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VOLUME 73 No.7 AUGUST 2016
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2 | THE LAMP AUGUST 2016
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.7 AUGUST 2016
Hunter Office 8-14 Telford Street, Newcastle East NSW 2300 NSWNMA Communications Manager Janaki Chellam-Rajendra T 1300 367 962
COVER STORY
12 | Safety fears at mental health ICU A Local Health District has proposed the introduction of assistant in nurses in one of the most dangerous workplaces in the state. Gabi Pearson and Michelle Rosentreter PHOTOGRAPH: SHARON HICKEY
REGULARS 5 6 8 33 35 39 41 43 45 47
Editorial Your letters News in brief Ask Judith Social media Nursing research online Crossword Books Movie of the month Diary dates
PRIVATISATION
22 | The sneaky sell off of Medicare
COVER STORY
14 | Patients, nurses exposed to greater risk The NSWNMA has called on the Ministry of Health to intervene to stop local health districts employing assistants in nursing in mental health intensive care units.
AGED CARE
18 | Bupa needs to catch up BUPA is NSW’s third largest aged care provider but surprisingly its wages and conditions lag way behind its position.
During the federal election campaign Malcolm Turnbull denied his government would privatise Medicare. Health experts say he was being “disingenuous”.
COMPETITION
6 | Win a relaxing Southern Highlands escape
BREXIT
26 | NHS a Brexit pawn Leave campaigners promised Britain a fictitious windfall for the NHS if it left the European Community.
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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EDITORIAL BY BRETT HOLMES GENERAL SECRETARY
A dangerous precedent The introduction of unregulated AiNs into the unstable and unpredictable environment that is a Mental Health ICU is a recipe for disaster.
It is hard to see how a decision to introduce AiNs into Hornsby Ku-ringgai Hospital’s Mental Health ICU fits into a strategy of minimising workplace violence in our hospitals.
The introduction of AiNs into acute mental health services, particularly Mental Health Intensive Care Units (MHICUs) as a cost saving measure is short sighted and risky. It is risky for both patients and staff because AiNs don’t have the necessary skills and experience to deal with the challenging situations that arise in these units. It is short sighted because it will probably lead to a rise in health care costs due to higher workers compensation costs and longer and more frequent client admissions. AiNs have important roles to play in our health system but this isn’t one of them. The NSWNMA has always maintained that AiNs should not be employed at the expense of registered or enrolled nurse positions and must be employed to provide nursing care where appropriate. MHICUs are by nature unpredictable, volatile environments where workplace violence is an ongoing hazard and where patients require constant clinical assessment and nurses with highly technical and professional skills are critical and irreplaceable. AiNs do not have that kind of training or experience. Workplace violence is an issue that we take very seriously. We have devoted a lot of space in The Lamp to it. It was not hyperbole on our part to describe some mental health units with atrocious histories of endemic violence as among Australia’s most dangerous workplaces. It was (and remains) a serious problem that was acknowledged by the government, NSW Health and the NSWNMA when we agreed to a taskforce to look at the issue earlier this year. We engaged with NSW Health in good faith to try and find ways to minimize the risk to patients and staff in our hospitals including mental health units. It is hard to see how a decision to introduce AiNs into Hornsby Ku-ring-gai Hospital’s Mental Health ICU (see story page 12) fits into a strategy of minimising workplace violence in our hospitals. THE THREAT OF PRIVATISATION Privatisation remains an ongoing threat to Medicare and our public health system despite
Malcolm Turnbull’s protestations to the contrary during the election campaign. The Association has campaigned strongly against privatisation for a long time. For many years it seemed we were a lone voice in the wilderness so it is encouraging that the federal election forced the political parties to front up – at least to some extent - on whether they will or won’t privatise Medicare and public health services. We welcome that development even if it has happened belatedly. It is a debate that needs to continue and to deepen if the public is to understand what is happening to Medicare and our public health system so it can make an informed choice about what sort of system it wants for the future. In this issue of The Lamp we look at what different health experts have to say about the privatisation of public health services (see pp 22-25). They argue that there are a lot of semantics in politic debate about what constitutes privatisation. There are many ways in which a shift from public to private can occur and the piecemeal way in which it does occur disguises what is being done to the system overall. Increased co-payments, the abolition of bulk billing incentives, the freezing of Medicare fees to doctors and the privatisation of funding through an expanded role for private health insurers all act to undermine the universality of public health. The NSWNMA recognises the important contribution of private health. General Practice is a part of private health care provision that is an integral part of our universal access. It is funded to a large extent by Medicare, which helps to constrain the costs of health care delivery. Private hospitals have an important role in our system and we know our members working in these hospitals deliver excellent care to many people. We also recognise that there is a role for private health insurance for those who can afford it. Very few people can afford private hospital care without it. What needs to be discussed is, whether private health insurance should be subsidised by the tax payer in the massive way that it now is and what are the consequences if public resources are diverted away from Medicare and public health. THE LAMP AUGUST 2016 | 5
YOUR LETTERS
LE TTE R OF THE MONTH
Lismore parking rebellion
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To enter the competition, simply provide your name, address and membership number and email your entry with the subject: Peppers Manor House to lamp@nswnma.asn.au *Conditions apply. Rooms subject to availability. Prize must be redeemed by 1 September 2017 and is valid for stays Sunday to Thursday nights. Competition entries from NSWNMA members only and limited to one entry per member. Competition opens 1 August 2016 and closes 31 August 2016. The prize is drawn on 1 September2016. If a redraw is required for an unclaimed prize it must be H E L Afrom M P the J U Loriginal Y 2 0 1draw 6 date. NSW Permit no: LTPM/16/00329 held up6to| 3Tmonths
On Monday 4th July, on-street Council paid parking in conjunction with the opening of the hospital paid parking station came into effect in the Lismore Base Hospital (LBH) precinct. Only 400 out of approximately 1600 staff requiring parking at LBH got a spot allocated by random ballot to park in the hospital car park for $12 a week. The only other street parking provided for staff by council was 91 spaces in a poorly lit street at a cost of $5 a day or parking in streets nearby for $3/hour with a 2-hour limit. Free parking was available a few blocks away but all in poorly lit areas, making it a safety concern for staff getting back to their cars at night. We decided at a Branch meeting that all staff would boycott council paid parking when it was introduced. On 4th July no staff member and very few visitors parked in Council paid parking and the streets were empty. Our public awareness campaign began that night, with photos of the empty council car park spaces posted to Facebook and encouraging staff to be resolute in their commitment to maintain the boycott – this post to Facebook got almost 60,000 views. Community support for the nurses at LBH has been outstanding. A LBH Neighbourhood Action group was formed to support health workers to achieve $2-a-day parking for all staff and visitors in council paid-parking areas at LBH. Members have been busy emailing councillors to support a motion at the October Council meeting for $2 a-day-parking. In September there will be Council elections and a new Council, so NSWNMA members will be busy lobbying all prospective councillors to be in favour of the motion at October’s meeting. We have also started a Change.org petition which we will present to the new Council. Our members have been fantastic and really engaged with this campaign, reinvigorating the LBH Branch. With community support and our commitment to maintain the boycott on Council parking, we will achieve a fair outcome for staff and our community. Shaen Springall RN CNS, Goonellabah The right to die with respect I attended the NSWNMA Professional Day at Rosehill last week. What a great day. There were two subjects I found particularly interesting. Former nurse Kate Swaffer told her own story about being diagnosed with dementia and the struggle she and her family have gone through. This gave me such insight and a new understanding of this illness. Andrew Denton’s talk on voluntary euthanasia ‘Better off dead’ touched my heart in a big way. I don’t understand why we in Australia don’t allow a person’s right to self determination. Andrew acknowledged that we as nurses can play a big role in this debate - the NSWNMA has a position statement about this. I think we need to help get an ‘assisted dying’ bill passed at all levels of government. The patients we care for have the right to live or die with respect. Stanley White EEN, Woollahra
Advertise in The Lamp and Reach more than 61,000 nurses and midwives. To advertise please contact Danielle Nicholson 02 8595 2139 / 0429 269 750 dnicholson@nswnma.asn.au
YOUR LETTERS
Nurse generation next I have just had a very proud mother and NSWNMA member moment. Having been a Registered Nurse and NSWNMA member for 30 years, I now have a daughter who has decided to become a Registered Nurse and is currently studying at UOW. Today she asked me if I receive The Lamp and if she could have a look at it. I carry the magazine with me everywhere I go, especially when working, so I dived into my workbag and said here, go for it! In another two and a half years, the NSWNMA may have another member. Mary Carroll-Cross RN, Horsley
WINTER NEWS
Issue: August 1, 20
EDITOR’S NOTE: Student membership of the NSWNMA is free when studying Nursing or Midwifery and gives you a great range of benefits: scholarships – use of library services – our monthly journal The Lamp – access to our professional services team – discounted rates to attend NSWNMA seminars, conferences and workshops – Union Shopper, a discount buying service. See details of the benefits that will assist you while you study @ www.nswnma.asn.au/members/benefits.
A memorable night with Vika Thank you for my lucky tickets [from the Nurse Uncut blog relaunch contest] to attend Vika Bull’s Opera House concert, ‘The Etta James Story’. My husband and I thoroughly enjoyed the show and gave Vika a standing ovation for such a magnificent voice. We were amazed by Etta’s life story and all her trials that brought her to sing such wonderful songs. We made a night of it, firstly going out to Mr Wong’s restaurant then staying overnight at the Park Regis. Thank you once again, Kris Blain RN RM, Thirroul Suffragette is a great movie Thank you very much for the DVD ‘Suffragette’ which I recently won in the Rural Member giveaway. It’s a great movie and I really enjoyed watching it. Jutta Flynn Professional Member, Willawarrin
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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NEWS IN BRIEF
Britain
Decriminalise drugs say public health experts Two of Britain’s leading public health bodies argue that drug misuse should be treated as a public health issue not a criminal one. The Royal Society for Public Health (RSPH) and the Faculty of Public Health argue that the war on drugs has done more harm then good and courts and prisons have not deterred people from taking drugs. They have produced a new report – Taking a new line on drugs (http://www.rsph.org.uk/) - that recommends a high priority be placed on the education of young people and children about drugs in school.
World
Climate change records smashed around the world Scientists are describing a string of climate change records this year as “a bombshell and an emergency”. They say that climate change has reached unprecedented levels and is no longer a threat for the future but is having a major impact now. Among the records set this year: • Every month this year has been the hottest on record globally for that month. • Concentrations of carbon dioxide in the atmosphere are expected to increase by a stunning 3.1 parts per million, up from an annual average of 2.1. • Australia clocked up its hottest ever autumn. Average temperatures were 1.86C above the average, beating the previous record of 1.64C above average, set in 2005. • The Arctic had its warmest winter on record in 2015-16. • India recorded its hottest day ever on 19 May – 51 degrees in Phalodi, Rajasthan. • Alaska had its warmest spring on record. • The Great Barrier Reef experienced its worst coral bleaching event. Prof Stefan Rahmstorf, from the Potsdam Institute for Climate Impact Research in Germany told the Guardian (June 2016) that these records were ‘very worrying signs’. “We need to change course very, very fast,” he said. “What is happening right now is we are catapulting ourselves out of the Holocene, which is the geological epoch that human civilisation has been able to develop in, because of the relatively stable climate.” Bob Ward from the London School of Economics’ Grantham Research Institute on Climate Change shared his concerns. “What’s worrying is that we are in unprecedented territory and we don’t really know what the consequences will be. There are likely to be plenty of surprises, some of which will be nasty,” he said.
