The Lamp June 2024

RATIOS ROLLOUT GETS UNDER WAY

Update your details using our online portal during 1 April 2024 - 30 March 2025 and you will automatically be entered in the draw to win. We are giving away two gift card bundles, each prize valued at $350.

Winner may choose one gift card valued at $350 or a selection* of gift cards to the value of $350.

* Up to a maximum of three different gift cards, to the total value of $350 per prize. **Winner must be a financial member of the NSWNMA. The Association will contact winners, ascertaining preferred gift cards. Gift cards are subject to availability and supplier t&c’s apply. Keeping your membership details up to date is very important. If you’re a dualqualified nurse/midwife, you can now update your

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NSW Nurses and Midwives’ Association

For all membership enquiries and assistance, including The Lamp subscriptions and change of address, contact our Sydney office.

Sydney Office

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50 O’Dea Avenue, Waterloo NSW 2017

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Editorial Committee

Shaye Candish, NSWNMA General Secretary

Michael Whaites, NSWNMA Assistant General Secretary O’Bray Smith, NSWNMA President

Michelle Cashman, Long Jetty Continuing Care

Richard Noort, Justice Health

Liz McCall, Byron Central Hospital

Diane Lang, South East Regional Hospital, Bega Valley

Karen Hart, Wagga Wagga Base Hospital

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The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Authorised by S. Candish, General Secretary, NSW Nurses and Midwives’ Association, 50 O’Dea Avenue Waterloo NSW 2017

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12 PAY CLAIM

14

18

gets underway

Our decade-long campaign to ease workloads and make public hospitals safer takes a big step forward.

15% pay claim an investment in nurses and midwives

The NSWNMA is campaigning for a 15 per cent pay rise, more funding for nurse-topatient ratios and better working conditions in 2024.

PAID PLACEMENTS

Push to end placement poverty

Despite a high student dropout rate, aspiring nurses and midwives are being punished by unpaid clinical placements.

VOLUNTARY ASSISTED DYING

Voluntary assisted dying –what it means for nurses

Voluntary assisted dying (VAD) became available in NSW in November 2023, following an 18-month implementation period. The Lamp l ooks at the introduction of VAD at Nepean Hospital in Western Sydney.

22 NSW ENVIRONMENT AWARDS

Nurses win joint environment award

NSWNMA members were recognised at the NSW Environment Awards for their campaign to stop a major gas project that threatens to contaminate the Great Artesian Basin. .

COVER STORY Ratios rollout

COVER : Mila Calderon, Shaye Candish, Mirabel Nelson, Deborah Chant and Simon Quinn

Photographed by Sharon Hickey

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SHAYE Candish

GENERAL SECRETARY

And we’re off!

The rollout of ratios has started with EDs at Liverpool and Royal North Shore Hospitals in the vanguard and recruitment for the new positions under way.

It has been a lengthy process as we have methodically worked our way through the detail but, finally, we are starting to see our long and hard-fought campaign for ratios come to fruition.

The reform has kicked off in Liverpool and Royal North Shore ED with both sites each receiving an additional 35 FTEs. Recruitment has commenced and members are already experiencing the benefits of these additional nurses in their units.

The remaining level 5 and 6 EDs will commence their ratios rollout in the next 6 months. Discussions will then turn to Level 3 and 4 EDs, ICU, Maternity, wards converting to NHPPD and MPSs. (This does not indicate the roll out order).

This is a major victory for patient safety, but also, this reform finally starts to acknowledge and value you and the incredible work you do.

There is still a long way to go, as we fight for more funding from the government to ensure ratios are implemented in every ward and every unit across the five areas as the government promised. We will continue our fight for ratios in all other clinical areas across our public health system. In a busy month we not only kick started the roll out of ratios, but we also lodged our log of claims for the Public Health System Award for 2024.

The claim seeks important improvements and sets out a plan to return NSW Health to being an employer of choice for nurses and midwives across Australia.

This will be critical if the ratios rollout is to be successful.

The claim was put together with direct input from members, and it was endorsed by an unprecedented number of members in a vote held in April 2024.

The claim calls for a 15 per cent pay rise, more funding for nurse-topatient ratios and improved working conditions.

The

claim seeks important improvements and sets out a plan to return NSW Health to

being an employer of choice for

nurses and midwives across Australia.

The log of claims committee settled on a 15 per cent figure after examining extensive data and assessing circumstances since the wages cap was introduced in 2011. It considered the spike in inflation and the productivity gains that we’ve consistently missed out on. It drew on the knowledge and experience of respected Industrial Relations experts.

