues of importance to that community. If you are not already part of one and there is one near to you I would encourage you to become part of this vibrant network.”

“PEOPLE HATE PRIVATISATION BECAUSE IT TAKES AWAY FROM THE PUBLIC THEIR RIGHT TO HAVE A SAY IN THOSE SERVICES. ” — NSWNMA Assistant General Secretary Judith Kiejda

THE LAMP SEPTEMBER 2016 | 15

COVER STORY

Healthcare’s perfect storm Health Minister Jillian Skinner thanked nurses for their contribution to the public health system, touched on the issue of violence in hospitals and said she did not think the demands on our health system would be met “by simply raising the budget”.

The NSW health system is facing a “perfect storm” according to Health Minister Jillian Skinner with the mix of an ageing population, the rising incidence of chronic conditions, greater expectations on consumers and a finite health budget.

Minister Skinner conceded that public services need more money but claimed that the “demands on our health system will not be met by simply raising the budget”.

“Our challenge requires new thinking, innovation and adoption of new technologies to more equitably deliver healthcare.”

She said the government had invested millions of dollars in eHealth to address the challenges of distance for rural and remote communities.

“TeleHealth complements face-toface consultation, reduces travel time and improves access to specialists and advice when it comes to the care our patients 16 | THE LAMP SEPTEMBER 2016

receive, and the support our nurses and midwives have.”

Jillian Skinner pointed out that for all the potential of technology “you can’t replace a nurse”.

“I will not stand here and try to convince you that TeleHealth, no matter how effective it has proven to be can substitute a living, breathing nurse in times of great stress.

“Nurses providing compassionate skilled care to patients and their families leave a legacy that cannot be underestimated.”

VIOLENCE AND SECURITY The Minister said that the issue of violence had become more prominent since the shooting at Nepean Hospital earlier this year.

“Hospitals are places of healing and violence should never be tolerated,” she said.

“Having the necessary staff was one thing identified in our security review but having the right staff with the skills to de-escalate dangerous situations was another.

“Since the shooting, we have provided $2.5 million for extra staff, $1.5 million to train ED staff to manage aggressive patients and $600,000 to provide security staff with skills specifically for hospitals.

“We have also heard from staff that duress alarms needed much improvement, not just in providing up-to-date alarms but also staff being more vigilant in wearing them.”

She said the introduction of 10-hour night shifts has also improved workplace safety and the government was announcing “extra funding across NSW Health to implement 10-hour night shifts in those remaining mental health units and emergency departments which routinely roster to an eight-hour shift pattern”.

“NURSES PROVIDING COMPASSIONATE SKILLED CARE TO PATIENTS AND THEIR FAMILIES LEAVE A LEGACY THAT CANNOT BE UNDERESTIMATED.” — Health Minister, Jillian Skinner

More privatisations, fewer aged care RNs and a concession on rural staffing In addition to her speech the Minister replied to questions from the conference floor: ON RNS IN AGED CARE The Minister was dismissive of the need for RNs to ensure safe and appropriate staffing in nursing homes. She claimed there was no evidence that aged care residents were better off with a registered nurse.

“

hat we did was look right across Australia.

W No other state or territory has this revision.

They all left it to the Commonwealth. There’s absolutely no evidence that any other nursing home residents are better off or worse off than in NSW. That’s the reality. That’s what’s been found.

”

MORE BIG PRIVATISATIONS ARE COMING Mrs Skinner answered a question from the Manly District Hospital branch, which pointed to a Queensland government report that showed public hospitals, are more efficiently run than private ones.

“ Some extra resources Jillian Skinner used the opportunity of her conference address to announce additional resources for the public health system: 30 additional Clinical Support Officers Extra funding to implement 10-hour night shifts in the remaining mental health units and EDs which routinely roster to an eighthour shift pattern Six extra palliative care CNS positions to rural and regional parts of the state

I can assure you that the contract we have signed with Healthscope for the Northern Beaches Hospital indicated a tremendous financial and quality advantage. We will look at involvement of the private sector and the not-for-profit sector in other places, such as Maitland. We’ve always said that. Watch this space for news about that in the future.

GOVERNMENT DIDN’T GET RURAL STAFFING RIGHT

”

In a reply to a question from the Wagga Wagga branch which questioned the logic of building new hospitals without funding appropriate staff needed for the extra demand:

“

ometimes these things take time to work S their way through. There are trade offs. I acknowledge the importance of making sure we have the right number of nurses. I give you my commitment that I will continue to raise this with the Ministry through to the districts.

”

THE LAMP SEPTEMBER 2016 | 17

COVER STORY VOICES FROM ANNUAL CONFERENCE

“I WAS BLOWN AWAY BY THE ANNUAL CONFERENCE, I THOUGHT IT WAS AMAZING. IT EXCEEDED ALL MY EXPECTATIONS.”

“OUR PATIENTS DON’T ALWAYS GET THE QUALITY OF CARE WE WOULD LIKE TO GIVE” — Natalie Ellis RN, Wagga Wagga

18 | THE LAMP SEPTEMBER 2016

Attending her first annual conference, RN Natalie Ellis took the opportunity to tell Health Minister Jillian Skinner her government had opened the new Wagga Wagga Rural Referral Hospital without funding to employ enough nurses.

After thanking the minister for the town’s “beautiful new hospital” which opened in January, Natalie said it had not been given enough funding “for safe staffing to cover the footprint on each shift.”

“We have seen a significant increase in presentations since opening and have been forced to endure around 600 hours of overtime per week across the hospital to meet the needs of our patients and we are exhausted.”

Natalie said Mrs Skinner promised to look into the matter but “she seemed to be suggesting that we had to accept ‘trade offs’. Perhaps she meant that the government has spent a lot of money on the new hospital so you should be thankful for what you’ve got.”

“The problem with that approach is that our patients don’t always get the quality of care we would like to give.”

Natalie said she recently became active in the union and is now branch president.

“I was blown away by the annual conference, I thought it was amazing. It exceeded all my expectations,” she said.

“I was impressed by how well organised it was and by the quality of the speakers – especially Andrew Denton and Richard Denniss.

“The opportunity to meet nurses from other hospitals and find out how they deal with similar issues was very useful.”

Natalie said Wagga Wagga hospital opened with almost 60 full-time-equivalent nurses fewer than the number required to staff all beds.

“Staff were repeatedly asked to do more and more overtime with people sometimes working three double shifts in a row.

“Nurses got texts and phone calls saying ‘please help we are desperately short of staff’ and people felt they were being pushed into doing overtime.

“We have made significant progress by working with management and we’ve now got an agreement that staff won’t be repeatedly asked to do overtime if they say no.

“Management have taken on more agency staff and recruited to most of the vacancies and we eagerly await their commencement dates.”

“THE CURRENT GOVERNMENT IS SHOWING A LACK OF FORESIGHT BY CUTTING HEALTH FUNDING” — Max Kettle RN, Tamworth

“WHILE I THINK STAFFING SHOULD BE OUR MAIN ISSUE I’M ALSO CONCERNED WITH HOW WE RESPOND TO THE POLITICAL ENVIRONMENT AND ITS IMPACTS ON HEALTH.” Tamworth RN Max Kettle warned of the risks of replacing registered nurses with unqualified assistant nurses in acute mental health units when he questioned Health Minister Jillian Skinner at annual conference.

Max is vice president of Tamworth Hospital branch and works in the 25-bed Banksia mental health unit.

He asked how the Ministry of Health would ensure that local health districts do not disregard NSW safety law and “allow AiNs to work in acute mental health units with the knowledge that it is a foreseeable risk.”

“The minister said she was not aware of the issue and would look into it, or words to that effect,” he said.

“It hasn’t become an issue at Tamworth yet but if it’s allowed to happen in one area they could roll it out everywhere.

“It is dangerous to the untrained nurses and their colleagues and no good for our clients either.”

Banksia includes a three-bed acute area for patients who might otherwise be sent to a psychiatric intensive care unit if the hospital had one.

“Some of our clients are very unwell and you need to be trained and experienced to handle them.

“I thought it was a very good conference with a lot of discussion about mental health nursing – especially the need for adequate staffing by trained people.

“While I think staffing should be our main issue I’m also concerned with how we respond to the political environment and its impacts on health.

“The current government is showing a lack of foresight by cutting health funding.

“I think the union is doing a pretty good job of focusing attention on the damage this is doing to health care and we need to maintain that focus.”

THE LAMP SEPTEMBER 2016 | 19

COVER STORY VOICES FROM ANNUAL CONFERENCE

“THERE WAS MORE FOCUS ON SMALL HOSPITALS WHICH WAS A WELCOME DEVELOPMENT” — Sharon Clapham, Rylstone

“IT WAS GOOD TO KNOW THAT WE ARE NOT ON OUR OWN AND THAT OTHER NURSES WHO WORK IN SMALL FACILITIES WITHOUT MANDATORY STAFFING RATIOS ARE FIGHTING FOR THE SAME IMPROVEMENTS AS WE ARE.” The NSWNMA annual conference had an increased focus on problems facing small rural hospitals, said Sharon Clapham, branch delegate and secretary at the 28-bed Rylstone District Hospital 238km northwest of Sydney.

“There was more focus on small hospitals than at previous conferences I’ve attended, which was a welcome development,” she said.

“It was good to know that we are not on our own and that other nurses who work in small facilities without mandatory staffing ratios are fighting for the same improvements as we are.

“The conference gave me the opportunity to meet nurses from other rural multipurpose services with similar concerns including staffing and hospital security.”

Sharon said the conference included excellent contributions from television broadcaster Andrew Denton who spoke about euthanasia and from nurse and dementia specialist Kate Swaffer on 20 | THE LAMP SEPTEMBER 2016

“Living Beyond Dementia”.