“WHAT’S WORRYING IS THAT WE ARE IN UNPRECEDENTED TERRITORY AND WE DON’T REALLY KNOW WHAT THE CONSEQUENCES WILL BE.” 8 | THE LAMP AUGUST 2016
“CRIMINALISATION AND INCARCERATION FOR MINOR, NONVIOLENT OFFENCES WORSEN PROBLEMS LINKED TO ILLICIT DRUG USE, SUCH AS SOCIAL INEQUALITY, VIOLENCE AND INFECTION.” One of the authors of the report, Professor John Middleton from the Faculty of Public Health, said there was a need for “a new, people-centred approach to drug policy, rooted in public health and the best available evidence”. “The time for reframing the global approach to illicit drugs is long overdue. The imbalance between criminal justice and health approaches to illicit drugs is counterproductive. Criminalisation and incarceration for minor, non-violent offences worsen problems linked to illicit drug use, such as social inequality, violence and infection. Possession and use should be decriminalised and health approaches prioritised.” The RSPH commissioned a poll of more than 2,000 adults and found that more than half – 56% – agreed that drug users in their local area ought to be referred for treatment, rather than charged with a criminal offence. Fewer than a quarter – 23% – disagreed.
Britain
The ‘silent epidemic’ of chronic pain 28 million British adults – two fifths of the population – are living with pain that has lasted for three months or longer, a new study reveals. The study was part funded by the British Pain Society and published in BMJ Open (June 2016). It involved a review of 19 studies conducted since 1990 involving nearly 140,000 people in Britain.
World
Australians want to back off the booze The Global Drug Survey has found that many Australians believe they are drinking too much alcohol and want help to drink less. Almost a quarter of Australian respondents to the 2016 Global Drug Survey (http://www.globaldrugsurvey.com/) said they had hurt themselves or others as a result of their drinking, while 42% reported wanting to drink less. 13.7% believed they needed help to drink less while 4.2% said they planned on taking steps to seek this help. The survey, which attracted more than 100,000 participants including 5,400 Australians, was one of the largest studies ever of drug-using behaviour. Guardian Australia was the local partner to conduct the survey. 59.9% of male respondents and 51.6% of women scored eight or more on the WHO Alcohol Use Disorders Identification test, which indicates hazardous and harmful alcohol use, as well as possible alcohol dependence. Nadine Ezard, the clinical director of St Vincent Sydney’s alcohol and drug service, told the Guardian many of those who took part in the Global Drug Survey recognised they needed help but fewer reported they intended taking steps to get it. “We need to talk about how common alcohol dependence is and to train up the health workforce to recognise it and provide help,” she said. “We also need to get the message out there that it’s OK to ask for help, because there is a lot of stigma still around asking for help for drinking.”
The authors found that women were more likely to experience chronic pain than men, while prevalence was generally found to increase with age. In one study, prevalence among those over the age of 75 was as high as 62%. The review also revealed that between 10.4 and 14.3% of the UK population have chronic pain that is either moderately or severely disabling. Researchers concluded that the figures were likely to worsen with an ageing population. Alan Fayaz, an author of the study from Imperial College, London said the public had a low level of awareness of the extent of chronic pain. “Nobody ever talks about chronic pain, it is like a silent epidemic,” he said. “What I would really like is for us to have better tools in order for us to identify those people who are most severely affected and how we can help them, what their care needs are.”
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“THE AUTHORS FOUND THAT WOMEN WERE MORE LIKELY TO EXPERIENCE CHRONIC PAIN THAN MEN.” THE LAMP AUGUST 2016 | 9
NEWS COVERINSTORY BRIEF
World
No smoking kills big tobacco Smoking bans have seen a decline in profits for tobacco companies in their domestic markets. It has also limited their capacity to move to other markets which could lead to the death of the industry. Smoking is on the decline in countries where smoking bans have been implemented. In Britain, for example, 400,000 people quit smoking within a year of the introduction of a smoking ban in all enclosed workplaces. More than 170 countries have signed the World Health Organisation’s Framework Convention on Tobacco Control, a treaty that commits them to introduce comprehensive smoking bans. It was thought that tobacco firms based in countries with smoking bans would target markets without bans – predominantly in poorer countries. But British researchers have found that a ban on smoking has led to a decline of tobacco companies expanding internationally reports The Conversation (May 31). “Not only did bans affect their cash flow, and therefore reduce their funds for international expansion, there was another reason at play, too,” they said. “It seems that tobacco companies are sensitive to their public profiles and … do not want to be seen to be exploiting the poorest countries.” The researchers concluded that firms based in countries with a smoking ban are influenced by a society’s changing norms. “As (these norms) are enforced with growing conviction around the world, this may ultimately lead to the death of the industry,” they wrote.
“DOCTORS WANT THE LAW CHANGED SO THAT OTHER HEALTH PROFESSIONALS, INCLUDING MIDWIVES, PHYSIOTHERAPISTS AND SENIOR NURSES, CAN SIGN A SICK NOTE TOO.”
10 | THE LAMP AUGUST 2016
“BANS AFFECT TOBACCO COMPANIES’ CASH FLOW, AND THEREFORE REDUCE THEIR FUNDS FOR INTERNATIONAL EXPANSION.” Britain
Doctors cry out for help British GPs are under so much pressure their leaders are calling for nurses and other health professionals to take on some of their roles. The British Medical Association (BMA) has called on the NHS to allow patients to bypass seeing a family doctor and be treated by an experienced nurse, physiotherapist, or mental health specialist to help tackle the “pressure cooker” of GP work reports the Guardian. Dr Chaand Nagpaul, the chair of the BMA’s GP committee, said people with sore backs and other musculoskeletal problems should be allowed to seek help directly from a physiotherapist without having to first see a GP. Similarly, advanced nurse practitioners could take on more of the role of visiting the growing number of housebound patients. “At the moment it’s a pressure cooker, so we need other health professionals to support us,’’ he said. Letting patients directly access other NHS staff would improve their outcomes and reduce waits that can hit six weeks to see a family doctor, he argued. The BMA was to consider a resolution at its annual conference that “demands that certification of fitness to work (‘fit notes’) need not be done by a medical professional and that there should be an extension of self-certification for illness from seven to 14 days”. Doctors want the law changed so that other health professionals, including midwives, physiotherapists and senior nurses, can sign a sick note too.
NEWS IN BRIEF
Australia
Australia’s Health Tracker Chronic diseases, like CARDIOVASCULAR DISEASE CANCER
and
1 in 2
DIABETES
are the leading cause of illness, disability and death in Australia.
Australians have a chronic disease. Despite the need… Almost
ONE THIRD could be prevented
by removing exposure to risk factors such as smoking, high body mass, alcohol use, physical inactivity and high blood pressure. 2
of spending* is dedicated to prevention. *As a proportion of total health expenditure.
AUSTRALIA’S HEALTH TRACKER – 2016
Australia’s Health Tracker is a new report card that assesses the health of Australians in relation to chronic diseases and their risk factors. It is an initiative of the Australian Health Policy Collaboration at Victoria University that was launched last month reported The Conversation (July 5). Australia’s Health Tracker uses health targets and indicators set by the nation’s leading health researchers to help Australians reach the World Health Organisation’s 2025 targets to improve health around the globe. According to the initial report card the results are not great: almost three in four Australian children consume too much sugar, 91.5% of young people do not meet physical activity recommendations, and Australians are among the most obese people in the world. One in two Australians have a chronic disease and those on a low income are disproportionately affected. But, crucially, one-third of the disease burden is preventable it says. There is good news: public health efforts to reduce risky alcohol consumption and smoking in adults are working and Australians are heeding advice to participate in screening programs for breast and bowel cancers. “We are well on track to meet our target of 41% of Australians participating in bowel cancer screening (currently 36%) and 54% of women participating in breast cancer screening (currently 53.7%),” researchers say. The experts behind Australia’s Health Tracker say there is an urgent need for active and effective public health policies and services to improve the health of all Australians. “Investment in preventive health in Australia in 2013-14 was 1.5% of the national total recurrent health expenditure. This is much lower than investment levels in New Zealand (6.4%), Finland (6.1%) and Canada (5.9%),’ they said.
INVESTMENT IN PREVENTIVE HEALTH IN AUSTRALIA IN 2013-14 WAS 1.5% OF THE NATIONAL TOTAL RECURRENT HEALTH EXPENDITURE. THIS IS MUCH LOWER THAN INVESTMENT LEVELS IN NEW ZEALAND (6.4%), FINLAND (6.1%) AND CANADA (5.9%).
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THE LAMP AUGUST 2016 | 11
COVER STORY
Safety fears at mental health ICU A Local Health District has proposed the introduction of Assistants in Nursing in one of the most dangerous workplaces in the state.
An industrial battle has erupted over a proposal by the Northern Sydney Local Health District for the possible introduction of Assistants in Nursing (AiNs) in the Mental Health Intensive Care Unit (MHICU) of Hornsby Ku-ring-gai Hospital. At the time of the The Lamp going to press, the LHD had not put forward a concrete proposal - rather, it was seeking to engage a consultant to review the proposal’s efficacy within a consultative framework with the NSWNMA.
There is no other reason to introduce an AiN into such a critical and specialised area where a high level of communication, observation and response is vital.” Nurses were planning to hold a stop work meeting at the hospital to further highlight their concerns with the proposal, but this was withdrawn following the intervention of the Industrial Relations Commission. The Commission continues to have a watching brief over the dispute and is providing oversight to the consultation process being established.
‘It would be negligent to place a minimally qualified worker in this environment.’– Judith Kiejda The MHICU has seen patients kick down doors, smash equipment and bash and strangle nurses. NSWNMA Assistant General Secretary, Judith Kiejda, said AiNs were not qualified to work in such a dangerous environment often with highly agitated, volatile and unpredictable patients. “While AiNs play an important role caring for patients in low-care settings, it would be negligent to place a minimally qualified worker in this environment,” Judith said. “This is clearly a cost saving measure. 12 | THE LAMP AUGUST 2016
This consultation process was continuing when The Lamp went to press. A MOVE BACKWARDS The LHD move came only three months after health unions and the Ministry of Health agreed on a plan to tackle worsening hospital violence. Hailed as a breakthrough after persistent campaigning by health unions the plan included a security audit of emergency departments, improved staff and management training, development of better ways of managing drug and
alcohol-affected patients and examination of possible legal changes. The January edition of The Lamp highlighted the unacceptable level of aggression and violence at the Yaralla MHICU at Cumberland Hospital. Judith said the unpredictable nature of patients in the MHICU required “constant clinical assessment and technical, professional skills.” An AiN could receive their qualification after a six week course, while an RN had completed an undergraduate degree and often gone on to do further study, such as a graduate diploma or Master of Mental Health Nursing at university to specialise in mental health. “Workers need to have sufficient grounding or at least an understanding of the complexities of mental illness and an AiN does not have that kind of experience,” she said.