15 per cent is a reasonable goal but we will still need to campaign hard to achieve it. On the one hand it is ambitious, as combined with the implementation of ratios it calls on the government to make a substantial investment in our public health system. But it is also reasonable and responsible when considering our analysis of what is needed to attract nurses and midwives back into the system after a decade of wage suppression and the barely believable burdens placed on the nursing and midwifery workforces during COVID.

As always, we will need the support of the community and we will need to articulate our case well to galvanise their support.

A STEP FORWARD ON PAID PLACEMENTS

In this edition of the Lamp, we also look at the difficult financial situation faced by many undergraduate nursing and midwifery students during their hundreds of hours of mandatory unpaid clinical placements (p14).

During these placements, students are expected to fund their own travel and accommodation on top of the loss of wages from their regular job.

Unsurprisingly, this leads to a high dropout rate, hardly a sensible or desirable outcome when we need all hands on deck to meet the challenges in implementing ratios.

As the Lamp goes to press the federal government has announced it will establish a “Commonwealth Prac Payment” of $319.50 per week to support nursing, midwifery and other tertiary students during mandatory workplace placements.

This is clearly insufficient to properly alleviate this existing “placement poverty” but it is a welcome first step and at least a recognition of the existence of the problem.

Finally, I would like to commend to you an article in this month’s Lamp on Voluntary Assisted Dying (p18). Staff from the Nepean/Blue Mountains LHD tell us how much appreciated nurses are by patients and families as they navigate this difficult process.

Nurses can be proud of their role in making this final part of a person’s life full of kindness, compassion and respect.

We can also take pride in our union and our campaigning efforts that helped to bring VAD into existence. It is heartening to know that a discussion about such a sensitive issue with many differing views can be conducted with intelligence and tolerance and with the wellbeing and wishes of patients the goal of public policy. n

ELITECARE SCRUBS FOR

Have your Say

FEATURED LETTER

The midwife who inspired my career change

In September 2003 at Royal Prince Alfred Hospital, I gave birth to my second baby following a far from great experience with my first birth.

My midwife, Georgia, was amazing. She advocated for my wishes and guided me through birthing a 4.5-kilogram newborn.

Georgia did this with amazing skill, despite the complexity of my son getting somewhat stuck.

The experience I had that day made me think being a midwife would be an amazing career path. But I was at the start of a very different career in law and policy, and now had two young children. There was something about midwifery that I couldn’t quite shake; something I kept returning to.

I did my RN training part-time once my kids were in high school and over the last year, I have now finished my graduate diploma.

Recently, I also became a registered midwife. I finally feel like I am in a career that I love and feel passionate about, despite the big pay cut. I just wanted to say thank you to Georgia, who worked at RPAH 20 years ago. Wherever you are – thank you.

Thank you for being the kind of midwife I want to be. Thank you for inspiring me to make this career change, even if it did take me 20 years to get here.

Dominika Rajewski, RN and RM

Respect us, before it’s too late

I am a registered nurse, midwife, and clinical midwifery specialist, working in public health in regional NSW. As a midwife nearing the end of her career, I couldn’t bear to watch on in abject horror at the state of the workforce I leave behind.

As a profession, we have been battling for safe nurse-topatient ratios and a wage that respects and acknowledges the vital work we do as a profession.

When will the premier and health minister act? Will it be when our young nurses and midwives take themselves, their HECS debts and their families, to other states that respect their worth? That will pay them a wage that covers their mortgages, and which allows them to rent without fear of homelessness? To states that have safe nurse-to-patient ratios?

Featured Letter

Can the premier and health minister honestly tell me from the bottom of their hearts that after 45 years working in NSW Health, I don’t deserve safe nurse-to-patient ratios and a wage that values my 45 years of knowledge, experience and dedication?

At 64 years of age, and after 45 years of nursing and 40 years of midwifery, I am exhausted. This week alone I have already worked two shifts in a row, when I was unable to even go to the toilet, let alone have a meal break or a drink. This is not abnormal – this is ‘our normal’, week in, week out, understaffed and overworked with overtime.

As a profession, we are paid much less than those who have the luxury of working a regular 9–5 job. Those who get to go home, turn off the lights, sleep and enjoy their weekend.

There are many days where I sit in my car in the hospital car park and negotiate with myself, through tears, trying to convince myself that I can push on and do just one more shift for my patients.