“Andrew Denton, who witnessed his father’s long, drawn-out death, made the point that he wasn’t lobbying for a law to help ‘bump off Granny,’ and doctors or nurses who were opposed to euthanasia for religious or moral reasons would not be required to assist their patients to die.

“He was proposing a law to make legal a practice he believes is already happening in Australia – a practice he states is without regulation, support, transparency or accountability. He also believes this practice is also at times happening without consent.

“This has always been a very controversial topic and it was very interesting to hear the points of view of a local personality with first hand experience.”

“Anyone who gets the opportunity to read Kate Swaffer’s book should do so.

“With an increasing number of people being diagnosed with early onset dementia it is important to keep informed of the treatments and best practices to help the individuals based on their diagnosis, expectations and lifestyle wishes.

“I believe the most important message Kate delivered that day was that we need to stop ‘doing for’ our dementia patients. This not only disempowers them but also takes away their independence and self worth.

“NURSES AT MANLY AND MONA VALE REMAIN ANXIOUS ABOUT THEIR FUTURE.” Manly Hospital RN and NSWNMA branch delegate Stephanie Cummings quizzed Health Minister Jillian Skinner about her government’s support for privatisation during annual conference.

Stephanie told the minister a series of reports including by the Queensland government’s Commission of Audit showed that privatisations are bad for government budgets and the hip pockets of consumers.

“My question is, are there plans to privatise other public hospitals in NSW, like Maitland?

“And, given the report from Queensland, how can you justify that public hospitals in NSW are more efficiently run by the private sector rather than under the public?”

Speaking after the conference, Stephanie said: “Ms Skinner replied that she didn’t know which reports I had been reading, and continued to emphasise that the privatisation was in the best interest of patients and taxpayers. She also didn’t rule out further privatisations of public hospitals.”

Stephanie said nurses at Manly and Mona Vale Hospitals remain anxious about their future as the government moves to close both hospitals and open a new Northern Beaches hospital under Healthscope management.

“The government and Healthscope have not told us how long they intend for us to hold on to our conditions.

“Consequently all the nurses are anxious about what will happen to their conditions like sick leave, annual leave, long service leave and salary packaging. “ The uncertainty means that vacant positions at Manly and Mona Vale can’t be filled because nurses won’t take up jobs with no security and no transparency about the future.

“There are a lot of vacancies in the mental health unit and the staff are overstretched and working lots of overtime.”

“It’s important that the union fights for Manly and Mona Vale nurses to keep their conditions for the lifetime of their employment at the new hospital.”

Public Services International, the NSWNMA and other public sector unions have organised the People’s Inquiry Into Privatisation.

We want to hear your view about the state of Australia’s vital public services.

Go to www.peoplesinquiry.org. au and make a submission.

“IT’S IMPORTANT THAT THE UNION FIGHTS FOR MANLY AND MONA VALE NURSES TO KEEP THEIR CONDITIONS FOR THE LIFETIME OF THEIR EMPLOYMENT AT THE NEW HOSPITAL.” — Stephanie Cummings, Manly Hospital

THE LAMP SEPTEMBER 2016 | 21

COVER PROFESSIONAL STORY DAY

When you’re ‘better off dead’ Andrew Denton watched his father endure a drawn-out and painful death.

Now he wants nurses to support his quest to legalise assisted dying.

Television presenter and comedian Andrew Denton says watching his father Kit die slowly and painfully of heart failure “remains the most profoundly shocking experience of my life”.

Kit Denton, 67, was given ever-increasing doses of sedatives to settle the pain.

“But morphine never did settle the pain – not his and not ours. The images of those final three days 19 years ago will never be erased,” Andrew Denton told the NSWNMA annual conference.

In 2014 he set out to investigate the issue of assisted dying and to test the arguments of its opponents.

He spent “hundreds of hours” talking to nurses, doctors, politicians, lawyers, academics, priests, surgeons, palliative care specialists and activists on both sides of the debate here and overseas.

“Above all I spent time with those who embody the need for this law in Australia –the dying and their families,” he said.

The result was a podcast series “Better off dead” freely available online and a lobby group to campaign for law reform called Go Gentle Australia.

It argues for “a right to have a choice about what happens to us at the end of our lives and not to be coerced, when we are at our most vulnerable, into cruel and avoidable suffering.”

Denton travelled to Belgium, the Netherlands and Oregon in the United States, which have assisted dying laws.

He found they operate with rigorous safeguards and transparency, are closely supervised by medical peers and strongly supported by the public, though only a tiny fraction of people use them – ranging from less than one half of one per cent of the dying in Oregon to less than four per cent of the dying in Holland.

22 | THE LAMP SEPTEMBER 2016

Support for assisted dying

70-80% from the public

50% from doctors

‘WHY SHOULD A COMPETENT ADULT WHO IS DYING AND SUFFERING AND WHO ASKS TO DIE QUICKLY BE TOLD THEY HAVE TO DIE SLOWLY INSTEAD?’ — Andrew Denton

LAWS THAT GIVE A CHOICE “They are not being killed by the state – they are dying. These laws give them a choice and some measure of control over how hard that dying needs to be,” he said.

How does Australia, with no law for assisted dying, compare?

Denton cited a June report by a Victorian parliamentary inquiry which recommended legislation to allow people to seek assistance to die.

The inquiry found that in the absence of such a law Australians were forced to take their own lives often in horrific circumstances.

Denton said: “Coroner John Olle gave examples including a 90 year old man with prostate cancer and a poor prognosis who shot himself with a nail gun. And a 93 year old woman with crippling arthritis who smuggled a razor blade into her aged care facility and bled to death.”

“Coroner Olle went to out of his way to stress these were people without a history of mental illness faced with the slow irreversible decline of chronic disease.”

He said the national coronial information service estimates that two people over 80 take their lives in Australia every week. The most common method used is hanging.

Denton said the Victorian inquiry found that doctors practice unlawful assisted dying despite its prohibition.

“It’s happening without regulation, support, transparency or accountability – and from the evidence received sometimes without patient consent.”

Denton cited evidence by Sydney University professor of health law and governance Roger Magnusson that almost 20 per cent of doctors he interviewed reported being involved in mismanaged attempts of assisted dying.

“Professor Magnusson found that in many cases doctors and nurses miscalculated the dosages required to achieve death and resorted to suffocation, strangulation and injections of air.”

Denton said he was amazed that society considered it ethically and legally acceptable for a dying patient “to choose a slow and psychologically painful death by dehydration and starvation” but legally and ethically unacceptable to choose a quick and painless death.

“Why should a competent adult who is dying and suffering and who asks to die quickly be told they have to die slowly instead?”

PUBLIC SUPPORT IS STRONG He said opinion polls showed public support for assisted dying at between 70-80 per cent and support among doctors running at around 50 per cent.

However it was still opposed by the leaderships of most medical organisations such as the AMA and Royal College of Physicians.

“There is only one medical organisation in this country that officially supports a law for assisted dying. Significantly it is an organisation whose members see the suffering close up and on a daily basis –

the Australian Nursing and Midwifery Federation.”

Overseas research indicated nurses were “the most trusted voice” on assisted dying because “you, not doctors are the ones who are with the patients 24 hours a day. You are the ones who see the suffering and you are the ones who hear our patients’ pleas for help to die.”

“An assisted dying law will not only offer choice and dignity to your patients it will also offer protection to you and clear guidelines as you negotiate good palliation with doctors.

“I would encourage you to read the AMMF’s position statement and if you’re in support of it to discuss it with your colleagues.

“Of course if you’re not in support that is your absolute right. The very core of these laws is that they’re voluntary – for nurses and doctors every bit as much as patients.”

Listen to the podcast BETTER OFF DEAD? Andrew Denton on the assisted dying debate. bit.ly/ShiftDenton THE LAMP SEPTEMBER 2016 | 23

COVER Professional STORY day

Living beyond dementia Kate Swaffer’s nursing career ended when she was diagnosed with dementia at 49. Now she is an internationally–regarded advocate for the right of people with dementia to remain engaged with their pre-diagnosis lives.

Eight years ago, at the age of 49, nurse Kate Swaffer was diagnosed with younger onset dementia and became one of more than 353,000 Australians with dementia.

She had been juggling a hectic lifestyle as a mother of two teenage children – one doing Year 12 – while working full time in an operating theatre and studying at the University of South Australia.

“I was doing all that – although with some difficulty – the day I was diagnosed.

Then suddenly all that anyone saw were my missing pieces; my deficits,” she told the NSWNMA annual conference.

She went from having “a reasonably healthy IQ and a photographic memory” to some days not remembering her husband Peter’s name; from having “exceptional spelling and grammar and maths to not being able to spell simple words such as ‘that’.”

At 50 she badly failed her driver’s test, partly due to dementia symptoms similar to those of dyslexia.

“I was going through red lights thinking they were green and throwing on the brakes at green lights thinking they were red.”

Now an author, international speaker and activist for the rights of people with dementia, Kate Swaffer said she had learned to “live beyond dementia” – the subtitle of her book “What the hell happened to my brain?”

She argues it is wrong to try to start doing everything for someone with dementia and to tell them to slow down.

“In the first couple of years my husband was always trying to take over and do things for me rather than letting me struggle with my increasing disabilities.”

One day she found Peter sitting on the steps in tears with his head in his hands. He told her, ‘I know I am losing you and I’m afraid of what the future holds.’

Life can continue normally Kate told conference: “For me to function with dementia I look calm on the surface but below the surface I’m paddling quite hard even to speak. Over the years my paddling has got more 24 | THE LAMP SEPTEMBER 2016

difficult and causes more fatigue.

“However if that swan stops paddling it will sink. We need to be supported to paddle harder so we can keep functioning for as long as possible.”

She calls the standard medical approach to dementia “prescribed disengagement” and brands it unethical “because it takes away all sense of hope for a future”, she believes.