‘AiNS HAVE TO BE IN A PLACE WHERE THEY ARE SAFE AND ABLE TO DELIVER PROPER NURSING CARE.’ – Peg Hibbert
Hornsby nurses from left: Michelle Rosentreter, Peg Hibbert and Gabi Pearson
The LHD’s proposal has caused widespread concern throughout the hospital, said Peg Hibbert, a registered nurse, NSWNMA Councillor and vice president of the hospital’s NSWNMA Branch. “Our members are extremely concerned with the proposal, which has such a potential impact on the safety of patients and staff” she said. “When the proposal first appeared there was widespread concern so we involved the whole branch, not just members in mental health. “The issue is widely and deeply felt by all branch members.”
LIVES AT STAKE She said the branch feared for the lives of AiNs who may be sent to work in the MHICU without sufficient qualifications and mental health experience. “We feel it’s just a money saving exercise though management deny that. They say things like it will ‘enhance the nursing perspective’ and the role of the AiNs and creates a better mix of people working in the unit. “These are just wonder words. You don’t need a better personality mix you need qualified staff. “We’re not saying we don’t want AiNs anywhere in mental health because they are employed in acute care units and
step down or psychiatric geriatric units. “We are simply saying AiNs have to be in a place where they are safe and able to deliver proper nursing care within their scope. “We know that if someone gets hurt as a result of the introduction of an inexperienced and unqualified AiN, management will trot out every policy and procedure they can find to tell the nurses why it is their fault. “Management won’t take any responsibility for anything that happens as a result of this policy. “They might get their wrists slapped but some nurse will be badly injured or dead.”
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COVER STORY
Patients, nurses exposed to greater risk The NSWNMA has called on the Ministry of Health to intervene to stop local health districts employing assistants in nursing in mental health intensive care units. Employing AiNs in mental health intensive care units (MHICUs) is “an ill considered approach” that will leave patients, visitors and nurses “exposed to an increased risk of significant and probable harm” said NSWNMA General Secretary Brett Holmes. He made the comment in a letter to the ministry’s acting executive director of mental health, drug and alcohol programs, Dr Karin Lines. Brett noted there was an increasing trend for LHD mental health services to try to cut costs by employing unregulated health workers. He said AiNs were valuable members of the nursing team with a distinct role.
VIOLENCE IS AN ONGOING HAZARD National Mental Health Standards required nurses to have an in-depth knowledge of mental illness, its management and treatments. “MHICUs are highly volatile working environments where workplace violence is an ongoing hazard (where) qualified and experienced RNs and ENs are required to make informed clinical decisions based on their education, experience and competency level. “Introducing AiNs in such a critical and specialised area will increase the risks of violence against staff and patients. “The AiN is unable to perform mental state observa-
‘THE LIMITED TRAINING AN AiN UNDERGOES IS NOT THE APPROPRIATE LEVEL OF TRAINING REQUIRED TO PROTECT THEM AND OTHERS FROM THE VERY REAL RISK OF VIOLENCE.’ – Brett Holmes
However their qualifications and knowledge in specialised acute areas such as acute mental health was “quite restricted” in comparison to the RN or EN with mental health qualifications and/or experience. “Highly educated and experienced nursing clinicians are required to provide optimum care managing clients who have been detained under the Mental Health Act, due to being unwell and a high possibility of being a danger to themselves and/or others.” These patients needed the most skilled and highly qualified nursing care “to ensure the best possible outcomes for all involved.” “The limited training an AiN undergoes is not the appropriate level of training required to protect them and others from the very real risk of violence. “Clients are often highly agitated, volatile and unpredictable.” He said putting AiNs into MHICUs would breach various laws, regulations and policies set out by the NSW Work Health and Safety Act, the Australian Health Practitioners Regulatory Agency, NSW Health and the National Mental Health Standards.
14 | THE LAMP AUGUST 2016
tion and risk assessment, the core mental health nursing skills requirement” for MHICU nurses. “This type of assessment needs to be conducted at every interaction with clients on an ongoing basis to monitor and assess their level of risk.” Brett said the introduction of AiNs would significantly increase the workload of RNs who would have to oversee and manage an AiN while trying to manage their own patient allocation. Having to oversee an AiN would expose both to increased risk from aggression as well as greater risk to the RN’s registration, given that the RN would be legally and professionally accountable for the work of the AiN. Introduction of AiNs would also foster a task-oriented model of care leading to more use of seclusion and consequent higher risk from aggression. Patients would be “deprived of the opportunity of receiving the highest quality of care they need from highly qualified and competent nursing staff.” “The intensive structure and the potentially volatile nature of a MHICU require a high nurse to patient ratio. “It must follow that clients who require intensive observation due to a high level of acuity and complexity require the most skilled and highly qualified staff not the least qualified.”
“Anywhere else in the world the MHICU is the last place you would put an AiN” Gabi Pearson, Hornsby Branch Secretary, says it is “outrageous” to entertain the idea of putting AiNs to work in a Mental Health ICU. She says it is unfair to AiNs to expose them to the dynamics that occur in such a tough environment. “I think some patients – those that understand the system – would just play the AiNs. They would manipulate them and play them how they can. It’s unfair to the patients as well because they don’t get the appropriate care or the appropriate structure they need in order to be safe. “I have trained in Germany in a big mental health facility with over 800 beds. There, they wouldn’t even think about using untrained AiNs in an acute mental health environment. You can’t imagine that happening there. Not even remotely. Even student nurses would not be able to work in the forensic part of a mental health facility,” she said. Gabi says it is hard to understand where the idea even came from and the Hornsby branch feels strongly that it should be opposed. “Absolutely everybody in the branch and the hospital believes that this proposal should not be allowed to happen.”
‘ABSOLUTELY EVERYBODY IN THE BRANCH AND THE HOSPITAL BELIEVES THAT THIS PROPOSAL SHOULD NOT BE ALLOWED TO HAPPEN’ – Gabi Pearson
THE LAMP AUGUST 2016 | 15
COVER STORY
AiN plan would hinder patient recovery The proposal to introduce AINs into the MHICU left clinical nurse specialist James Wall feeling “extremely concerned”. He said MHICU staff felt frustrated because “an AiN activity list does not match the work required to be performed by an RN within the MHICU.” He said the medical team, allied health personnel and managers of other units at the hospital support MHICU nursing staff on this issue. “Other areas within the hospital are concerned that if AiNs can be brought into one of the most intense and volatile environments in the LHD then they could potentially replace RN positions in other acute specialty areas,” said James who has been a MHICU staffer since 2008. The MHICU is a tertiary referral unit that services all hospitals in the LHD. It accepts care of patients who can’t be managed safely by a general acute psychiatric inpatient unit because they present with high-risk behaviours that include aggression, self-harm, or absconding. Some patients may be sexually disinhibited or otherwise vulnerable to exploitation. James said the job of the MHICU is to care for patients to the point where their risk decreases enough for them to be repatriated back to the referring unit. “We frequently manage patients who are in a highly aroused, agitated and distressed state and who at times are physically aggressive towards staff and other patients. “This requires a team approach of highly trained and appropriately skilled nurses who can quickly assess a situation, formulate a plan to manage the risk or problematic behaviour, and then implement that plan in a safe and therapeutic manner. “The MHICU requires a team nursing process to function safely and effectively. It is definitely not a task orientated or an activity completion style of nursing, which is what an AiN would be capable of in this environment. “AiNs cannot complete a mental state examination or risk assessment and therefore cannot perform the core work required of a nurse in the MHICU. This places more pressure on the existing RNs and will mean that potential early warning signs of an escalating situation could be missed. “This may lead to more adverse incidents, increased physical restraint and seclusion episodes, poorer patient outcomes, and a generally more unsafe work environment.” James said that if the proposal resulted in AiNs replacing RNs, this could potentially double each RNs patient load. “The RN would be responsible for four patients – their own two patients plus the two under the care of the AiN – and would be responsible for supervising the AiN as well.”
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MHICU needs high-level skills Replacing RNs with AiNs in mental health intensive care presents major safety concerns says Mick Robson, who has been a mental health nurse for 20 years. The AiN’s task oriented role is unsuited to mental health intensive care said Mick, a clinical nurse specialist at Hornsby Ku-ring-gai Hospital’s MHICU. “AiNs work well in areas like rehab with structured activities. Intensive care requires more independent thinking, risk assessment and risk management. “Patients are referred to the MHICU because their high level of risk does not enable safe therapeutic management in a general mental health acute ward. “Incidents in the MHICU don’t often happen in isolation. Episodes of disturbed behaviour can trigger similar episodes in other patients due to their disturbed mental state. “Staff operate on principles of risk assessment and risk management. They must be able to respond immediately to critical situations and work autonomously. “Any delay in intervention will lead to increased risks to staff and patients. “RNs need to be on the floor making these risk assessments because the AiN’s scope of practice involves observing, reporting or assisting but not risk management.” Mick said that if the LHD proposal led to AiNs replacing existing RN positions, it would result in RNs spending more time in the office and the least trained and least qualified staff spending the most time with the LHD’s most challenging patients.
‘STAFF MUST BE ABLE TO RESPOND IMMEDIATELY TO CRITICAL SITUATIONS AND WORK AUTONOMOUSLY.’ – Mick Robson
“Problems will be picked up at a later stage and we will have to intervene at a later stage which increases the risk to patients and staff and can hinder the process of their recovery. “Management claim it is a natural progression to have AiNs who operate now in acute areas able to move to intensive care areas. Mick said the LHD had denied the move was a money saving exercise “but if it was about improving the quality of patient care you wouldn’t reduce the skill level of the staff looking after them.”
“I don’t see how it is working for a better future in healthcare”
‘THERE WAS A GOOD 90 PER CENT OF STAFF THAT DID NOT FEEL THAT THE MOVE TO AINS IN THE MHICU WAS SATISFACTORY.’ – Michelle Rosentreter
Michelle Rosentreter, Hornsby Assistant Branch Secretary, says that there is widespread unease throughout the hospital about the proposal to introduce AINs into the MHICU. We did a lot of consultation on campus – walking around and meeting people and asking for feedback and getting their general feeling. There was a good 90 per cent of staff that did not feel that the move to AiNs in the MHICU was satisfactory. “The initial proposal that was brought to us was just for mental health but a lot of the nurses in the branch thought this would be a gateway – if AiNs went into the MHICU it would end up being filtered into other acute areas in the hospital and it would be inappropriate to do so,” she said. “Our branch members were horrified. The general nurses throughout the hospital were quite shocked – that it was putting staff at risk. Nobody could understand the rationale about why this was happening. Michelle says that AiNs are uncomfortable about the development. “I went around speaking with AiNs working in other parts of the hospital. Most were surprised that there was such a move. None would be putting their hand up for it.” She says it is bewildering that such steps are being taken when the government and NSW Health have set up a taskforce to look at workplace violence after numerous violent events in the state’s hospitals. “It’s like taking a step backwards. The taskforce is trying to make sure it is safe for staff and that we can deliver quality care and yet they are thinking about something like AiNs into the MHICU. It’s counterproductive what they are doing. I don’t see how it is working for a better future in healthcare.”