But I will be honest: it is becoming harder and harder to keep convincing myself. I challenge the premier and health minister to take a walk in my shoes, on my whole 18-hour shift.

I ask the government to not miss this opportunity. Show us the NSW Minns Labor government respects us, before it’s too late and we all turn off the lights and go home for the weekend too.

Jennifer Greed, RN and RM

Volunteering on a Log of Claims Committee

Earlier this year, all public health delegates were approached for nominations on the Log of Claims Committee (or LoCC for short).

For those unfamiliar with the process, there are six positions available on the LoCC to develop our ‘Public Health System Award’ claim. The claim is endorsed by public sector members and is served on the Ministry of Health,

If there’s something on your mind, send us a letter and have your say. You could WIN scrubs to the value of

as our list of demands for changes to nurses and midwives’ wages and working conditions. The claim forms the basis on which the NSWNMA and NSW government negotiate.

This year the claim was complex, and we met twice to sift through the many claims passed at Committee of Delegates (COD) over the last 12 months by elected delegates.

The passing of motions brought by public sector branches through COD helps inform what we hope to achieve in the Draft Log of Claims, which is put to members to vote on. We had robust discussions on every motion and spoke through the merits and winnable nature of each. It was very democratic. To assist us, we had an industrial officer and two councillors, and we sat down with economic and workplace adviser Professor John Buchanan. He presented us with evidence and a breakdown of previous pay claims won by NSW public sector employees. It was very insightful and informative.

Discussion around our 2024 wage component took a large portion of time within the LoCC. Various numbers were considered, informed by the research presented to us, and we landed on the present claim of 15 per cent – with no concessions. There were other motions regarding our pay claim, but they were over multiple years, and we settled on a non-negotiable figure and a one-year deal. We didn’t want it to be over two years due to the state government being in election mode in the lead up to the next state election.

I am very proud to represent our nurses and midwives, and it’s an honour to sit on the LoCC as a rural RN. Every branch has a democratic right to lodge and present a motion at COD, which is then put to delegates to endorse, or not. I encourage every branch to become involved.

Mark Brennan, RN

Advertise in The Lamp and reach more than 75,000 nurses and midwives.

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

Opal, give a little, and gain so much more

I became an enterprise bargaining representative quite accidentally. But it was a happy accident. After sending through some information to our NSWNMA organiser, I got invited to be part of a leaders group and I learned more about the process behind our bargaining meetings with Opal. I wanted to put my hand up and be part of the bargaining team, as I felt it was important to represent not only my colleagues in negotiating our enterprise agreement (EA), but also fight to ensure provisions are in the EA to ensure residents are safely cared for.

My experience of being a part of the enterprise bargaining team has really opened my eyes to how a big business reacts to its employees. It has been a very trying time, speaking from the heart about our experiences at work and discussing the challenges we and our colleagues are facing, only to be shut down and dismissed.

Staff at Opal have just voted ‘No’ to a proposed agreement because it didn’t offer a fair pay increase, or any staffing or sick leave improvements. Before the ‘No’ vote, 1700 workers signed a petition calling on Opal to improve its offer, and requested to meet with the CEO. She declined to meet with the bargaining representatives and instead they went to a vote. Now we are talking with members about what action we will take to bring Opal back to the bargaining table, so we can continue negotiations and come to an agreement. If only Opal was willing to give a little, it would gain so much more in return. It would be a company with an amazing reputation, with skilled and experienced employees. But most importantly, our residents could be adequately staffed and cared for.

Kristy Brennan, AIN

Ratios rollout gets underway

Our decade-long campaign to ease workloads and make public hospitals safer takes a big step forward.

Shift by shift ratios are being rolled out in the emergency departments (EDs) of two Sydney hospitals – the first in the state to benefit from the union’s safe staffing ratios campaign.

About 70 additional full-time equivalent (FTE) nurses are being recruited for the EDs of Royal North Shore and Liverpool hospitals to meet a minimum ratio of 1:1 in resuscitation bays, and 1:3 in ED “generally occupied treatment spaces”.

This is the start of a phased rollout in five clinical areas of the public hospital system, agreed between the state government and the NSWNMA. Between now and July 2027, ratios will extend to other EDs, and then intensive care units (ICUs), adult in-patient wards, maternity services and multiple-purpose service sites.

The rollout is being overseen by the Safe Staffing Levels Taskforce, made up of state health officials and the NSWNMA.