“When I was diagnosed with dementia at 49 I was told to give up work and study because it would be too stressful and to get my end of life affairs in order. And to start going to respite care one day a month so I could get used to it.

“My husband was told that very soon he would have to give up work and become my full time carer.”

She said she lost her job because

“If that swan stops paddling it will sink. We need to be supported to paddle harder so we can keep functioning for as long as possible.”

— Kate Swaffer

– and also why our care partners become consumed in caring for us and often take on a martyr role.

“The thing that is missing is support for us to keep living: to stay at work, be volunteers, be active in our communities and to keep living our pre-diagnosis life if that’s what we want.”

“nobody told me I had rights to remain employed with reasonable adjustments.”

However her university lecturers said there was no need to give up university and the university’s disability support staff “gave me back my hope. They set me up with an amazing amount of support.”

“Prescribed disengagement can often be the reason why people take on the persona of people living with dementia

people living with dementia deserve disability support She cites a nurse she knows who had a stroke at 52.

“We didn’t think she would ever walk, talk or feed herself or use her right side again. Within six weeks she was out of hospital and within 12 months she was back at work following rehab.

“That’s when I thought, where the hell was my rehab? I have what could be likened to a progressive brain injury so I started to prescribe rehabilitation for myself.

“My neuro physiotherapist started to see the benefits of supporting me on that pathway and now teaches it to his masters of physiotherapy students at Flinders Uni.” She said people with dementia deserve the same disability support as any other person living with disability.

“We need to support access for people with cognitive impairment in the community in the same way there is a ramp for people in a wheelchair in this building.

“We need to be helped to manage risk not eliminate risk.”

A holder of several awards, Kate said she was particularly proud of being recognised in the 2015 national disability awards “because that puts dementia properly in the disability space.”

“The more I learn about dementia the more I realise that if we do treat the symptoms as disabilities, everyone with dementia will live a longer more productive life than they currently are able to.”

Kate Swaffer started her nursing career specialising in dementia and later worked in operating theatres until she was diagnosed with younger onset dementia – a category covering those under 65.

She is co-founder and chair of Dementia Alliance International, a board member of Alzheimer’s Disease International, chair of Alzheimer’s Australia Dementia Advisory Committee, and co-chair of the Consumers Dementia Research Network.

She regularly presents nationally and internationally on topics such as stigma and language and has received several national and international awards.

FIND OUT MORE

Come to our Aged Care Nurses’ Forum and hear from a range of speakers from different aged care settings.

When: Friday 14 October, 9 am to 4pm Where: NSWNMA, 50 O’Dea Avenue, Waterloo

THE LAMP SEPTEMBER 2016 | 25

WORKPLACE SAFETY

A higher priority for personal safety There are pockets of workplace health and safety excellence in the public health system but we still need to lift our game in many ways, the Ministry of Health’s Karen Crawshaw told annual conference.

The shooting incident at Nepean Hospital emergency department earlier this year has led to a lot of soul searching about the personal safety of staff in the public health system.

The Ministry of Health’s Deputy Secretary of Governance, Workforce and Corporate Karen Crawshaw says the incident has led to a major audit of emergency departments throughout the state which has thrown up a number of major challenges.

“I don’t want to be dire about workplace health and safety in health because it’s not bad. We’ve got pockets of excellence. We’ve had a really good go at addressing manual handling, body stressing issues and slips, trips and falls in the workplace health and safety domain.

“But in terms of a holistic approach to a workplace health and safety culture that prioritises vigilance by everyone, particularly about their personal safety, we’re not there yet,” she said.

The obvious key challenge coming out of the Nepean incident is managing aggression and preventing violence against staff. Nurses in particular bear the brunt of this aggression.

“Eighty per cent of the staff that were victims of physical assault or other physical incidents are nurses. We also know the majority of those who instigate physical incidents are inpatients,” Karen Crawshaw said.

“Health workers when they are presented – particularly in EDs – with patients that are aggressive don’t necessarily have the options that other workplaces have when confronted with aggressive behaviour: of walking away when it is a patient in front of them that often needs treatment.”

“It is that conundrum of how do they keep themselves and their colleagues safe while at the same time rendering the treatment that they need to give the patient in front of them.”

ED AUDIT REVEALS SECURITY WEAKNESSES Karen Crawshaw says the detailed audit of 20 emergency departments by a combination of experts from inside and outside the health system along with a self-assessment by a further 135 EDs had thrown up common themes.

“One thing that came through clearly was there was a level of lack of staff vigilance about their own safety and that of their own colleagues.

“Often secure entrance doors were jammed open when they were designed to be locked for security or shut for security reasons.

26 | THE LAMP SEPTEMBER 2016

“Sharps were left unsecured. Security management of identity cards was inadequate. Duress alarm systems were inadequate,” she said.

Ms Crawshaw said her own visits to hospitals had revealed an unevenness in the quality of duress alarms that were available to staff but also a variability in their use.

“In this one hospital I went to the ED where there was an antiquated system. So, rightly, they have being asking for a better system. The inadequacy came from the system there.

“I was then taken to the wards. On one ward I arrived at, there was a box of pristine, up-to-date, modern, lightweight duress alarms sitting on the nurses’ station with no staff wearing them including the NUM. “I then went to another ward at that same hospital.

They were all wearing their duress alarms from the NUM down. No issue.”

TRAINING IS WITHIN OUR CONTROL Karen Crawshaw says an area the Ministry has identified for improvement is training.

“Training is inadequate. We have good training programs but staff are not getting away to complete them. In EDs you can’t go off to a four-day, stateof-the-art course that we offer. So we’ve had to do something about that. We’ve had to roll out a multi-disciplinary training course that will be in small chunks that can be delivered on site,” she said.

“Violence prevention management training is generally well done through the mental health teams but in the non-mental health area we definitely need to lift our game.”

She says that instead of training being done in silos there needs to be an all-staff approach to training.

“Security staff don’t train with the clinical staff.

Nurses don’t necessarily train with the doctors. We’ve got to get a more multi-disciplinary approach.”

There were other issues arising from the departmental audit that the Ministry was committed to addressing Karen Crawshaw said: • “The incident management system is a very clunky system and it’s quite an old system now. We’ve got a new system coming. It will have an auditable log created once the incident has been put into the system.”

• “We’ve talked about clarifying the roles and the fact that the security staff are there to back up the clinical staff and not lead the charge when it comes to patients.”

Karen Crawshaw

“EIGHTY PER CENT OF THE STAFF THAT WERE VICTIMS OF PHYSICAL ASSAULT OR OTHER PHYSICAL INCIDENTS ARE NURSES. WE ALSO KNOW THE MAJORITY OF THOSE WHO INSTIGATE PHYSICAL INCIDENTS ARE INPATIENTS” • “We’re also recruiting extra security staff. We’re putting in another 30 over the course of the next year.”

• “We’re also looking at legislative changes. We did some changes to better support security staff who help mental health professionals when they had to detain acutely mental health people. We’re also looking at the powers to deal with aggressive visitors.”

LEARNING FROM OTHERS The Ministry has been looking at other industries for insight and ideas for improving health and safety particularly the construction industry says Karen Crawshaw. “(Construction) has been made a priority through Safework Australia. Over an 11-year period from 2001-02 to 2011-12 the focus on systemic improvement resulted in the incidence rate for serious claims reducing 31 per cent. The fatality reduction was even better. They reduced their fatality rate by 68 per cent. They’ve had a really successful trajectory.”

“Tool box talks” are a key initiative that has driven these improvements.

“The toolbox talks come from teams gathering around a tool box on a construction site to discuss the upcoming job or what’s going on for the day on the site. It’s an informal group discussion for 10-15 minutes. And it is used to facilitate health and safety discussions. By encouraging workers to discuss health and safety matters and make suggestions for improvement you’re opening up new avenues of communication between employers and workers,” she said.

“If workers are reminded on a regular basis of the impact an injury can have on their home life and personal relationships they will be more likely to work safely and avoid risks that can result in accidents to themselves and others.

“So we’ve got clinical handover as an opportunity to have the sort of toolbox approach and piggybacking on something that is already well inculcated in the patient safety culture.”

THE LAMP SEPTEMBER 2016 | 27

COVER WORKPLACE STORYSAFETY

When alcohol isn’t fun Alcohol can reduce inhibitions in a pleasant way but it is also a major contributor to aggression and violence in our health system, says Dr Peter Miller.

“Alcohol has a major relationship with violence.

Most people are not surprised by that, certainly not nurses,” Dr Peter Miller, Professor of Violence Prevention and Addiction Studies at Deakin University, told annual conference.

Alcohol can lead to violence, he says, because people start to lose their ability to think properly after two drinks.

“It’s quite shocking to somebody like me who doesn’t mind two drinks on occasions. We become disinhibited which is what we most like about alcohol.

We start to focus very much on the moment and we begin to become obsessional in our thinking. And we also do a poor job of interpreting social cues,” he said.

Alcohol affects people differently and the people who are more likely to be aggressive or experience alcohol related aggression “have higher numbers of important personality and physical traits”.

“They are more likely to be dispositionally angry.

That means more angry more of the time. They have trait anger and rumination. They think about stuff and they get angry about stuff.

“They are also strong in sensation seeking and impulsivity and they show lower emotional control.”

Interestingly protagonists on both ends of a violent incident – perpetrator and victim - can share similar psychological profiles. “(Street victims) have slightly less trait anger although still high compared with people who don’t get involved at all. That makes sense when you think about the fact that most of us see an aggressive person and we tend to walk in the opposite direction.

“People who often get into fights don’t walk in the opposite direction. They engage with these people.”

Intoxication by either perpetrator or victim also drastically increases the odds of violence.

“For perpetrators with heavy episodic drinking of more than eight drinks in a session you are 1.4 times more likely to perpetrate,” Dr Miller says.