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COVER AGED STORY CARE
Bupa needs to catch up BUPA is NSW’s third largest aged care provider but its wages and conditions lag way behind its position Bupa may position itself as an industry leader promoting quality aged care but it’s failing its nursing staff when it comes to wages and conditions. Compared against all other NSW aged care providers Bupa is ranked third in size for number of residential places, 33rd on pay for experienced RNs, 14th on pay for experienced AiNs and doesn’t pay AiNs for administering medications. Bupa is one of the only providers in NSW who doesn’t have a legally enforcable commitment to safe staffing or a process to address understaffing, workload problems, working short or replacing staff absences. Negotiations between NSWNMA and Bupa Care Services for a new enterprise agreement commenced last month. NSNWMA submitted a log of claims approved by members. The NSWNMA claim seeks a four per cent annual pay rise for a new three-year agreement with Bupa - a UK-based private multinational company. Bupa entered the Australian aged care market in 2007 and is now the third largest provider in NSW. NSWNMA General Secretary Brett Holmes says Bupa is a highly profitable company that can afford to offer higher wages and better staffing to deliver the quality care they so proudly promote. “Bupa increased its net profit by 154 per cent between 2013 and 2015,” he said. “As a profitable industry leader it’s disappointing that its conditions and wages are sub-standard.” Brett says Bupa nurses want their wages to either match those of the leading aged care providers or their public sector counterparts. “They also want their workloads, safety concerns and ability to provide quality care addressed through a commitment to
replacing staff absences and minimum safe staffing levels. “AiNs want to be paid for administering medications - an additional responsibility the company now requires.” Winning a pay rise and safe staffing are the most important issues Bupa nurses want addressed in a new agreement, a NSWNMA survey of the workforce revealed.
84% want minimum safe staffing levels set 76% prioritise higher pay rates 45% prioritise better staffing or rank it equal to higher pay
Brett Holmes said there was strong member response to the online survey which sought nurses’ views on the content of the claim. Input into the claim also came through site visits by NSWNMA organisers, branch meetings at individual facilities and teleconferences involving delegates from over 20 facilities. Having adequate staff to manage workloads, complete tasks, reduce risks to staff and residentsand provide quality care was an area of high concern. “Too many nurses expressed frustration and concerns about the failure to replace sick staff and regular staff shortages,” Brett said. “Sixty five per cent told us they can’t provide quality on most days, 61 percent can’t complete their tasks most days due to staff shortages. That is unacceptable to nurses and should also be unacceptable to Bupa management.”
How Bupa ranks in NSW PROVIDER
SIZE
RESIDENTIAL PLACES
FACILITIES
RN PAY
AiN PAY
AiN MEDICATION PAYMENT
SAFE STAFFING COMMITMENT
Uniting Care
1
5,243
59
5
5
✓
✓
Opal
2
3,293
39
8
9
✓
✓
Bupa
3
2,728
28
33
14
✗
✗
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STRONG CALL FOR ON-CALL At Bupa’s Armidale nursing home in Northern NSW, Branch Secretary Barbara Archer AiN said the NSWNMA should push hard for a pay rise. “Pay increases should be a top priority because it’s a fairly low paid industry given the work and skills that are required,” she said. “Bupa are trying to grow their aged care business and are positioning themselves as the go-to provider for quality aged care around Australia. “However their pay rates are not as good as others and they really need to pay appropriate wages in order to attract top quality staff.” Barbara said ensuring adequate staff are rostered to give quality care should also be a priority. She said the Armidale branch strongly supported the claim for an on-call allowance to be paid to a nurse to cover unexpected absences on morning shift. “A staff member can spend up to half an hour trying to contact a relief nurse when someone falls sick. “Other shifts have clerical and reception staff who can make those calls but morning shift does not – we have to take a nurse off the floor to make the calls. “If a nurse calls in sick during the night or early morning we can’t start phoning possible replacements until at least 6am, which is a very busy time for staff. “If a nurse was paid an allowance to be oncall that would make a huge difference.”
Photo: James Brooks
‘THEY REALLY NEED TO PAY APPROPRIATE WAGES IN ORDER TO ATTRACT TOP QUALITY STAFF.’ – Barbara Archer
THE LAMP AUGUST 2016 | 19
COVER AGED STORY CARE
An expanding multinational UK-based Bupa makes good money from its Australian aged care facilities
‘WE ARE SHORT STAFFED ALMOST EVERY DAY AND BUPA SEEM TO HAVE LITTLE INTEREST IN CHANGING THAT.’ – Terese Kelleher ALLOWANCE FOR ADMINISTERING MEDICATIONS IMPORTANT Terese Kelleher, an AiN at Bupa Eden on the NSW far South Coast, said the next enterprise agreement must include payment of an AiN allowance for administering medication, to reflect the responsibility required for the task. “Bupa recently introduced a new model of care known as BMOC which includes AiNs administering certain medications as part of ‘Person First Care’,” she said. “Currently there is no recognition in our pay and I think it is really important that staff are paid for doing this task.” Terese is not alone with 24 per cent of AiNs in the NSWNMA workforce survey nominating it as the most important issue for the next agreement. NSWNMA is seeking a $1.20 an hour medication allowance for AiNs. Terese said the agreement should also include measures to tackle staff shortages. She supports the NSWNMA claim for mandatory minimum staffing levels and hopes to see these changes in the upcoming agreement. “In the 18 months I’ve been at Bupa Eden, numerous staff have left and not much has been done to bring numbers back up again. “We constantly get urgent texts from management asking for staff for this or that shift – sometimes two or three staff on one shift. “Nurses are burnt out from having to cover sick leave. “The worst affected are those people who constantly put up their hands for extra shifts because they don’t want the residents to be left without care. “I’ve worked in aged care for 14 years and in other places they’ve always had a casual pool to cover annual and sick leave, with management responsible for ensuring there is a consistent flow of interviews to bring new staff in as we need them.”
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Bupa’s Australia and New Zealand division has performed well compared to other parts of the global Bupa business. The combined Australian and New Zealand arm contributed 37 per cent of Bupa’s total revenue and 41 per cent of total underlying profit in 2015. Bupa’s Australian aged care business known as Bupa Care Services made a net profit of more than $29 million in 2015. NET PROFIT ROSE BY A MASSIVE 154% BETWEEN 2013 AND 2015 Bupa has more aged care facilities and places in NSW than any other state. Bupa continues to expand in NSW with two new facilities opened in 2016 and another to open later in the year.
BUPA at a glance A UK-based international private company employing over 84,000 people in 190 countries Health insurance delivers 71% of global revenue and it also owns private hospitals, dental clinics and aged care facilities Bupa entered the aged care business in Australia in 2007 buying the Amity Group for $1.2 billion Nationally Bupa has around 73 facilities and 7,074 residential places In NSW Bupa has 28 facilities and over 2,700 residential places Bupa was the 3rd largest NSW aged care provider in 2015 In 2016 Bupa employs 3,305 staff in NSW Nurses are approximately 72% of the Bupa workforce
Staff shortages hit quality care
3 key elements in Bupa claim
The NSWNMA nursing workforce survey covered 58% of nurses across all of Bupa’s NSW facilities in April. Results reveal that:
4% annual wage increase
65% are unable to provide quality care most days due to staff shortages
1. BETTER PAY $1.20 an hour AiN Medication Allowance A voluntary on-call roster so that nurses in receipt of on-call allowance are available to cover last minute absences
25% rarely or never provide quality care
10% shift loading for nurses called in without 24 hours notice to fill an unexpected absence unless they are already getting an on-call allowance
Only 35% provide quality care every or most days
New higher pay level to reward experienced AiN Cert IIIs (Year 4 and thereafter)
24% rarely or never complete assigned tasks
RN pay increased to match industry leaders
Only 39% per cent complete tasks every or most days
2. BETTER STAFFING RATIOS, BETTER CARE
56% said not enough staff were rostered
Guarantee to replace staff absences including sick, annual and parental leave and when staff are undertaking e-learning or approved training
48% said nurses on sick leave were not replaced
Rosters to include time for nurses to complete mandatory e-learning
84% want minimum staffing levels in their new enterprise agreement 68% said staff shortages would be eased by an on-call roster, where off duty nurses are paid an allowance to be called back to work at short notice 70% are prepared to be placed on an on-call roster
WHAT BUPA NURSES HAVE TO SAY
Many nurses commented on Bupa’s inability to attract experienced staff to cover shifts when roster absences happen. Staff turnover and burn out were raised as serious issues that management needs to address properly.
A new guaranteed, fair and quick process to fix staffing problems Minimum safe staffing ratios on every shift AM SHIFT
PM SHIFT
NIGHT DUTY
1 AiN to 5 residents
1 AiN to 6.6 residents
Includes AiN Team Leaders
Includes AiN Team Leaders
1 AiN to 15 residents
Minimum of 2 RN/ENs per 60 residents
Minimum of 2 RN/ ENs per 60 residents
1 RN to 40 residents
Plus an RN in-charge for the facility on the weekend
Plus an RN in-charge for the facility
1 Care Manager for up to 40 residents
3. PAID LEAVE
‘We struggle every day, someone is going to get hurt.’
Parental leave – 14 weeks paid leave by Bupa to primary caregiver and 2 weeks leave for secondary caregiver
‘Too many staff are leaving for a better workplace.’
Employee representative leave – currently this leave is unpaid
‘Resident care level increases, staff levels does not.’
Family violence leave – to support you if subjected to family violence
Follow this campaign Like and share the Facebook page Bupa Aged Care NSWNMA Subscribe to Bupa enews at bupa@nswnma.asn.au Contact NSWNMA Bupa team Paul or James on 8595 1234
THE LAMP AUGUST 2016 | 21
PRIVATISATION COVER STORY
The sneaky sell off of Medicare During the federal election campaign Malcolm Turnbull denied his government would privatise Medicare. Health experts say he was being “disingenuous”.
When Labor claimed during the federal election campaign that Medicare was threatened by privatisation it met with a near-hysterical reaction from the Coalition and conservative elements of the media. Yet many health experts vouch for the validity of Labor’s claims. Professor Lesley Russell from the Menzies School of Health at Sydney University says the public was “rightly sceptical” of Malcolm Turnbull and the Coalition’s protests. She said it was disingenuous of the Coalition to say they are not privatising Medicare. “Semantic games have gone on about what constitutes privatisation and about the differences between Medicare payment systems and Medicare services,” she says. “A surreptitious shift from public to private is occurring via increased co-payments, the abolition of bulk-billing incentives, the freezing of Medicare fees to doctors, and other measures. Outof-pocket costs are the fastest rising part of the healthcare budget.” Stephen Duckett, the Health Program Director at the Grattan Institute says that “outsourcing is only one form of privatisation, and nowhere near the most pernicious”. “While privatisation of service delivery is now off the table, greater privatisation of funding - that is, the share of health costs met by private insurance or patient co-payments - is still very much on the cards,” he says. THE UNIVERSALITY OF MEDICARE UNDERMINED Health commentator John Menadue, from the Centre for Policy Development says public subsidies for private health insurance divert valuable resources away from Medicare. “The Coalition has been eroding Medicare from within for a decade and a half since John Howard. The vehicle for this erosion is private health insurance (PHI) and the government is facilitating this process with the $11 billion per annum taxpayer funded subsidy to support private health insurance,” he says. Private health insurance not only undermines the universality of Medicare, it is inefficient according to economists and the rebate should be scrapped. “Subsidising people to do something they would do anyway is a waste of taxpayers’ money. The rebate reduces the discipline on health insurance funds to keep their premiums under control. And it’s a form of middle-class welfare that the country can no longer afford,” Saul Eslake, one of Australia’s leading economists told the Sydney Morning Herald earlier this year.