NSWNMA General Secretary Shaye Candish said the union has been working with the government on the implementation of ratios as part of the Taskforce since May 2023.

“This has been a lengthy process, but we are starting to see this hardfought campaign come to fruition,” she said.

“After more than a decade of fighting to have our voices heard, this is a key moment in our efforts to ensure patient safety is given the priority it deserves.

“It is also a step in the right direction to help rebuild the workforce and retain nurses and midwives in the public health system.

‘After more than a decade of fighting to have our voices heard, this is a key moment in our efforts to ensure patient safety is given the priority it deserves.’

— NSWNMA General Secretary, Shaye Candish

“We look forward to seeing ratios expand into other EDs, and then ICUs, adult in-patient wards, maternity services and multiplepurpose service sites.

“The government has committed 2480 FTE nurses and midwives to help deliver this, but we know more must be done.

“Your union is fighting for more funding from the government, to ensure these five clinical areas receive ratios.

“We know current funding won’t cover all wards and units in every hospital, and the government must do more to ensure this, because our public health system cannot afford to be shortchanged on this vital reform.” n

SIMON QUINN - BRANCH PRESIDENT, MILA CALDERON - BRANCH DELEGATE, MIRABEL NELSON - BRANCH SECRETARY AND DEBORAH CHANT - BRANCH VICE PRESIDENT

A milestone union achievement

The introduction of ratios at Liverpool Hospital Emergency Department will particularly benefit acute area night shifts and resuscitation bays.

The introduction of ratios is an important union achievement that will make a “significant difference” to patients and staff, says Liverpool Hospital ED nurse Simon Quinn.

Simon is an NSWNMA delegate and president of the union’s Liverpool Hospital branch.

Shift by shift ratios of 1:1 in resuscitation bays, and 1:3 in acute areas, are about to be introduced at Royal North Shore and Liverpool EDs.

At Liverpool, current ratios in acute areas of the ED are 1:3 on morning and afternoon shifts, and 1:4 on night shifts. In resus, the current ratio is 4:5.

Once ratios are in place, acute area staffing will increase to 1:3 on nights and 5:5 in resus on all shifts.

“Night shifts can be just as hectic as day shifts, and having extra nurses at night will make an enormous difference,” Simon said.

“People don’t wait until morning to have a heart attack or a stroke, and the extra staff at night will make our workload more manageable.

“Ratios will make a significant difference in resus where, with the current ratio of 4:5, it can sometimes be challenging to manage the workload when two or more patients arrive back-to-back.”

Simon said, “As a Level 6 ED, we receive the most critically unwell patients, and there are times when we have to temporarily pull people from other areas of the ED in order to manage the workload. A 1:1 ratio in resus will go a long way to addressing this.

‘Ratios are a win for patients, a win for nurses, and a win for the health system.’

— Simon Quinn, Liverpool Hospital NSWNMA branch president

“With our current resus capacity, we sometimes have to step a patient down into the acute area before we’d ideally want to, in order to accommodate another patient coming in.

“However, it is anticipated that the number of resus beds will increase at Liverpool when our new department opens in October. This, along with the incoming 1:1 ratio, will make us much better equipped to serve our most critically unwell patients.”

AN EXCITING TIME

Simon added that ratios will benefit patients, staff and the entire health system.

“Ratios are a win for patients, a win for nurses, and a win for the health system. They will make our hospitals safer and strengthen our ability to deliver timely, person-centred and holistic care.

“Ratios will benefit nurses by reducing our workload; this will go some way to addressing the high levels of stress and burnout that our profession has grappled with for decades, and in turn this will aid in staff retention.

“Finally,” he said, “ratios will be a net benefit for the health system as a whole.

“More staff will obviously cost the system more money, but I expect some of that will be recouped as a result of their introduction.

“For example, more staff will allow us to deliver more timely care, and I expect there will be a decrease in the number of adverse outcomes related to treatment delays, which can result in prolonged and costly hospital stays.”

Simon said every area of Liverpool Hospital needs ratios.

“My colleagues in every area of the hospital are in need of ratios just as much as we are in ED.

“The recruitment of new staff is already underway, and this is an exciting time for us and the system as a whole.

“We haven’t been given an exact timeline for the introduction of ratios into other areas of the hospital yet, but I’m hopeful announcements in relation to this will be made soon.” n

Closer

More hands on deck

monitoring of high-risk patients is one of many benefits expected to flow from the introduction of ratios in EDs.