For street victims heavy drinking plays a much more significant role in predicting physical aggression - you are eight times more likely to get involved in a fight.

THERE IS USUALLY A HISTORY BEHIND THE VIOLENCE Dr Miller says what has been missing in discussions about alcohol and violence is the histories of perpetrators and victims.

“The biggest single predictor for someone being involved in aggression either as a perpetrator or a

28 | THE LAMP SEPTEMBER 2016

victim is having been abused or neglected as a child: poor behaviour management particularly through poor supervision of children, poor parenting, high levels of family conflict and high family histories of anti social behaviour.

“We’ve got to think about the first 1000 days of life and the first 5000 days of life. And it is even genetic. If you have a short version of the MAOA gene you are about 85 per cent more likely to be aggressive throughout your life.”

Having these insights into alcohol and aggression can help health staff deal with potential violence, he said.

“People who are walking through your doors, they’re not just drunk. If they have been in a fight they are likely to be carrying significant other issues.

“It’s not just about the alcohol and not just about the drugs. It’s also about their personality types and their aggression. The fact is we know overwhelmingly they are more likely to respond immediately and uncontrollably to aggressive cues - to things they perceive as being aggressive.

“If we try to give them the negative look, the negative cues they are looking for that’s how they’ll respond because that is because they have been emotionally and genetically conditioned over a long period of time.”

STOPPING THE HARM Dr Miller says policy experts have come up with a four-step plan to try and stop the harm caused by alcohol and violence in emergency departments: • Brief interventions in EDs – identifying, reducing and preventing problematic use, abuse and dependence on alcohol • Add alcohol to patient data sets – to provide a clearer picture of the extent of the problem and an evidence base to inform and evaluate policy decisions.

• Regulate advertising and tax – take a national approach to reduce the exposure of young people to alcohol advertising, establish an independent regulatory body for alcohol promotion and tax alcohol appropriately.

• Reduce opening hours – there is a considerable body of evidence to show that reducing the trading hours of licensed venues and limiting the density of outlets can reduce alcohol-related harm.

“The best way to try and reduce the injuries you are going to see in the ED particularly around violence is to try and prevent them from coming in at all,” he said.

“THE BEST WAY TO TRY AND REDUCE THE INJURIES YOU ARE GOING TO SEE IS TO TRY AND PREVENT THEM FROM COMING IN AT ALL” Dr Peter Miller has been a passionate advocate for tougher alcohol laws and has conducted some of the largest ever studies into licensed venues, comparing 11 Australian cities (and Wellington, NZ) over five years and talking to more than 15,000 patrons.

Are you a victim of workplace violence?

Download the NSWNMA App and report your workplace violence incident.

The links between alcohol and violence The evidence of a direct relationship between alcohol and violence:

60% 30% Street violence

Family violence

30-40% 24,000 Domestic violence

Child abuse cases

How alcohol causes violence: > > > > >

Reduces cognitive ability after two drinks Disinhibition Temporality – focusing on the moment without thought of consequences Obsessional thinking Poor interpretation of social cues.

The APP is Free and available to download from iTunes and Google Play store.

THE LAMP SEPTEMBER 2016 | 29

ANNUAL CONFERENCE DINNER

GREAT GATSBY

20s

The roaring 20s were a time of celebrity, corporate greed and a roller coaster economy – that sounds familiar! – and delegates at our annual conference dinner relived the hedonism and embraced the spectacular fashions of America’s jazz age.

JUNE 30

30 | THE LAMP SEPTEMBER 2016

2016

THE LAMP SEPTEMBER 2016 | 31

CHINA FREE TRADE AGREEMENT

Trade deal opens way for exploitation A new “free trade” deal is replacing Australian workers with underpaid foreign labour.

The China Australia Free Trade Agreement (Chafta) is making it easier for employers to flout Australia’s worker protection laws.

This is shown by media investigations and cases before the Fair Work Commission since Chafta came into effect last December.

Negotiated between the federal Liberal government and the Chinese government, Chafta was touted as a breakthrough for Australian service industries – banks, insurers, lawyers, architects and education providers – and some farmers, seeking to sell services and products to China.

There was a little-discussed downside for Australian manufacturers: the elimination of the few remaining tariffs (taxes on imports) on Chinese manufactured goods entering Australia.

Just over half of all Australian manufacturers expected to be hurt by the removal of tariffs on Chinese products, a survey found.

“The FTA will benefit low-employment agriculture and mining while destroying jobs in high-employment manufacturing,” warned the Australian Manufacturing Workers’ Union’s economic adviser, Tom Skladzien.

32 | THE LAMP SEPTEMBER 2016

Chafta is about more than trade in goods and services, however.

Chafta makes it easier for Australian employers to import Chinese workers on ‘temporary’ visas – up to four years at a time, with the possibility of further stay.

Chafta immediately eliminates the requirement to assess the skills of Chinese workers in 10 blue-collar occupations.

POTENTIAL CONSEQUENCES FOR NURSING It aims to eliminate skill tests for Chinese workers in all occupations within five years – a measure which could potentially impact nursing.

Some projects with Chinese investment are permitted to bring in entire Chinese workforces.

Fairfax Media found a Sydney company purchased a car park stacker from China that came “with labour” – seven Chinese workers flown to Australia for 10 weeks and paid $US75 a day – half now and the rest when they returned to China.

Their pay rate was well below the going rate for a lift industry worker of $42 an hour.

And they were not given pay slips, paid penalty rates or paid super, despite working six days a week.

COMPANIES CLAIMED THE VISAS WERE GRANTED DUE TO THE HIGH LEVEL OF SKILLS OF THE CHINESE TECHNICIANS. HOWEVER AUSTRALIAN WORKERS ON THE SITE DISAGREED, SAYING A LOT OF THE WORK WAS BASIC WELDING.

“In effect they agreed to work for less than $US10 an hour, a sum that is illegal in Australia, but more than double the average hourly wage paid in China,” Fairfax Media reported in June.

A Chinese company supplied the equipment and labour and paid the wages. The Australian company receiving the equipment paid the airfares, accommodation and food.

Both companies claimed the visas were granted due to the high level of skills of the Chinese technicians.

However Australian workers on the site disagreed, saying a lot of the work was basic welding.

The non-English-speaking workers were granted “work safely in construction industry” certificates or “white cards” and had no WorkCover insurance.

AUSTRALIA’S RULES EASILY CIRCUMVENTED The case “shows the ease with which the rules designed to protect Australia’s labour market and industrial system can be circumvented when free trade agreements open the nation’s markets to the world because of a lack of oversight and enforcement,” Fairfax Media commented.

According to employment migration expert Joanna Howe, a senior law lecturer at Adelaide University, Chafta workers are required to be employed in accordance with Australian law.

But she said there are less checks and balances.

“Chafta prevents labour market testing which means there is no proper mechanism to determine that a Chinese worker is not replacing local workers in the Australian labour market,” she said.

Last September, Prime Minister Malcolm Turnbull accused an anti-Chafta union advertising campaign of “extreme scare-mongering” “designed to frighten people back into poverty”.

The issue briefly resurfaced in the election campaign in June with more advertising by the Electrical Trades Union.

ETU national secretary Allen Hicks said Chafta created a situation in which Chinese workers could enter the country to work “regardless of whether there might be Australians that might be available who are better qualified”.

Tales from the ‘black economy’ Workers from overseas in Australia on work visas now number 1.3 million – equivalent to one in 10 of the Australian workforce.

A Melbourne Age investigation in conjunction with Monash University last year found “hundreds of thousands of temporary foreign workers illegally exploited and underpaid in what has become a widespread ‘black economy’ for jobs.”

The problem extended “across the economy, in food courts, cafes, factories, building sites, farms, hairdressers and retail” with workers paid as little as $4 an hour.

“This is a starkly different labour market from that which greeted the surge of migrant workers after World War II,” the Age noted.

“Back then, newcomers typically had permanent residency and far greater legal and work rights than today’s foreign workers on visas.”

According to the Fair Work Ombudsman, nearly 12 per cent of all requests for assistance in the past financial year came from visa holders, and the agency recouped $1.6 million for underpaid visa-holders.

In recent examples: • The Melbourne Age reported dozens of low-paid Chinese workers on the $630 million Bendigo Hospital project had not received any wages for more than two months after their Melbourne-based employer collapsed and went into administration.

• Convenience chain 7-Eleven was exposed for systemic underpayment of wages mostly to foreign students on visas.

• A survey by United Voice found that of more than 200 international students, 25 per cent were receiving $10 or less an hour and 60 per cent were earning less than the national minimum wage.

• The Fair Work Ombudsman launched court action to prosecute an employer it says underpaid four Filipino workers by more than $260,000 between 2012 and 2015. The workers on 457 visas were employed at motels on call 24 hours a day, and paid as little as $3 an hour.

• A manufacturing business that illegally exploited dozens of Chinese and Filipino workers for as little as $4 an hour is now allegedly refusing to back pay its staff, according to the Fair Work Ombudsman.

• A Sydney fast-food outlet fabricated employment records and underpaid 11 Korean workers more than $108,000, the Fair Work Ombudsman alleged.

THE LAMP SEPTEMBER 2016 | 33

Cleveland Clinic Abu Dhabi is now hiring - ICU Nurses Interviews in Sydney this October The intensive care unit is an exciting and challenging environment at Cleveland Clinic Abu Dhabi (CCAD), offering world class innovative experiences and opportunities for nurses. You will be challenged with high acuit y critical patients, work with a world class team and receive support to provide patient centered care. While patients are complex, CCAD will support your professional growth and offer mentorship.

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ASK JUDITH WHEN IT COMES TO YOUR RIGHTS AND ENTITLEMENTS AT WORK, NSWNMA ASSISTANT GENERAL SECRETARY JUDITH KIEJDA HAS THE ANSWERS. Accumulated ADOs in the State Award I am a Registered Nurse in a Local Health District. I read in last month’s Ask Judith that up to five ADOs can be accumulated.