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LAYING THE GROUNDWORK FOR MORE PRIVATISATION Since coming to office in 2013 the Coalition under both Tony Abbott and Malcolm Turnbull have commissioned various bodies to look at health spending which have delivered clear recommendations to the government to privatise Medicare. The 2014 National Commission of Audit flagged the idea that higher-income earners should take out private health insurance for basic health services in place of Medicare. It, and the government’s Harper Competition Policy Review, also advocated for an expanded role and less regulation for the private health insurance sector. The government has since committed to a further Productivity Commission review of how competition principles can be applied to the human services sector, including health. The government has also indicated it will allow private health insurance to play an expanded role in primary care. Some of the larger funds are already expanding their activities in this sector, but with little regulatory oversight.
“(THE PRIVATISATION OF MEDICARE IS) A GROTESQUE LIE. HOWEVER THERE WAS SOME FERTILE GROUND IN WHICH THAT GROTESQUE LIE COULD BE SOWN. THERE IS NO DOUBT ABOUT THAT.”– Malcolm Turnbull
David Pope / Fairfax Syndication
“MEDICARE IS THE COMMUNITY STANDARD, IT’S THE GOLD STANDARD, IT SPEAKS TO AUSTRALIANS ABOUT WHO WE ARE. IT’S AN ECHO OF AN OLDER, UNCOMPLICATED SENSE OF SOLIDARITY, THE BELIEF THAT THE HEALTH OF ANY ONE OF US MATTERS TO ALL OF US. IT’S ALSO THOROUGHLY MODERN ECONOMIC POLICY.”– Bill Shorten
What health experts say “A surreptitious shift from public to private is occurring via increased co-payments, the abolition of bulk-billing incentives, the freezing of Medicare fees to doctors, and other measures.” – Lesley Russell, Menzies School of Health, Sydney University
“Outsourcing is only one form of privatisation, and nowhere near the most pernicious. While privatisation of service delivery is now off the table, greater privatisation of funding (that is, the share of health costs met by private insurance or patient co-payments) is still very much on the cards.”
“The Coalition has been eroding Medicare from within for a decade and a half since John Howard.” – John Menadue, Centre for Policy Development
“At every opportunity (the Coalition) has used regulatory and budgetary support for private insurance to undermine Medicare, which it has tried to redefine as a charity service for the poor or indigent.” – Ian McAuley, University of Canberra
– Stephen Duckett, Grattan Institute Health Program Director THE LAMP AUGUST 2016 | 23
PRIVATISATION COVER STORY
Coalition’s history of hostility to Medicare The Coalition has a long and chequered history opposing a universal health care system in Australia, resisting the introduction of Medibank by the Whitlam government in the mid-70s and then opposing Medicare when the Hawke government created it in 1984. “History shows that while ideologies may be temporarily cast aside for political gain, they are never abandoned,” says Lesley Russell from the Menzies School of Health Policy. “Labor sees the health of Australians as a matter of sufficient national importance that it requires government intervention; the Coalition sees it more as a matter of personal responsibility and individual choice.” She says that when John Howard was opposition leader during the period of the Hawke government he spoke out “often and vehemently’ against Medicare. “He declared Medicare a “disaster” and a “nightmare” and promised that under his government “bulk billing under Medicare would go, except for those classified as disadvantaged and there would be the option of belonging either to Medicare or to a private health fund.” Eventually the pragmatic Howard was converted to Medicare by its popularity although his government continued to bolster the uptake of private health insurance and erode bulk billing rates from the heights of the Hawke years.
$6
proposed co-payment for Medicare general practice services
$15
co-payment per GP visit recommended
$57b
cut from public hospital funding over 10 years
24 | THE LAMP AUGUST 2016
Tony Abbott, Howard’s Minister of Health, famously said, “private health insurance is in our DNA”. Medicare has again come under attack since the election of the Coalition in 2013. The Coalition has repeatedly claimed that Medicare spending is unsustainable and Medicare services are overused. The government has tried to introduce GP co-payments and abolish bulk billing incentives and when these have hit the wall of public resistance resorted to a back door strategy of extending a freeze of Medicare fees to doctors among other measures. It has also initiated a number of audits and commissions that have advocated a greater emphasis on private health insurance and more out-of-pocket expenses. “It is disingenuous of the Coalition to claim it has no intention of privatising Medicare when this option has clearly been considered; and it’s important to remember that the Coalition has said nothing that would preclude private initiatives from competing alongside Medicare,” says Lesley Russell. “The risk is that Australia is headed stealthily but inexorably towards a two-tiered health care system in which those with resources and access can purchase the services they want, regardless of need, and Medicare becomes a ragged safety net for the less well-off.”
Coalition record on Medicare and public health Since it came to office in 2013 the Coalition government under both Tony Abbott and Malcolm Turnbull has consistently flagged policies that could undermine Medicare. It privatised Medibank. It proposed a $6 co-payment for Medicare general practice services and suggested that anyone who didn’t like the co-payment should take out private health insurance. he Coalition-appointed Commission of Audit recommended a T co-payment of $15 per GP visit and suggested that public hospitals should charge patients. The government has extended the freeze of the Medicare rebate for five years. The government cut public hospital funding by $57 billion over 10 years. The government indicated it will allow private health insurance to play an expanded role in primary care.
“IT IS DISINGENUOUS OF THE COALITION TO CLAIM IT HAS NO INTENTION OF PRIVATISING MEDICARE WHEN THIS OPTION HAS CLEARLY BEEN CONSIDERED; AND IT’S IMPORTANT TO REMEMBER THAT THE COALITION HAS SAID NOTHING THAT WOULD PRECLUDE PRIVATE INITIATIVES FROM COMPETING ALONGSIDE MEDICARE.”– Lesley Russell
NSW government record on health privatisation Mike Baird’s NSW government too has shown plenty of zeal for the privatisation of public health services:
More information Lesley Russell: Chequered history, uncertain future: Medicare and the election (http://insidestory.org.au/)
Northern Beaches Hospital – the Baird government has commissioned Healthscope to design, construct, operate and maintain a public hospital on Sydney’s northern beaches.
John Menadue: Privatisation and the hollowing out of Medicare (johnmenadue.com/blog)
ADHC – the privatisation of Ageing, Disability and Home Care affects 14,000 jobs including 1200 nurse positions and is one of the state’s largest privatisations.
Stephen Duckett: Is Medicare under threat? Making sense of the privatisation debate. (theconversation.com/au)
Mental health services have been put out to tender to private companies and the non-government sector to deliver mental health, physical health and drug and alcohol support. Palliative care has been outsourced to private consortiums in numerous LHDs.
Ian McAuley: Bill Shorten is right: Malcolm Turnbull is a threat to Medicare (newmatilda.com)
THE LAMP AUGUST 2016 | 25
BREXIT
NHS a Brexit pawn Leave campaigners promised Britain a fictitious windfall for the NHS if it left the European Community. On the contrary, Brexit could have far reaching negative consequences for the health system and workers’ rights say health experts and unions.
When Conservative MP Boris Johnson, one of the most prominent leaders of the campaign for Britain to leave the European Community, barnstormed his way around the country arguing for Brexit he did so in a bus branded with the words, “We send the EU £350 million a week. Let’s fund our NHS instead”. This seductive argument was demolished during the campaign by a number of economic experts including the UK Statistics Authority, the Institute of Fiscal Studies and the Treasury but it still held sway with many voters. Within days of winning the historic referendum Johnson and other Brexit leaders were backpedaling on this promise. MORE COMES IN FROM THE EU THAN GOES OUT A slew of health experts came out on the side of Remain. An editorial in British Medical Journal said it “could not name one prominent national medical, research, or health organisation that has sided with Brexit.” 60 prominent health experts warned of Brexit’s dire consequences for health in a joint letter to the Times. They pointed out that Britain had benefited from European action on matters including “new infectious disease (including the Zika virus), environmental pollution, climate change, and antibiotic resistance – all of which are public health threats that don’t stop at the channel.” The European Medicines Agency, based in England, ensured rapid access to new medicines while the EU currently funded 20% of the country’s medical research, they added. “We receive a considerable amount more back from the EU than we pay in,” they said.
26 | THE LAMP AUGUST 2016
STAFF SHORTAGES COULD WORSEN Experts have also warned of worsening staff shortages in the NHS as a result of Brexit. Currently 30,000 doctors (11% of the total) and 20,000 nurses (5% of the total) in the NHS come from other European countries. In addition more than 100,000 other NHS employees, mainly care workers, come from the EU. Many NHS staff from overseas countries have been subject to racial abuse following the referendum. A musculoskeletal radiologist M Ali Abassi tweeted “Last night a Sikh radiographer colleague of mine was told by a patient “shouldn’t you be on a plane back to Pakistan? We voted you out.” A theatre nurse from Sweden working in the north of England voiced the uncertainty felt by many: “I’m absolutely devastated. I’ve worked in the NHS for 30 years and kept my Swedish passport. Now what I am meant to do?” THE THREAT TO THE NHS COMES FROM WITHIN The NHS was also dragged into the Brexit debate through concerns over the Transatlantic Trade and Investment Partnership (TTIP) and how it would impact on health. Prominent supporters of the Leave campaign such as former Labor minister David Owen argued that health would be opened up to competition and public providers wouldn’t be able to compete with the power of global corporations. On the Remain side health experts such as Martin McKee, professor of European public health argued that while concerns about TTIP were justified officials in the European Community had responded to these fears. Did these concerns about TTIP justify Britain withdrawing from the EU, he asked.
130,000 20,000 11% people working in the NHS who qualified elsewhere in the European Community
NHS nurses are from another EU country
“Absolutely not. Leaving the EU would expose the NHS to much greater risk,” he wrote in the British Medical Journal. “Effective advocacy within countries has ensured that national governments have woken up to the risks (from the TTIP) and, through the Council of Ministers have given clear directives to the European Commission officials involved. It is clear that many of our concerns have been taken on board.” The bigger threat to the NHS he says lies closer to home. “No one who lived through the passing of the 2012 Health and Social Care Act should be naïve about the threat to the NHS. However that threat comes from some of our own politicians and not from the EU.” The Health and Social Care Act 2012 opened up the NHS to competitive tendering with massive NHS contracts given over to the private sector. WORKPLACE RIGHTS UNDER THREAT Christopher Cox of the Royal College of Nursing, says many complex issues impacting on the NHS and its staff including nurses will have to be resolved following the vote to leave the European Community. “It’s worth reminding ourselves that the EU has been the source of many employment rights, including working time, work-life balance, key areas of equality including equal pay for work of equal value, and the treatment of part time, fixed-term contract, and temporary agency workers,” he said. “Currently, the workplace rights derived from EU law ensure a ‘level playing field’ for all Member States, so that one member state cannot undermine another by offering less workplace protection and poorer wages.” Cox says an important workplace right under threat to British workers comes from the European Working Time Directive. “In 1998 this introduced a maximum 48 hour working week for most occupations (averaged over 17 weeks); a daily rest period of 11 consecutive hours; a weekly rest period of 24 consecutive hours; and rest breaks during the working day” he said. Although Britain opted out of the 48 hour limit, he says, “it is estimated that, compared to 1998, 700,000 fewer employees now work more than the 48 hours limit.”
of doctors – just over 30,000 – come from another European country
More information The British Medical Journal published an excellent series of articles debating the impact of Brexit on the NHS, public health, pharmaceuticals, trade, finance and employment law: www.bmj.com/brexit.