I thought it was only three.

In the NSW Health Service, across all awards, that is correct. Under Clause 4(vii) of the Public Health System Nurses’ and Midwives’ (State) Award, employees can accumulate up to three ADOs. An employee who has already accumulated three must then be able to access future ADOs when they fall due in accordance with the roster. The employer must not unreasonably refuse a request by an employee to subsequently access their accumulated ADOs. The previous answer in Ask Judith was related to the Modern Award (federal).

Workplace change in an aged care facility I am an Assistant in Nursing working in aged care. Recently the Service Manager informed all staff that total hours of work in the facility were excessive, and there would need to be changes. When I subsequently spoke to the Service Manager, they confirmed that this could lead to a reduction in contracted hours.

Can they do this?

This is a very topical and important question. The Association has recently been assisting hundreds and hundreds of members across several aged care employers and facilities – for profit and not for profit – about such changes. Most enterprise agreements covering aged care facilities contain provisions relating to workplace change.

Obligations on the employer usually include providing proper notification and clearly setting out the proposed change in writing; the effect the changes will have; and what can be done to mitigate or avert any adverse impact. Most contain the ability for employees to ‘appoint’ a representative for the purposes of participating on their behalf in such procedures, which can be the Association.

Most agreements also set out provisions relating to hours of work, which may include how permanent part time hours, for example, are established.

It should also contain consultation mechanisms and procedures by which a dispute can be settled if problems arise.

However each agreement will have its own particulars and subtleties, so it is very important to seek the assistance and advice of the Association at the first sign of any proposed change.

If you are approached by your employer to reduce your hours or vary your usual employment arrangements, you should contact the Association immediately. You should if at all possible seek such advice before signing any new contract. In some cases, the Association may be able to approach the issue on behalf of many or all nursing staff, depending on the nature of the issue and changes proposed.

BREAKING NEWS

Changes to NSW IRC powers As the Lamp goes to print, the Baird NSW Government announced that it will be undertaking changes to the Industrial Relations Commission of NSW (‘IRC’). The intent of its proposal appears limited to ‘stripping out’ those matters that are dealt with by the IRC sitting as an Industrial Court and have those alternatively reside within the Supreme Court of NSW. This will mean a consequential change in the makeup of IRC officers.

At this stage the NSW Government has stated that the proposed change will leave undisturbed the conciliation, arbitration, award and agreement making powers of the IRC (although subject to the NSW Wages Policy and Regulation).

Unions NSW (and the Association) are reviewing these changes closely to ensure that access to the IRC – as an effective, user-friendly and highly expert industrial tribunal – is not lost to public health members. Watch this space.

Contracted hours for a permanent part timer I work as an Enrolled Nurse in a public hospital. I work permanent part time but I regularly work additional shifts beyond my contracted hours. This occurs essentially every fortnight. I am happy to do the extra shifts but it would be good to have certainty of my hours. Is there anything I can do?

Under Clause 29(xii) of the Public Health System Nurses’ and Midwives’ (State) Award, a part time employee can elect to have their contracted hours increased to reflect the average hours worked per fortnight in the preceding 12 month period. The employer is not to unreasonably withhold agreement to such a request. The one exception is when the additional shifts are specifically to help backfill a position temporarily vacant due to the substantive position holder being on extended leave.

Do I have to clean?

I am Registered Nurse employed in a public hospital and we have been recently approached to take on some cleaning duties. Apart from the fact we are busy enough as it is, can we be made to do these duties?

Clause 44 of the Public Health System Nurses’ and Midwives’ (State) Award sets out that except in certain prescribed circumstances, “nurses shall not be required to perform, as a matter of routine, ...washing, sweeping, polishing and/or dusting of floors, walls or windows of wards, corridors, annexes, bathrooms or verandas or any other duties which are generally performed by classifications other than nursing staff”.

Temporary contracts and annual leave I am on a temporary contract in a public hospital as a part time Registered Nurse.

How much annual leave do I accrue?

Employees on temporary contracts are to receive annual leave on the same basis as permanent employees and consistent with relevant award entitlements (see for example PD2014_029 Leave Matters for the NSW Health Service).

Under Clause 29 ~ Part 1 of the Public Health System Nurses’ and Midwives’ (State) Award, a part-time employee is entitled to four weeks annual leave at their ordinary rate of pay, following the completion of twelve months service.

If your temporary contract is for a period of less than one year, you would receive payment of the monetary value of your pro rata annual leave at the conclusion of your contract.

THE LAMP SEPTEMBER 2016 | 35

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A BLOG FOR AUSTRALIAN NURSES AND MIDWIVES www.nurseuncut.com.au

WHAT’S HOT THIS MONTH

Do you have a story to tell? An opinion to share?

Nurse uncut is written by everyday nurses and midwives.

We welcome your ideas at nurseuncut@nswnma.asn.au

You’re more likely to survive hospital if your nurse has a degree Your chances of leaving hospital alive are greater if your nurse has a degree, new research shows.

www. nurseuncut. com.au/youremore-likely-tosurvive-hospitalif-your-nursehas-a-degree/

Surgical playlists – help or hazard in the operating theatre?

Music might help the surgeon focus, but is it a distraction for other staff in the OT? http://www.nurseuncut.com. au/surgical-playlists-help-or-hazard-inthe-operating-theatre

An English matron and her Aussie Poms

Don’t throw the birth plan out with the bathwater Birth plans aren’t new age nonsense – they protect mothers’ medical rights, say a midwife and a lawyer. www.nurseuncut.com.au/dont-throwthe-birth-plan-out-with-the-bath-water/

Nurse paints doctor for the Archibald Prize A CNS in medical imaging enters a portrait of his neuroradiologist colleague. www.nurseuncut.com.au/ nurse-paints-doctor-for-the-archibaldprize/

Make your voice heard in the voluntary euthanasia debate

Should I start nursing studies at age 49?

Am I crazy to even consider pursuing nursing at such a late stage of my life, asks Patricia.? www.nurseuncut.com. au/should-i-start-nursing-studies-atage-49/

Nurses’ voices on this issue are critical, writes South Australian Susie Byrne. www.nurseuncut.com. au/ make-your-voice-heard-in-thevoluntary-euthanasia-debate

We’re on

Blanche Lee was the Matron of numerous NSW hospitals who went everywhere with a bunch of Pomeranians. www.nurseuncut.com. au/ an- english-matron-and-heraussie -poms

Instagram!

Share your photos by tagging @nswnma and don’t forget to use the hashtag #nswnma!

New on SupportNurses YouTube channel MARCH TO MIKE’S OFFICE Disability workers are mad as hell at Mike Baird for privatising their sector bit.ly/AHDCMike

NEW DELEGATES AT CONFERENCE Some of our first-timers give their impressions. bit.ly/ delegatesnswnma

Listen to our podcast BETTER OFF DEAD? Andrew Denton on the assisted dying debate. bit.ly/ShiftDenton

Connect with us on Facebook

Nurse Uncut > www.facebook.com/NurseUncutAustralia New South Wales Nurses and Midwives’ Association > www.facebook.com/nswnma Ratios put patient safety first > www.facebook.com/safepatientcare Aged Care Nurses > www.facebook.com/agedcarenurses

Follow us on Twitter @nswnma @nurseuncut

Look for your local branch on our facebook page www.facebook.com/ nswnma

THE LAMP SEPTEMBER 2016 | 37

Expression of interest

MeMbers for the CliMate Change aCtion referenCe group (CCarg) The NSWNMA are seeking expressions of interest from enthusiastic members to join our Climate Change Action Reference Group (CCARG).

The Association needs the support and advice of members who are keen climate activists. We have committed to working with the Climate & Health Alliance (CAHA), in regard to promoting their National Strategy for the Climate, Health and Well-being Campaign.

NSWNMA will be involved in sharing climate and health information with members, assisting with related surveys, and providing access to active members associated with the Global Green & Healthy Hospital’s (GGHH) network. The end goal is to lobby the government through trained climate activists sending media messages to the community in order to promote the introduction of the National Climate, Health and Well-being Policy.

The CCARG will primarily be made up of our members and interested staff. We may invite experienced climate experts who wish to work towards changing the current situation around Climate Change and health outcomes to participate from time to time. This reference group will meet the first Thursday of every second month to discuss a variety of topics and professional issues related to climate and health.

We are seeking nurses and midwives who work in either a private or public health setting and are interested in being proactive in Climate Change, including those who have experience in a rural setting, as well as those with aged care experience. Teleconferencing facilities are available at Meetings for those that cannot attend in person.

Please direct enquiries to: Dr Janet Roden at jroden@nswnma.asn.au

Registered Training Organisation (TOid 41134)

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www.bowentraining.com.au 38 | THE LAMP SEPTEMBER 2016

SOCIAL MEDIA | facebook

WHAT NURSES & MIDWIVES

SAID & LIKED on facebook www.facebook.com/nswnma Funding cuts kick in Nursing education faces a crisis in Newcastle after a federal budget shortfall.

Clinical liaison nurses were told to reapply for a reclassified role and new rate of pay – $22 an hour less.

Bupa needs to catch up Many posts confirmed our Lamp story that BUPA – NSW’s 3rd largest aged care provider – lags way behind the industry leaders when it comes to pay and conditions for their nurses.

Frustration with Riskman A Ten News report asked just how deep problems go within our public hospital system. Managers can edit and alter staff complaints – sometimes to downgrade the severity of the grievance and prioritise according to cost.

Too old to begin nursing?

Is 49 too old to begin nursing studies as an EN or RN?

Certainly distressing times ahead! Nursing is being slowly eroded. For all the years asserting our place as a profession that adds value, the bean counters continue to see our worth as dispensable and a ‘cost’ to the system.

This is just wrong. Our health system is down the gurgler! If you pay peanuts you get monkeys. Not to mention the overall devaluing of the profession. Would they try this with doctors? Imagine the uproar.

This is happening everywhere. Downgrading of skills to justify introducing reduced-skill workers.

So disappointed in the direction nursing is taking. Patients will suffer even more. Disgraceful.

Beautiful facilities/beautiful residents; overworked stressed staff who try their best; lowest paid compared to other aged care facilities; so sad for residents who pay an awful lot of money to be there.

The work is hard enough without getting correct pay rates.

You don’t get buddy shifts as an EEN - you are expected to walk straight in and be in charge of 30 residents and all that entails.

Age care nurses should be on equal pay as all nurses; we are all there for the same reason, to care for people.

Aged care should be not for profit!

Salary packaging for staff would be a huge help. It wasn’t done when I worked at BUPA. It makes a big difference to the pay packet.

What nurses need to do is pass on all Riskmans to the union so they have the information too.

Riskmans should always be followed up with management as to what the outcome was.

I always kept copies of my Riskman but it really was a waste of time. Management just altered complaints to suit.

Without doubt there are countless Riskmans not done because they are deliberately onerous and time consuming and already the core business of nursing/ midwifery has been diverted from bedside to computer and lodging one of these can take 30 to 60 minutes. What clinician has that time?

Not all issues fit into those dropdown boxes and people change facts to make them fit. Important facts are omitted to make the complaint stick.

I started my RN when I was 48. I absolutely love it. No ageism except people expecting me to be more experienced than I am.

I’m a 50yr old EEN working in Paediatrics. 6 months in, wouldn’t change a thing. I’m not looking to climb a corporate ladder like the young RNs can. Just want to be a nurse. LOVE my job.

Being an RN is rewarding at any age. I’m a neonatal RN and we have co-workers of all ages.

PHOTO GALLERY

Conference first-timers Kulpreet and Lena, drug and alcohol nurses.

From our Instagram photo booth at annual conference.

A short break from the agenda...

Delegates enjoy their morning coffee.

THE LAMP SEPTEMBER 2016 | 39

LIONS NURSES’ SCHOLARSHIP

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.

Looking for funding to2017? further your studies in

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 twelve 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

holarships open The Lions Nurses’ Sc ar 31 October each ye on e os cl d an t us ug on 1 A

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

Completed applications must be in the hands of the secretary no later than 31 October Lion Nurses Scholarship.indd 1

24/06/2016 9:33 AM

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NURSING RESEARCH ONLINE

This year at Professional Day delegates participated in a discussion about the relationship between health and inequality. A podcast for the session is available on the NSWNMA website.

All Australian health professionals need to understand the role of inequality in health. Despite much effort and attention we have an unacceptably vast gulf in health outcomes between the richest and the poorest Australians. Equity must be a fundamental principle that underpins all our efforts. Please contribute your thoughts to the discussion taking place on Nurse Uncut (http://www.nurseuncut.com.au/series/vision-statements/).

Health in an unequal world Professor Sir Michael Marmot, Harveian Oration Clinical Medicine 2006; 6: 559–72 This year the 2016 Boyer Lecture Series will be delivered

by Professor Sir Michael Marmot, President of the World Medical Association, Director of the Institute of Health Equity and a leading researcher on health inequality issues for more than three decades. Sir Michael’s 57th Boyer Lecture Series will explore the challenges faced by communities in solving issues around health inequality.

In poor countries, tragically, people die unnecessarily.

In rich countries, too, the higher death rate of those in less fortunate social positions is unnecessary. Can there be a link between these two phenomena: inequalities in health between countries and inequalities within?

Surely, we could argue, the depredations of grinding poverty— inadequate food, shelter, clean water, and basic medical care or public health—that ravage the lives of the poor in developing countries are different in kind from the way that social disadvantage leads to poor health in modern Britain, for example. The diseases of the slums of Nairobi are, to be sure, different in kind from the diseases that affect disadvantaged people in east London in the UK, or Harlem in the USA, and have different proximate causes. There is, however, a link. The unnecessary disease and suffering of disadvantaged people, whether in poor countries or rich, is a result of the way we organise our affairs in society. Sir Michael shall argue that failing to meet the fundamental human needs of autonomy, empowerment, and human freedom is a potent cause of ill health. http://www.who.int/social_determinants/publications/ health_in_an_unequal_world_marmott_lancet.pdf

Thomas Piketty’s “Capital”, summarised in four paragraphs The Economist Explains, May 2014 It is the economics book taking the world by storm: “Capital in the Twenty-First Century”, written by the French economist Thomas Piketty. The English version quickly became an unlikely bestseller, and it has prompted a broad and energetic debate on the

book’s subject: the outlook for global inequality. Some reckon it heralds or may itself cause a pronounced shift in the focus of economic policy, toward distributional questions. The Economist has hailed Mr Piketty as “the modern Marx” (Karl, that is). But what’s it all about?

“Capital” is built on more than a decade of research by Mr Piketty and a handful of other economists, detailing historical changes in the concentration of income and wealth. This pile of data allows Mr Piketty to sketch out the evolution of inequality since the beginning of the industrial revolution. In the 18th and 19th centuries western European society was highly unequal. Private wealth dwarfed national income and was concentrated in the hands of the rich families who sat atop a relatively rigid class structure. This system persisted even as industrialisation slowly contributed to rising wages for workers. http://www.economist.com/blogs/economistexplains/2014/05/economist-explains

Health and Economic Inequality Andrew Leigh, Christopher Jencks, Timothy Smeeding More than 100 articles have been published over the past two decades on whether changes in economic inequality lead to changes in health (Lynch et al, 2004a).

A somewhat smaller literature has looked at whether changes in health affect economic inequality. An even smaller literature looks at whether economic inequality predicts the size of health disparities between educational or economic groups.

This review looks at the most common hypotheses about how inequality might affect health and vice versa.

Hypotheses about how income inequality might affect health fall into three broad classes: those that focus on the implications of diminishing marginal health benefits from increases in individual income, those that focus on relative deprivation, and those that focus on societywide effects of income inequality. Theories about how health might affect inequality also focus on three potential mechanisms: labor market effects, educational effects, and marriage market effects. http://andrewleigh.org/pdf/HealthInequalityOUP.pdf

THE LAMP SEPTEMBER 2016 | 41

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

Authorised by B.Holmes, General Secretary, NSWNMA

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

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

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

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

Watch Alexis talk about Journey Accident Insurance

JOURNEY ACCIDENT INSURANCE

Your journey injury safety net

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

Change your payment information online at

42 | THE LAMP SEPTEMBER 2016

www.nswnma.asn.au

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Across 1. Aversion of a free edge; usually applied to the eyelid (9) 9. Sloping, slanting, or leaning (8) 10. Situated entirely within, or pertaining exclusively to, a part (9) 12. Having teeth of different shapes, such as the molars and incisors of humans (10) 13. To tip away from an upright position (4) 17. A cell distinct from others in the same tissue (9) 19. Mucous membrane (6) 22. Sinus tachycardia (1.1) 23. Symbol for tellurium (2) 24. Cubic centimeter (1.1) 25. A large vein on the anterior surface of the heart (5.7.4) 28. Consisting of two similar separable parts (8) 30. Ejection fraction (1.1) 31. Moved in waves or in a wavelike motion (9)

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34. Imaginary; fictitious (8) 35. The services rendered by members of the health professions for the benefit of a patient (4) 36. Baglike organs or structures (4) 37. The crushing of calculi in the bladder, urethra, kidney, or gallbladder (11) 38. The point-for-point pairing of homologous chromosomes during the prophase of meiosis (8) 39. An involuntary intake of breath through a wide open mouth (7) Down 1. Producing or releasing something (8) 2. Combine, compound (8) 3. Leave out (4) 4. Interstitial cell-stimulating hormone (1.1.1.1) 5. Winked, blinked (8) 6. Albinism, depigmentation (8) 7. The organ or seat of consciousness and higher functions of the human brain (4)

8. Bundles of nerve fibres in the brain or spinal cord (8) 11. That is (1.1) 14. The innate aspect of the personality dominated by the pleasure principle and seeking immediate gratification (1.1) 15. Disorder in which all aspects of speech and communication are severely impaired (5.7) 16. Vocal fold (5.7) 18. Produces sounds by rubbing one part of the body against another (11) 20. A noncriminal legal action (5.6) 21. A common skin disease characterized by pimples on the face, chest, and back (4) 26. To consider or make an abstract idea real or concrete (5) 27. Incision of the iris (9) 28. Confuses; bewilders (7) 29. A cerebroside from brain tissue (7) 32. Symbol for tantalum (2) 33. Dose equivalent (1.1) THE LAMP SEPTEMBER 2016 | 43

RECRUIT A NEW MEMBER & GO INTO THE DRAW TO WIN A 4-NIGHT STAY AT

LOCKYER VALLEY, QUEENSLAND

PRIZE DRAWN 30 JUNE 2017

THE 2016 – 2017 NSWNMA MEMBER RECRUITMENT SCHEME PRIZE The winner will experience all the style and comfort of a luxury retreat with the warmest of country welcomes. A four night (midweek) stay for two with: • Wine and Cheese plate on arrival; • Breakfast daily; • 2 x 2 course lunches; • 2 x 3 course dinners; • 2 x 60 minute facial or massage for 2 guests (4 in total) • 4 wheel drive tour for 2 guests.

44 | THE LAMP SEPTEMBER 2016

The NSWNMA will arrange return flights for two from Sydney to Brisbane and car hire for the duration of the prize.

Spicers Retreat Hidden Vale is a gem, an uncomplicated escape just an hour’s drive from Brisbane.