THE LAMP AUGUST 2016 | 27
COVER RATIOS STORY
LIONS NURSES’ SCHOLARSHIP
Looking for funding to2017? further your studies in
The trustees of the Lions Nurses’ Scholarship Foundation invite applications for scholarships. Nurses eligible for these scholarships must be resident and employed within the State of NSW or ACT. You must currently be registered with the Nursing and Midwifery Board of Australia and working within the nursing profession in NSW or the ACT, and must have a minimum of three years’ experience in the nursing profession – the last 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 on 1 Aug
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
Nursing Review (185 mm x 133 mm)
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
Cleveland Clinic Abu Dhabi is now hiring Critical Care Nurses - Interviews on the 20th-22nd of October The intensive care unit is an exciting and challenging environment at CCAD, offering world class innovative experiences and opportunities for nurses. You will be challenged with high acuity 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.
Come and meet us! CCAD representatives will be attending the ANZICS ACCCN Annual Scientific Meeting at Perth Convention and Exhibition Centre. Concurrent to the conference, CCAD will be holding interviews on the 20th-22nd of October. Please bring an updated CV if you are interested in job opportunities at CCAD. Skype interviews are also available for nurses located in other cities in Australia and New Zealand. Please contact CCM for more information. Cleveland Clinic Abu Dhabi (CCAD), part of Mubadala’s network of world-class healthcare facilities, is a multispecialty hospital on Al Maryah Island in Abu Dhabi, UAE. CCAD is a unique and unparalleled extension of US-based Cleveland Clinic’s model of care, specifically designed to address a range of complex and critical care requirements unique to the Abu Dhabi population. Benefits: In addition to being part of an international clinical team, successful applicants will receive accommodation, a transportation allowance, health insurance, annual travel allowance to their home country and a generous annual leave package. To apply, please email: Dawn at dawn@ccmrecruitment.com.au or Raquel at raquel@ccmrecruitment.com.au or by phone at Free Phone AUS: 1800 818 844, Free Phone NZ: 0800 700 839 www.ccmrecruitment.com
2 8 CCAD_Nursing_Recruitment_Adverts.indd | T H E L A M P A U G U S 13 T 2016
29-06-2016 12:18:14 PM
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.
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/14/00042. THE LAMP AUGUST 2016 | 29
COVER STORY
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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
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www.bowentraining.com.au THE LAMP AUGUST 2016 | 31
EDUCATION@NSWNMA
what’s ON PRACTICAL, POSITIVE WAYS IN MANAGING STRESS AND BURNOUT – 1 Day
O CATI
EDU
NMA
SW N@N
n Monday 8 August, Waterloo Members $85 | Non-members $170
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 Thursday 25 August, Wagga Wagga n Wednesday 7 September, Coffs Harbour Members $40 | Non-members $85 LEGAL AND PROFESSIONAL ISSUES FOR NURSES AND MIDWIVES – ½ Day
Learn about potential liability, disciplinary tribunals, NMC and HCCC complaints, Coroners Court and more. n Friday 26 August, Wagga Wagga n Thursday 8 September, Coffs Harbour Members $40 | Non-members $85
APPROPRIATE WORKPLACE BEHAVIOUR FOR NURSES AND MIDWIVES – 1 Day
n Thursday 1 September, Gymea Members $85 | Non-members $170
MENTAL HEALTH AND DRUG & ALCOHOL NURSES’ FORUM – 1 Day
n Friday 9 September, Waterloo Members $30 | Non-members $50
MANAGING OVERTHINKING – 1 Day n Monday 19 September, Parramatta Members $85 | Non-members $170
FOOT CARE FOR NURSES – 2 Days
n Tuesday 20 & Wednesday 21 September, Tamworth Members $203 | Non-members $350
AGED CARE NURSES’ FORUM – 1 Day
For RNs, ENs and AiNs in residential, community and hospital aged care settings, across private and public sectors. n Friday 14 October, Waterloo Members $30 / Non-members $50
Register online 32 | THE LAMP AUGUST
WWW.NSWNMA.ASN.AU/ EDUCATION/ EDUCATION-CALENDAR
For enquiries contact NSWNMA Metro: 8595 1234 2016 Rural: 1300 367 962
Mental Health and Drug & Alcohol Nurses’ Forum
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n Wednesday 17 August, Gymea Members $85 | Non-members $170
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TOOLS IN MANAGING CONFLICT AND DISAGREEMENT – 1 Day
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Friday 9 September
CULTURAL BARRIERS Accessing Mental Health and Drug & Alcohol Services Hear from speakers across a range of areas and services including: Sydney District Nursing, HIV Mental Health Registered Nurse and Bhutan Refugee Transcultural Mental Health Centre NSW Refugee Health Service NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARRTS) Aboriginal Mental Health Workforce Program Aboriginal Counselling Services Harm Reduction Australia
!
Attendance at A SWNM Education@N count sessions may uing tin towards Con nal io ss fe Pro t (CPD) en m op Devel hours
Register online
NSWNMA 50 O’DEA AVENUE WATERLOO 9AM TO 3.30PM Members $30 Non-Members $50 Lunch & refreshments provided
WWW.NSWNMA.ASN.AU/EDUCATION/
For enquiries call 8595 1234 (METRO) 1300 367 962 (RURAL)
ASK JUDITH WHEN IT COMES TO YOUR RIGHTS AND ENTITLEMENTS AT WORK, NSWNMA ASSISTANT GENERAL SECRETARY JUDITH KIEJDA HAS THE ANSWERS. Minimum shift pay I am a casual employee working in the private sector under the Nurses Award 2010 (Private Hospitals and Day Procedures). Recently I agreed to a shift but it was subsequently cancelled after I worked for half an hour. Will I be compensated in any way? Yes you should be. I refer you to clause 10.4 Casual employment Sub clause (c) of the Nurses Award 2010 (Private Hospitals and Day Procedure Centres) which states: “A casual employee will be paid a minimum of two hours pay for each engagement.” Therefore, because you had already commenced the shift in question and the employer decided they did not require your services after half an hour, you have to be paid for two hours as a means of compensating for the loss of the remainder of the shift.
Maximum number of ADOs that can accrue I am a Clinical Nurse Consultant (CNC) working in a private hospital under the Nurses Award 2010. Because I have been busy over the past three months, I have not had the opportunity to take my ADOs. I did discuss the issue with my manager who agreed to allow me to accrue them during this period. How many ADOs can I accumulate and if I don’t take them will I lose them? The Nurses Award 2010, clause 24 Accumulation and taking of accrued days off (ADOs), sub clauses 24.1, 24.2 and 24.3 state as follows: “24.1 – Where an employee is entitled to an ADO, in accordance with the arrangement of ordinary hours of work as set out in clause 21 – Ordinary hours of work. ADO’s will be taken within 12 months of the date on which the first full ADO accrued.” 24.2 – With consent of the employer, ADOs may be accumulated up to a maximum of five in any one year. 24.3 – An employee will be paid for any accumulated ADOs at ordinary rates, on the termination of their employment for any reason.” This means you can only accumulate up to five ADOs per year. Once you have accrued five ADOs they must be
taken within 12 months from the date the first ADO was accrued, otherwise they are paid out when you leave your current employer.
BREAKING NEWS Redundancy under threat Members will recall from our previous update that on 17 June 2016, without any fanfare or warning, the Baird NSW Government had the Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 (‘Regulation’) gazetted. The disgraceful objective of this Regulation is to further erode the rights of government sector workers whose role may be subject to privatisation. In short, the Regulation provides that a government sector employee – whose employment ceases as a result of the transfer of services to the non-government sector (previously provided by the government sector agency) – is not entitled to any redundancy payment for the cessation of employment if the person is offered “comparable employment” by the non-government sector body. This Regulation will have immediate consequences to members working in areas that may be subject to future contracting out or privatisation. The Association has made representations to the Ministry of Health to identify how this Regulation will impact on, for example, the Northern Beaches Redevelopment. For example, will it also erode the rights of employees to be found alternative suitable work if they elect to remain with the LHD, or is that too collateral damage arising from the Regulation. To date the Ministry has verbally responded that the Regulation would not be applicable to the Northern Beaches proposal as commitments made to staff about being able to exercise a choice with their employment as part of that process had previously been guaranteed – and predated this Regulation. We hope that this will be the case. But that falls short of addressing future/other privatisations. Accordingly, Unions NSW and affiliates are continuing to agitate with cross bench members of the NSW Upper House, as the ALP Opposition has lodged an intention to seek a disallowance debate of the Regulation. This debate is due to be held this month.
Progression through pay points I am an Assistant in Nursing (AIN) working in the aged care sector on a full time
basis under the Nurses Award 2010. I am currently being paid AIN 2nd year rates but should be paid at the AIN 3rd year rate. Can you please advise me how many hours I need to work to move up to my next increment? I refer you to the Nurses Award 2010 clause 15: Progression through pay points: Progression for all classifications for which there is more than one pay point will be by annual movement to the next pay point, or in the case of a part-time or casual employee 1786 hours of experience, having regard to the acquisition and use of skill described in the definitions contained in Schedule B – Classification Definitions and knowledge gained through experience in the practice settings. You must work 1786 hours; this equals the hours worked by a full time employee over a twelve month period. The Association would advise that you submit all previous statements of service and any other relevant documentation to your current employer so they can calculate and pay you at the appropriate rate. You are only entitled to be incremented once in any twelve month period.
Higher grade annual leave I work for a small public hospital and have been relieving the Nursing Unit Manager (NUM) who is on maternity leave. I have been relieving for over a year and have been receiving the higher grade duty allowance. I am now due to take annual leave and when I return from leave I will continue to relieve in the NUM position. Am I eligible to be paid my annual leave at the higher grade rate? Because you have been relieving your NUM for over 12 months and because you will continue to relieve her on your return to work you are entitled to be paid for your annual leave at the higher rate. NSW Health service policy PD2014_029, Leave Matters, part 2, sub section 2.9 states: “ Employees who have acted continuously for one year or more in the same higher graded role and who continue to act in that role are eligible for payment of the higher duties allowance for any annual leave which is taken during the further period of higher duties.” THE LAMP AUGUST 2016 | 33
id N w SW iv NU es RSE ’s S AN ho D M rt IDWI fil VES’ m ASS fe OCIA st TION iv al nu rs es &
m
REC
NSWNMA NIDA Film Making Workshops BUDDING FILM MAKERS!
2 DAY INTRODUCTORY FILM MAKING WORKSHOP
The Association is running two NIDA Film Making Workshops for NSWNMA Members and Associate Members wanting to learn new, or brush up on existing film making, skills.
10AM — 5PM THURSDAY 20 AND FRIDAY 21 OCTOBER 2016 This course is fully sponsored by the NSWNMA.
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.
WWW.NSWNMA.ASN.AU/ SHORT-FILM-FESTIVAL
34 | THE LAMP AUGUST 2016
5 DAY ADVANCED FILM MAKING WORKSHOP 24 — 28 OCTOBER 2016 This course is part sponsored by the NSWNMA. Cost to participants $400+GST. 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.
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
Is stress incontinence more prevalent amongst nurses? Midwife and physiotherapist Heather Pierce is investigating pelvic floor health in the nursing and midwifery workforce.
www.nurseuncut.com.au/is-stressincontinence-more-prevalent-amongstnurses
A day in the life of a remote continence nurse Anita, a continence nurse in the far west of the state, describes her typical day, with catheters playing a leading role. www.nurseuncut.com.au/a-dayin-the-life-of-a-remote-continencenurse/
We’ve all heard about – and probably experienced – the rapid rise in type 2 diabetes. Annette, a credentialed Diabetes Educator, explores the implications for nurses. www. nurseuncut.com.au/the - diabeteschallenge -for-nurses
CDC – ‘Consumer directed care’ If you haven’t heard of CDC, you soon will. It’s a growing trend, especially in aged and community care. Is it relevant to nurses? www.nurseuncut.com.au/visionstatements4
Medicare and the ‘L’ word Both major parties accused the other of lying about Medicare during the election campaign. Was it really just a Mediscare? www. nurseuncut.com. au/medicare-andthe-l-word
The diabetes challenge for nurses
The aged care ‘industry’ and the Stock Exchange What are the implications when companies list on the stock exchange and profits and dividends enter the aged care picture? http://www. nurseuncut.com.au/the-aged-careindustry-and-the-stock-exchange/
A day in the life of a student nurse in Malawi A nursing student has to care for a seven year old with cerebral malaria and anaemia. www.nurseuncut.com. au/a-day-in-the-life-of-a-student-nursein-malawi
New on SupportNurses YouTube channel NO VOICE, NO CHOICE FOR STOCKTON NURSES Registered nurses reduced to the level of carers with first aid certificate in the ADHC privatisation.
OPAL NURSES – A MULTILINGUAL MESSAGE A message for Opal nurses – in three different languages.
bit.ly/stocktonnurses
bit.ly/opalnswnma
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
We’re on
Instagram!
Share your photos by tagging @nswnma and don’t forget to use the hashtag #nswnma!
Look for your local branch on our facebook page www.facebook.com/ nswnma
THE LAMP AUGUST 2016 | 35
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
36 | THE LAMP AUGUST 2016
www.nswnma.asn.au
SOCIAL MEDIA | facebook
WHAT NURSES & MIDWIVES
SAID & LIKED on facebook www.facebook.com/nswnma Profit before care The funding of aged care homes requires transparency, scrutiny and accountability. Are some providers rorting the system?
Student midwives asked to sink or swim Maternity wards are at breaking point across the state and second year midwifery students are being used as assistants.
Parking boycott Staff from Lismore Base Hospital refuse to park in the Lismore City Council’s new paid parking areas.
This article certainly reflects my 12-month experience working as an RN in residential care. Staff work hard and for the most part really care. Overarching organisations do not. It is purely a money making venture. If subsidies drop, the loss will be recouped by cutbacks in staff, meals, continence aids, wound dressings and cleaning. Staff are not replaced if sick and staffing ratios are deplorable. Having worked as a manager for a well-known large for-profit provider, ACFI coordinator didn’t know the residents from a bar of soap but was responsible for ALL ACFI submissions. I can absolutely attest to deliberate fraud. 80% downgrade on the first day of a two-day validation. I walked out the next day. I was disgusted at the profit over care mentality. I am lucky to work in a private nursing home where we are encouraged to be honest with our ACFI reporting, as our owner is more concerned with his good name than massive profits. We have adequate staffing, great facilities and the owner still makes a profit, which makes me wonder how much the big players who just want money are ripping off the residents and taxpayers. A solution might be to set minimum staff ratios to ensure residents get the care they deserve and to make profit-making concerns put the money they siphon from the public purse to its correct and just use. I give the “industry” 5 years before it hits a Titanic Royal Commission iceberg. When essential services are privatised, why is anyone surprised when profiteering is the end result?
Ihave never seen/heard a B-Mid student (the ones who work as AIMs) being rostered as numbers in birth unit but I have seen plenty of RN-midi students rostered and counted as staff numbers yet they have only just started their midi. Yes but RN-Mids are RNs - they would know what to do in an emergency situation and would know when to escalate care, one would hope. Let’s face it, the scary thing about this is ... the understaffing due to funding No one said student midwives aren’t great! But they should not be used as numbers. It is unfair/ unsafe for everyone including the student that is meant to be there to learn. In all hospitals students are used as extra staff, been happening for a long time. We only have RMs and student midwives in a small rural hospital with a birthrate of 450. Little access to a casual pool and no agency, so we have no one to call upon other than our students. We are living this problem daily in our unit. The government is failing to provide the policies they endorse. It’s a stupid state government decision, they should provide free parking for their employees, all other major employers in Lismore do ...If the car park is not paid for in 3 years, the $2.4M cost will come out of the North Coast area health budget and impact on health services for our community. Paid parking at any hospital is an absolute rort. Staff need to be there... No one is going there for the cafeteria. Like every bunch of nurses from Sydney hospitals that has protested paid parking, after a long drawn out battle, we pay. We won’t because we don’t live in Sydney. This is country Lismore and no one pays to park here and neither will we. I know I will walk 10km and back from my home each day before I give them a cent!
PHOTO GALLERY
Coffs Harbour mental health branch hold a lunchtime protest about staffing issues.
Happy campers at our annual forum for Enrolled Nurses.
Shellharbour Hospital members – they care and they vote!
Dog, baby, desert (and members too!) – in beautiful Broken Hill.
THE LAMP AUGUST 2016 | 37
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NURSING RESEARCH ONLINE The Association has adopted a strategic plan for the next 5 years to guide us forward as we face the challenges to our professions and the environments where we live and work. A key objective of the strategic plan is to promote a world class, well-funded integrated health system. Over the following months, this page will cover some of the issues we need your feedback on. Go online to NurseUncut to share your wisdom and experience. The links at the end of this article provide further reading. This month we look at immigration and national health priorities.
Immigration and national health priorities People arriving in Australia, particularly from non-English speaking countries, are often unaware of what health services are available to them1. Australia has one of the most diverse populations globally and prides itself on its inclusive approach to immigration. In 2011 the Australian Census showed that the fastest growing sections of the Australian population originated from India, China and New Zealand, respectively2. NSW already has the largest population of any Australian state and the highest cultural diversity. Over 31% of Sydney’s population alone was born overseas compared to just over 22% of Australia’s general population3. While NSW benefits from the richness of its diverse population, it is also challenged by the unique health needs that these populations bring. Children born in Australia to overseas migrants integrate well within Australian society. However, the 2011 census revealed that within the current population 20% of Australians aged over 5 years spoke a second language at home, and 2% didn’t speak English at all. The most common languages other than English were Arabic, Mandarin and Cantonese1. We already know that different populations have unique differences in their health needs and that prevalence varies according to cultural background4.
different communities within NSW have different health needs negating the possibility of a ‘one size fits all’ approach to health prevention across the state. 2016 marks the ten-year anniversary since the original study but there is still a lack of ongoing and coordinated data collection to comprehensively assess the health needs and inequalities within the NSW population. There is a range of other sources that could be used including National Health Performance Authority (NHPA) data. This data shows a variance across NSW and even within primary care regions in Sydney on attendance at GP surgeries. For example, NHPA data shows that 10% of people in North Sydney Primary Health Network did not see their GP in the preceding 12 months but needed to. This figure is doubled for people in South Western Sydney Primary Health Network6. The demographics of both areas are made up of almost 50% of overseas born people. However, two of the top three countries of birth for North Sydney are English speaking: United Kingdom and New Zealand (China is the third), compared to Vietnam, Iraq and Lebanon in the South West7.
LANGUAGE BARRIERS AND HEALTH CHALLENGES
Questions:
During 2006-09 The Centre for Epidemiology and Research conducted one of the few studies undertaken to establish the health needs of NSW populations born overseas5. This research confirmed that
• What are the clinical issues you encounter related to your Culturally And Linguistically Diverse (CALD) patients?
Go to Nurse Uncut and let us know:
• How can we improve our response to the needs of CALD populations?
10%
of people in North Sydney Primary Health Network did not see their GP in the preceding 12 months but needed to.
20%
of people in South Western Sydney Primary Health Network8 did not see their GP in the preceding 12 months but needed to.
We want to hear what you think Please go to Nurse Uncut to read more about the current state of Immigration and health issues and give us your feedback on our strategic plan:
www.nurseuncut. com.au/visionstatements5/ NSW NurSeS aNd midWiveS’ aSSociatioN
Strategic Plan
1. N SW Ministry of Health (2012) Policy and Implementation Plan for Healthy Culturally Diverse Communities 2012-2016, North Sydney: NSW Ministry of Health. 2. Australian Bureau of Statistics (2015) Reflecting a Nation: Stories from the 2011 Census, 2012–2013. Available at: http://www.abs. gov.au/ausstats/abs@.nsf/Lookup/2071.0main+features902012-2013 3. R egional Development Australia (2015) RDA Sydney. Available at: http://www.rdasydney.org.au/the-sydney-region~1/socialdemographic-profile/. 4. G uo, S. et al (2015) Cardiovascular Disease Risk Factor Profiles of 263, 356 Older Australians According to Region of Birth and Acculturation, with a Focus on Migrants Born in Asia, PLoS ONE, 10(2): e0115627. 5. C entre for Epidemiology and Research (2010). 2006–2009 Report on Adult Health by Country of Birth from the New South Wales Population Health Survey. North Sydney: NSW Department of Health. 6. National Health Performance Authority (2015) My Health Communities. Available at: http://www.myhealthycommunities.gov.au/. 7. Regional Development Australia (2015) RDA Sydney. Available at: http://www.rdasydney.org.au/the-sydney-region~1/socialdemographic-profile/. 8. National Health Performance Authority (2015) My Health Communities. Available at: http://www.myhealthycommunities.gov.au/.