Experience the uniquely revitalising effect of spending time on 12,000 acres of true Australia bush. Space to relax. Space to listen, to laugh and to embark on an adventure amongst the abundant wildlife.

Every member you sign up over the year gives you an entry in the draw!

RECRUITERS NOTE:

Join online at www.nswnma.asn.au If you refer a member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entitled to your vouchers and entry in the NSWNMA Recruitment Incentive scheme.

SPICERSRETREATS .COM

Conditions apply. Prize must be redeemed by 30 June 2018 and is for stays outside of School Holiday periods, midweek (Monday to Thursday). Competition opens on 1 August 2016 and closes 30 June 2017. The prize will be drawn on 30 June 2017. If a redraw is required for an unclaimed prize it must be held up to 3 months from the original draw date.

NSW Permit no: LTPM/16/00329.

BOOK ME All the latest Book Me reviews from The Lamp can be read online at www.nswnma.asn.au/library-services/book-reviews.

REFLECTIVE PRACTICE IN NURSING (3RD EDITION) Lioba Howatson-Jones SAGE Leaning Matters (available from Footprint Books): http://www.footprint.com.au RRP $47.95. ISBN 9781473919297 Reflective practice enables us to make sense of, and learn from, the experiences we have each day and if nurtured properly can provide skills that will you come to rely on throughout your nursing career. Using clear language and insightful examples, scenarios and case studies the third edition of this popular and bestselling book shows you what reflection is, why it is so important and how you can use it to improve your nursing practice.

LIVING WITH LYMPHOMA: A PATIENT’S GUIDE (2ND EDITION) Elizabeth Adler Johns Hopkins University Press (available from Footprint Books): http://www.footprint.com;au RRP $63.00. ISBN 9781421418100 This new edition includes the latest information on lymphoma diagnosis, treatment, and incidence, and describes the most recent update to the WHO system of lymphoma classification and staging.

Adler discusses new targeted therapies like ibrutinib and idelalisib and describes how other treatments, including radiation therapy and stem cell transplants, have been modified, while others have been discontinued.

She also addresses new developments, such as the possible role of lack of sunlight and vitamin D in the pathogenesis of lymphoma, and the use of medical marijuana.

INTRODUCTION TO PUBLIC HEALTH Raymond Goldsteen, Karen Goldsteen, Terry Dwelle Springer Publishing Company (available from Footprint Books): www.footprint.com.au.

RRP $92.00. ISBN 9780826196668 Updated and thoroughly revised, the second edition of this foundational text continues to cover all major topics of organisation, financing, workforce, goals, initiatives, accountability, and metrics from the perspectives of academicians and officials in public health. This second edition is the only public health text to encompass the new legislation implemented by the Affordable Care Act, with its focus on prevention and increase in funding for

DISCOUNT BOOKS FOR MEMBERS! The Library is pleased to announce that McGraw Hill Publishers are now offering members a 25% discount off the RRP! The offer currently covers medical as well as a range of other professional series books.

Please see the online Book Me reviews for a link to the promotion code and further instructions, or contact the Library directly for further information.

SPECIAL INTEREST SISTER JANET: NURSE & HEROINE OF THE ANGLO-ZULU WAR 1879 Brian Best and Katie Stossel Pen & Sword Books

(available from Booktopia) http://www.booktopia.com.au RRP $59.95.

ISBN 97818441542589 Janet Wells was only 18 when decorated for her nursing service to the Russians in the 1878 Balkan War. The following year she became the only nurse to serve at the Front in the Anglo Zulu War. After a period in Northern Zululand she was sent to the garrison at Rorke’s Drift very soon after the legendary action.

Revered by the soldiers, she had to make do in appalling conditions with scant supplies. She overcame extreme difficulties and prejudice despite her youth. After returning to England in time for her 20th birthday, her achievements were recognized by the award of the Royal Red Cross – the highest accolade and the equivalent of the Victoria Cross.

This is a gripping tale of a true heroine who refused to accept the conventions of the age and in so doing made a huge contribution to the welfare of the British Army.

prevention research. It also examines resulting job opportunities and expanded interest in the public health field. Comprehensive and accessible, the text discusses a variety of new trends in public health, particularly regarding primary care and public health partnerships. The second edition also includes information about new accountability initiatives and workforce requirements to contribute to ‘public health services and systems research,’ better known as health services research and clinical outcomes research in medical care. The text stresses the increasing emphasis on efficiency, effectiveness, and equity in achieving population health improvements, and goes beyond merely presenting information to analyze the question of whether the practice of public health achieves its promise.

All books can be ordered through the publisher or your local bookshop. NSWNMA members can borrow the books featured here via the Library’s Online Catalogue: visit http://www.nswnma.asn.au/library-services. Call 8595 1234 or 1300 367 962, or email gensec@nswnma.asn.au for assistance with loans or research.

Some books are reviewed using information supplied and have not been independently reviewed.

THE LAMP SEPTEMBER 2016 | 45

Going to work shouldn’t mean stepping into this.

ARE YOU A VICTIM OF WORKPLACE VIOLENCE? Have you or a colleague been assaulted at work?

Have you reported your incident?

Download the NSWNMA App and report your workplace violence incident.

The NSWNMA has a new tool as part of our NSWNMA Toolkit App that allows you to quickly report an incident to the Association as soon as it happens. It’s an easy fillable form that you can submit from your mobile device and an officer of the Association will be in touch with you.

Nursing is considered one of the most dangerous professions.

HELP STOP VIOLENCE AT WORK!

46 | THE LAMP SEPTEMBER 2016

NSWNMA Toolkit App is FREE and available to download from iTunes and Google Play store

MOVIE OF THE MONTH

METRO MEMBER GIVEAWAY

The Girl on the Train

DVD SPECIAL OFFER

RURAL MEMBER GIVEAWAY

Based on the best-selling novel by Paula Hawkins, The Girl on the Train is an electrifying thriller directed

by Tate Taylor (The Help) and starring Emily Blunt.

Devastated by her recent divorce, Rachel (Blunt) spends her daily commute fantasising about the seemingly perfect couple who live in a house that her train passes every day, until one morning she sees something shocking happen there and becomes entangled in the mystery that unfolds.

EMAIL The Lamp BY THE 12TH OF THE MONTH TO BE IN THE DRAW TO WIN A DOUBLE PASS TO THE GIRL ON THE TRAIN THANKS TO ENTERTAINMENT ONE. EMAIL YOUR NAME, MEMBERSHIP NUMBER, ADDRESS AND TELEPHONE NUMBER TO lamp@nswnma.asn.au FOR A CHANCE TO WIN!

MURDER – THE COMPLETE SERIES BBC’s BAFTA Award winning 4-part series, MURDER, throws a stark and unsettling light on four separate cases titled Joint Enterprise, The Third Voice, Lost Weekend and The Big Bang. Rich in forensic and psychological detail, with a unique depth of characterisation, each of the films pick apart a murder in all its terrible complexity, hearing the story from every angle and casting the viewer as a jury-member forced to decide on guilt and innocence. Mixing techniques of documentary with the power, invention and breathtaking visuals of drama, these haunting and graphic ‘whodunits’ live long in the mind.

EMAIL THE LAMP BY THE 15TH OF THIS MONTH TO BE IN THE DRAW TO WIN A DVD OF MURDER – THE COMPLETE SERIES THANKS TO RLJ ENTERTAINMENT RELEASES. EMAIL YOUR NAME, MEMBERSHIP NUMBER, ADDRESS AND TELEPHONE NUMBER TO LAMP@NSWNMA.ASN.AU FOR A CHANCE TO WIN! THE LAMP SEPTEMBER 2016 | 47

winter news

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NSWNMA NIDA Film Making Workshops

BUDDING FILM MAKERS! is erAssociation The is running two NIDA Film Making Laught e! st medicin the be Workshops for NSWNMA Members and Associate Members wanting to learn new, or brush up on existing film making, skills.

These are the only two NIDA film making workshops prior to the 2017 Nurses and Midwives Short Film Festival. All equipment for workshops is provided by NIDA. Places in each workshop is limited to 15 participants so make sure you get your applications in promptly.

2 DAY INTRODUCTORY FILM MAKING WORKSHOP 10AM — 5PM THURSDAY 20 & FRIDAY 21 OCTOBER 2016

I want one! Fill in the form and fax to (02) 9662 1414 or send to: NSWNMA, 50 O’Dea Avenue Waterloo NSW 2017.

Merchandise order forms also available at www.nswnma.asn.au Active Soft Shell Navy Jacket $50

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10 12 14 16 18 s m l xl xxl 3xl Postage & handling $5/item. totAl coSt of order $

This course is part sponsored by the NSWNMA. Cost to participants $400+GST.

AddreSS

PLEASE NOTE: Only those who have undertaken the 2 day NIDA Film Making Course, or can prove prior film making experience, will be accepted into the advanced course.

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48 | THE LAMP SEPTEMBER 2016

5 DAY ADVANCED FILM MAKING WORKSHOP 24 — 28 OCTOBER 2016

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Update your membership details online & go into the draw to

win a smart watch IT’S EASY! Log into the Association’s online portal at www.nswna.asn.au to check your membership details are correct. Do this at a time that suits you and your name will automatically go in the draw to WIN AN APPLE OR ANDROID SMART WATCH*!

For a chance to win, simply register with your membership number, name and email address and create your own password. Then use your member number and password to log in directly to the Members login area on the website.

You can now change your details at anytime – address, workplace, credit card number, mobile number, etc.

You can pay fees online, print a tax statement or request a reprint of your membership card – IT’S SIMPLE. All those who use our online portal from 1 July – 30 November 2016 will be automatically entered into the draw.

*The winner will be able to select one of these watches.

Winner must be a financial member of the NSWNMA.