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2020 THE LAMP AUGUST 2016 | 39
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
40 | THE LAMP AUGUST 2016
TEST YOUR KNOWLEDGE
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Across 1. Damaging or injurious 6. A wall or partition dividing a body space or cavity 10. A baglike organ or structure; see also bag, pocket, and pouch 12. Abolished, caused loss of identity, destroyed 13. Repetition time–MRI (1.1) 14. Obstruction 16. Oriented to or relying heavily on the faculty of hearing 18. Infant mortality rate (1.1.1) 19. Directions, orders 22. Endotracheal tube (1.1) 23. A technique for removing a bolus of food stuck in the oropharynx potentially causing acute asphyxia (8.8) 26. Pertaining to the fourth cranial nerve
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29. A lateral ventricle of the brain 30. One of the most common causes of food allergy 31. Performs a surgical procedure 34. Goodbye, farewell 35. Intensive care unit (1.1.1) 36. Pulmonary embolism (1.1) 37. To cause harm to; spoil or impair 38. A tubular case or envelope Down 1. Vesical calculus 2. Inspiratory reserve capacity 3. Relating to the prepuce 4. Pertaining to the essence or nature of a thing; inherent 5. Having both male and female characteristics 7. The rules of decorous behavior
8. Thyrotropin releasing hormone (1.1.1) 9. Mania [MADNESS] 11. A part of the circumference of a circle 15. Causing cancer 17. Symbol for inosine 20. The constricted region of a chromosome 21. A recurring sleep state during which dreaming does not occur; accounts for about 75% of normal sleep time (1.1.1.1.5) 24. Sick 25. A rounded elevation 26. Relating to a cough 27. A type of gas used in medicine as a diluent for other gases 28. A sweetened liquid that contains alcohol, water, and medicine 32. Quick to learn or understand 33. To perceive by the eye THE LAMP AUGUST 2016 | 41
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Free CPD courses visit www.nurseshub.com.au
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INTRODUCING
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BOOK ME All the latest Book Me reviews from The Lamp can be read online at www.nswnma.asn.au/library-services/book-reviews. Advanced Nursing Practice: Changing Healthcare In A Changing World Edited byThomas David Barton and Douglas Allan Palgrave Macmillan: http://www.palgravemacmillan.com.au/ RRP $49.95. ISBN 9780230378131 Advanced Nursing Practice provides a detailed review of the evolution of advanced nursing, its practice, theory and concepts. Written by leading experts with extensive experience in the field it provides practical guidance as well as a review of the current clinical, strategic, educational and research developments. While its focus is primarily on developments in the UK the intention of this text is to allude to developments that compare or contrast with the UK experience, which has been replicated in many countries.
Introduction To Quality And Safety Education For Nurses Patricia Kelly, Beth A. Vottero & Carolyn A. Christie-McAuliffe Springer Publishing Company (available from Footprint Books): http://www. footprint.com;au RRP $82.00. ISBN 9780826121837 This books aims to encourage health professionals to view a patient in his or her broad context, as a person, and as a person in a family, a cultural group, and in a society. Chapters address individual differences and developmental processes, relationships, the social determinants of health, existential and ethical issues, and prevention and promotion. In each chapter, to personalise and illustrate key points, the authors reflect on the examples of seven Australian and two New Zealand patients who have presented to their local general-practice clinics.
Florence Nightingale’s Notes On Nursing And Notes On Nursing For The Labouring Classes: Commemorative Edition With Historical Commentary Edited by Victor Skretkowicz Springer Publishing Company: http://www.springerpub.com/ RRP $45.00. ISBN 9780826118424 This beautiful book bound in red leather includes an in-depth history about each version and the preparation and publishing of Nightingale’s works. What is very interesting is the editor’s commentary on the bibliographical and social history behind the various versions. He discusses little known facts about the book, such as the one published for the educated professional is the second version, whereas the other versions, though more widely published and more widely known, were written mainly for the masses. The editor’s research clearly describes Nightingale’s legacy and the effect it has had on contemporary nursing as well as nursing’s future.
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 Our Vietnam Nurses: Compelling Australian Stories of Heroism, Friendship And Lives Changed Forever Annabelle Brayley Penguin Random House
(available from Booktopia), http://www.booktopia. com.au/ RRP $26.95. ISBN 9780143797029 Our Vietnam Nurses covers 15 stories from nurses and medics that show a side of the Vietnam War that has received little recognition but played an important part in shaping Australia’s presence in the war. From flying with critically injured soldiers out of turbulent war zones, to being held at gunpoint, the compassion, courage and grace under fire in Our Vietnam Nurses is inspiring and amazing.
Psychiatric-mental Health Nursing: An Interpersonal Approach (2nd Edition) Edited by Jeffry S. Jones, Joyce J. Fitzpatrick and Vickie L. Rodgers Springer Publishing Company (available from Footprint Books): www.footprint.com.au. RRP $133.00. ISBN 9780826131287 This psychiatric-mental health undergraduate textbook, based on the theories of Hildegard Peplau and Joyce Travelbee, is the first recent book devoted to interpersonal relations as the foundation for therapeutic practice in psychiatric nursing. It guides the student through the essential phases of selfdiscovery necessary to integrate interpersonal nursing theory into practice, and provides a historical overview of the profession. It offers an overview of theories of mental illness and a detailed discussion of commonly seen psychiatric disorders, and addresses mental health care settings across the lifespan and different populations. Clinical case studies and first-hand accounts vividly describe the realities of living with specific mental illnesses, “What would you do?” questions stimulate discussions, and sample and practice care plans for chronic mental illness facilitate integration of concepts into practice.
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 AUGUST 2016 | 43
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!
44 | THE LAMP AUGUST 2016
NSWNMA Toolkit App is FREE and available to download from iTunes and Google Play store
MOVIE OF THE MONTH
ABSOLUTELY FABULOUS METRO MEMBER GIVEAWAY This month The Lamp is giving away 10 FREE passes to Absolutely Fabulous – The Movie. Appropriate for their big screen debut, Edina Monsoon and Patsy Stone (Jennifer Saunders and Joanna Lumley) are still oozing glitz and glamour, living the high life they are accustomed to; shopping, drinking and clubbing their way around London’s trendiest hotspots. But when they accidentally push Kate Moss into the river Thames at an uber fashionable launch party, Eddy and Patsy become entangled in a media storm surrounding the supermodel’s untimely demise and are relentlessly pursued by the paparazzi. Fleeing penniless to the glamorous playground of the super-rich, the French Riviera, they hatch a plan to make their escape permanent and live the high life forever more! Absolutely Fabulous: The Movie is in cinemas from August 4. EMAIL The Lamp BY THE 12TH OF THE MONTH TO BE IN THE DRAW TO WIN A DOUBLE PASS TO ABSOLUTELY FABULOUS – THE MOVIE THANKS TO 20TH CENTURY FOX FILM DISTRIBUTORS. EMAIL YOUR NAME, MEMBERSHIP NUMBER, ADDRESS AND TELEPHONE NUMBER TO lamp@nswnma.asn.au FOR A CHANCE TO WIN!
DVD SPECIAL OFFER
RURALMEMBERGIVEAWAY
CAROL The sumptuous drama, Carol starring Cate Blanchett and Rooney Mara which was nominated for a slew of awards including Best Picture and Best Lead Actress at this year’s Academy Awards. Based on Patricia Highsmith’s novel The Price of Salt about the burgeoning relationship between two very different women in 1950’s New York. One, a girl in her 20s working in a department store who dreams of a more fulfilling life, and the other, a wife trapped in a loveless, moneyed marriage desperate to break free. This incredibly thought-provoking film received strong reviews and captured the attention of audiences around the world. The DVD/Blu-Ray features 8x interviews with key cast and crew including Cate Blanchett, Rooney Mara and Todd Haynes, and a cast and filmmaker Q&A. EMAIL THE LAMP BY THE 15TH OF THIS MONTH TO BE IN THE DRAW TO WIN A DVD OF CAROL THANKS TO ROADSHOW ENTERTAINMENT RELEASES. EMAIL YOUR NAME, MEMBERSHIP NUMBER, ADDRESS AND TELEPHONE NUMBER TO LAMP@NSWNMA.ASN.AU FOR A CHANCE TO WIN! THE LAMP AUGUST 2016 | 45
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
ANZSVS Vascular Conference 2016 5-8 August 2016 Sheraton on the Park, Sydney http://www.vascularconference.com/ registration/ DANA 2016 NSW Drug and Alcohol Nurses Forum 12 August 2016 Park Royal Hotel, Darling Harbour www.danaonline.org IASSIDD 15th World Congress 15-19 August 2016 Melbourne, Australia https://www.iassidd.org/conference/ index.php/HPC/IWC/index Cardiology and the Deteriorating Patient 19 August 2016 Deer Park, Armidale www.dibseducation.com.au Australian College of PerAnaesthesia Nurses (ACPAN) 20 August 2016 Coffs Harbour Public Hospital, Coffs Harbour www.acpan.edu.au Cardiology and the Deteriorating Patient 25 August 2016 Port Kembla Golf Club, Wollongong www.dibseducation.com.au Cardiology and the Deteriorating Patient 8 September 2016 Rydges Mount Panorama, Bathurst www.dibseducation.com.au The Children’s Hospital at Westmead Paediatric Perioperative Seminar 10 September 2016 Novotel Parramatta, Sydney claudia.watson@health.nsw.gov.au Cardiology and the Deteriorating Patient 15 September 2016 Gosford Golf Club, Gosford www.dibseducation.com.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 Transforming our Landscape Biennial State Conference 2016 13-15 October 2016 Broken Hill www.palliativecarensw.org.au Audiometry Nurses Association of Australia INC Annual Conference and AGM 26-28 October 2016 Quality Noahs on the Beach, Newcastle http://anaa.asn.au
46 | THE LAMP AUGUST 2016
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 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 Australian Women’s Health Nurse Association 30 Year In-service 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 4th International Collaboration of Perianaesthesia Nurses [ICPAN] Conference 1-4 November 2017 Luna Park, Sydney www.icpan2017.com.au
ACT
Smart Strokes 25-26 August 2016 National Convention Centre Canberra, ACT www.smartstrokes.com.au
INTERSTATE
2016 ANMF Health and Environmental Sustainability Conference 17th International Mental Health Conference 10-12 August 2016 Sea World Resort, Gold Coast, QLD www.anzmh.asn.au/conference Working Hours, Shifts and Fatigue Conference 18 August 2016 Carson Conference Centre, ANMF House https://www.anmfvic.asn.au/eventsand-conferences ACPAN Advanced Life Support 2 Day Certification 19-20 August 2016 Royal Darwin Hospital, Darwin, NT www.acpan.edu.au 26th Annual Spinal Injury Conference 25-26 August 2016 Hampstead Rehabilitation Centre, Northfield, SA jhebblewhite@bigpond.com 11th National Conference Australian College of Nurse Practitioners 30 August-2 September 2016 Alice Springs, NT www.dcconferences,com.au/acnp2016 Cardiology and the Deteriorating Patient 1 September 2016 Hotel Grand Chancellor, Melbourne www.dibseducation.com.au 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 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/ 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
Dubbo Base Hospital Graduate Nurses Reunion - Farewell to the George Hatch Building 6 August 2016 Sue O’Dea: 0438 845 225 Jenny Furney: 0419 480 259 Kempsey Hospital NSW Ex and Older Staff Reunion 10 September 2016 South West Rocks Country Club Trudy Lynch: 0265627794 Brenda: 0265674532 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 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
CROSSWORD SOLUTION
biggest ever CAR SALE
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BEAR COTTAGE DONATION DRIVE
12TH » 14TH AUGUST
Just like Superheroes, Bear Cottage is there for children and families who need them the most. AHG are raising funds for Superhero month to help support Bear Cottage, the only children’s hospice in NSW. $100 from each car sold at the Biggest Ever Car Sale weekend will be donated to Bear Cottage.
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39,990
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EXCLUSIVE TO LAMP READERS
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*Must present advert at time of purchase to be eligible. Cars must be picked up by the 30/08/16. Offer ends 31/8/2016. Highland Kackell Pty Ltd trading as Lander Nissan dealer license MD20305.
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ahg.com.au
THE LAMP AUGUST 2016 | 47
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.
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firststatesuper.com.au | 1300 650 873 Consider our product disclosure statement 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. 48 | THE LAMP AUGUST 2016