Membership online via www.nswnma.asn.au

THE LAMP SEPTEMBER 2016 | 49

COVER STORY DIARY DATES — CONFERENCES, SEMINARS, MEETINGS DIARY DATES IS A FREE SERVICE FOR MEMBERS Please send event details in the format used here: event name, date and location, contact details – by the 5th of each month. Send your event details to: lamp@nswnma.asn.au Fax 02 9662 1414 Post 50 O’Dea Ave, Waterloo NSW 2017. All listings are edited for the purposes of style and space.

DIARY DATES IS A FREE SERVICE FOR MEMBERS lamp @ nswnma.asn.au NSW

Cardiology and the Deteriorating Patient 8 September 2016 Rydges Mount Panorama, Bathurst www.dibseducation.com.au Enrolled Nurse Professional Association 8-9 September 2016 Novotel North Beach, Wollongong PO Box 775, Kingswood 2747 or 1300 554 249 The Children’s Hospital at Westmead Paediatric Perioperative Seminar 10 September 2016 Novotel Parramatta, Sydney claudia.watson@health.nsw.gov.au Midwifery Update Seminar- Sydney NSW 10 September 2016 Rydges Parramatta, Rosehill www.acutecareeducation.com.au/ seminar/midwifery-update-seminarsydney-nsw Cardiology and the Deteriorating Patient 15 September 2016 Gosford Golf Club, Gosford www.dibseducation.com.au Working Together: Eating disorder management seminar 16 September 2016 Albury Wodonga Health, Albury lauren.kendrick@awh.org.au Innovations in Cancer Treatment and Care Conference 2016 16 September 2016 Australian Technology Park, Sydney www.cancerinstitute.org.au/events/i/ innovations-2016 4th Annual Anaesthetics & PARU Conference 16-17 September 2016 Harbourview Function Centre, Newcastle www.empowernurseeducation.com.au Diabetes Update Day 17 September 2016 Australian Technology Park www.diabetesupdate2016.eventbrite. com.au Australasia-Pacific Post-Polio Conference 20-22 September 2016 Four Seasons Hotel, Sydney www.polioaustralia.org.au/ ACPAN Wollongong Twilight Seminar 22 September 2016 Wollongong Hospital, Wollongong www.aspaan.org.au ‘Working with Complexity in Maternity Care’ - One Day Seminar 23 September, 2016 KP Education centre, RPA, Sydney www.slhd.nsw.gov.au/RPA/cmnr/pdf/ Registration.pdf Transforming our Landscape Biennial State Conference 2016 13-15 October 2016 Broken Hill www.palliativecarensw.org.au Pain Interest Group Nursing Issues - Reframing Pain Professional Development Day 2016 21 October 2016 Le Montage, Sydney www.dcconferences.com.au/pigni2016 Audiometry Nurses Association of Australia INC Annual Conference and AGM 26-28 October 2016 Quality Noahs on the Beach, Newcastle http://anaa.asn.au Bones on the Beach Orthopaedic Conference

29 October 2016 Juliana Zvavanjanja: 024222 5966 or zvisinei.zvavanjanja@health.nsw.gov. au Nalda Ward: 024222 5811 or nalda. ward@health.nsw.gov.au 4th International Collaboration of Perianaesthesia Nurses [ICPAN] Conference 1-4 November 2017 Luna Park, Sydney www.icpan2017.com.au Australian Rural and Remote Mental Health Symposium 2- 4 November 2016 Mantra on Salt Beach, Kingscliff www.anzmh.asn.au/rrmh High Dependency Nursing Conference 4 November 2016 Westmead Hospital Katherine.Schaffarczyk@health.nsw. gov.au Perioperative Nursing Seminar 12 November 2016 Rydges Parramatta, Rosehill www.acutecareeducation.com.au/ seminar/perioperative-nursing-seminarsydney-nsw-4/ Australian Women’s Health Nurse Association 30 Year Inservice 17-18 November 2016 Carrington Hotel, Katoomba Jenny.Bath@hneheath.nsw.gov.au ‘Building Blocks of Critical Care’ Adult & Paediatric Seminar 18 November 2016 University of NSW www.acccn.com.au/events/event/nswcritical-care-seminar-18-november-2016 Perioperative Nursing Seminar 26 November 2016 Mercure Wagga Wagga, Wagga Wagga www.acutecareeducation.com.au/ seminar/perioperative-nursing-seminarwagga-wagga-nsw-2/ 26th Nepean Midwifery Conference – Save the Date 10 March 2017 Hawkesbury Valley Race Club, Clarendon Juanita Taylor: 0417 123 900

ACT

Optimising Health: Salutogenic approaches to health practice, policy, research and education 26-27 October 2016 Ann Harding Conference Centre.

University of Canberra, ACT www.canberra.edu.au/events/ view/13576

INTERSTATE

World Indigenous Women’s Conference 2016 14-16 September 2016 Stamford Beach Hotel Glenelg, Adelaide, SA www.indigenousconferences.com International Conference for Emergency Nurses 19-21 October 2016 Alice Springs Convention Centre, NT www.2016.icen.com.au The National Nursing Forum 26-28 October 2016 Melbourne Park Function Centre, VIC www.acn.edu.au/nnf2016 Nursing Network on Violence Against Women International Conference 2016 26-28 October 2016 InterContinental The Rialto, Melbourne, VIC www.latrobe.edu.au/jlc/news-events/ NNVAWI-Conference-2016

50 | THE LAMP SEPTEMBER 2016

Hospital in The Home (HITH) 9th Annual Scientific Meeting 2016 2-4 November 2016 Stamford Grand, Glenelg, SA www.conference.hithsociety.org.au Clinical Nursing & Nurse Education 2016 7-9 November 2016 Melbourne, VIC www.clinical.nursingconference.com ACPAN National Conference 12 November 2016 Park Hyatt, Melbourne, VIC www.acpan.edu.au 5th Closing the Gap Indigenous Health Conference and 2016 World Indigenous Allied Health Conference 1-3 December 2016 Pullman Cairns International Hotel, Cairns, QLD www.indigenousconferences.com STOP Domestic Violence Conference 5-7 December 2016 Mercure Brisbane, QLD www.stopdomesticviolence.com.au

INTERNATIONAL

5th World Congress of Clinical Safety 21-23 September 2016 Joseph B. Martin Conference Center, Harvard University Medical School, Boston, USA www.iarmm.org/5WCCS/ International Zika Virus Conference and Workshop 28-30 September 2016 Washington, DC, USA www.nordtree.com/ZIKV/index.php BIT’S 3rd Annual World Congress of Orthopaedics 29 September-1 October 2016 Korea International Exhibition Center (KINTEX), Goyang-Si, South Korea www.bitcongress.com/wcort2016/ Heart Rhythm Congress 9-12 October 2016 International Convention Centre, Birmingham, United Kingdom www.heartrhythmcongress.org 5th International Conference on Violence in the Health Sector 26-28 October 2016 Dublin, Ireland www.oudconsultancy.nl/dublin_5_ ICWV/index.html Emergency Care Conference 6-10 February 2017 Rusutsu Resort, Hokkaido, Japan www.emsconferences.com.au

REUNIONS

Kempsey Hospital NSW Ex and Older Staff Reunion 10 September 2016 South West Rocks, Country Club Trudy Lynch: 0265627794 Brenda: 0265674532 Royal North Shore Hospital May 1976-1979 Group 40 Year Reunion 17 September 2016 Boronia House, Mosman Carol Still: carolstill@me.com or 0409483308 Annual Reunion Lunch: Sydney Hospital Graduate Nurses Lunch 4 October 2016 Parliament House, Macquarie Street Jeanette Fox: 024751 4829 or bekysa@ tpg.com.au St Vincent’s Darlinghurst PTS Class March 1976-1979 40 year reunion 22 October 2016 Kerrie Maher: kerriefmaher@hotmail. com or 0408464903

Waratah House 30th Birthday Party Campbelltown Mental Health 22 October 2016 Troy Kiefer: troykiefer@sswahs.nsw. gov.au All PHH and NEC Nurses All Years & 50 year Reunion 29 October 2016 Nurses War Memorial Chapel, PHH Museum Margaret Paterson (President PHHNA): 0290190784 or lindapaterson@live. com.au St Vincent’s Darlinghurst PTS Class January 1977 40 year reunion Mary Piechowski (nee Morris):piechow@grapevine.com.au Anne Barudi (nee Whelan):annebarudi@optusnet.com.au Tamworth Base Hospital February 1976 intake 40-year reunion Contacts: Sandra Cox: sandra.cox@ hnehealth.nsw Sean O’Connor: 0408 349 126 Gerard Jeffery: 0417 664 993 Auburn Hospital October 1976-1979 40th Reunion Sharon Byers: 0419 144 965 or sbyers01@bigpond.net.au Margaret Borg (Mueller): 0431 159 964 or margaret_borg@bigpond.com Australian Women’s Health Nurses Association 30 Year Reunion Dinner 18 November 2016 Carrington Hotel, Katoomba Jenny Bath: Jenny.Bath@hnehealth. nsw.gov.au Royal Prince Alfred Hospital January 1977 (including Rachel Foster Hospital) 40 Year Reunion 3 Day Comedy Cruise P&O Pacific Pearl Cruise Number: P207 Booking Reference: GNVQXN Departs Sydney - 27 January 2017 Contact Michele Kristidis (nee ‘Lee’ Sweeney): michelekristidis@hotmail. com RAHC Royal Alexandra Hospital for Children PTS 1977- 40 Yr Reunion 4-5 February 2017 Coleen Holland (Argall): bobandcolh@ yahoo.com.au St Vincents Darlinghurst PTS Class March 1977- 40 year Reunion 25 March 2017 Frances O’Connor (nee Pugh): 0415764131 or fgoconnor@optusnet. com.au 25 year reunion: 1992 UWS Nepean Graduating Class July 2017 Sydney, NSW Bede McKinnon: bede01@bigpond.com

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