"Ratios will give us more hands on deck, which will take a lot of pressure off the nursing staff,” said Liverpool Hospital ED nurse Mila Calderon.

“Having more staff will benefit patient safety, with closer monitoring of high-risk patients, delirium patients etcetera,” she added.

Mila, who is an NSWNMA delegate for the hospital, said current staffing in acute areas is six patients between two RNs in the daytime and four patients to one RN at night.

“We see a lot more patients than the bed numbers, due to the rapid turnover of patients in ED,” she said.

“The current staffing levels can put huge pressure on nurses depending on how unwell the patients are.

“Sometimes, care is delayed or missed for a while because it gets so busy.

“It’s not often that we are able to pull a nurse from a different area to come and help.

“We rarely have a float nurse to give us a hand and when we do, they tend to float between triage and the resus area.”

Mila said, “The NUMs are not always able to stop what they’re doing and give us a hand.

“There are times when we can’t step out for a break during daytime, because it would mean leaving your partner on their own with six patients.

“We sometimes miss breaks at night, too. But since we’re 1:4 overnight, when a nurse goes on break, the neighbouring nurse has to overlook two lots of patients until the other RN comes back from their break.

“Sometimes we only get one break instead of the two we are supposed to have in the 8.5 hours we are on duty.

“You feel that you are drowning with so many things left to do.”

Mila said ED nurses know they would not be getting ratios without the NSWNMA.

“It is obvious to everyone that we finally got ratios thanks to the union.”

She said nurses have been talking about the introduction of ratios and are keen to see how they are going to work.

“Some people are very excited and positive about it, while others are doubting how it is going to work out in certain areas, such as the waiting area and sub-acute, where patients are being looked after by nurses but are not allocated a bed.” n

‘ It is obvious to everyone that we finally got ratios thanks to the union.’

— Liverpool Hospital RN Mila Calderon

Ratios needed to retain seniors and mentor juniors

President of the NSWNMA’s Royal North Shore Hospital Branch, Corrine Adams, joined General Secretary Shaye Candish and Health Minister Ryan Park at a media conference to announce recruitment for the ratios rollout had begun.

Corrine said safe staffing reforms would help attract and retain nurses and midwives well into the future.

“The staffing ratios won’t only be for our community and for patient safety, but also to help retain our staff and especially to support our novice staff members,” she said.

“We have to ensure we actually support our staff with our senior staff members and at this time, we can see that nursing staff are leaving in droves.

“We want to retain those senior staff members to support our novice staff members to ensure they have a rich career in nursing and midwifery.

Corrine added, “I’ve been a nurse for about 18 years and every year it is harder – especially when COVID-19 came around. To ensure solidarity and mateship within our crew, it is important that we have staff ratios."n

2024 PHS claim underlines need to invest in ratios

Stronger public investment in safe staffing ratios is an important part of the NSWNMA’s 2024 log of claims for a new public health system award.

The NSWNMA presented a document outlining the 2024 claims to the state government on 10 May.

The document welcomed the start of the ratios rollout and the government’s commitment to deliver 2480 full-time equivalent (FTE) positions in public hospitals.

However, more FTE positions will be needed to fully implement safe staffing ratios across the agreed five clinical areas, the document said.

Those five areas are:

• emergency departments

• intensive care units

• maternity (a review of Birthrate Plus and 1:3 in postnatal wards)

• multi-purpose services

• converting nursing-hour-perpatient-day wards and units to a shift-by-shift system.

The log of claims document said that under the current ratios rollout,

‘Our

position is that the government should fund this important workforce initiative within this term of government so that we are competitive nationally on workloads.’ — PHS log of claims

assistants in nursing or midwifery cannot be introduced into a staffing profile where they do not already exist, unless consultation with the NSWNMA occurs, and the number per shift that count towards the ratio is limited.

“Our claim for AINs to be supernumerary remains,” it said.

“Our position is that the government should fund this important workforce initiative within this term of government so that we are competitive nationally on workloads.

“All wards, units, and departments must be staffed with nurses and midwives who have the relevant skills and knowledge for that clinical setting, and with staff supported by CNEs/CMEs to develop their skills for the clinical setting.

“In line with a Memorandum of Understanding signed in 2023 between the NSWNMA and the Ministry of Health, we are seeking further funding to achieve full implementation of these historic reform measures.”

The document said the union’s Award claim will help to retain an experienced and skilled workforce in NSW and encourage the retention of early career nurses and midwives.

“We need functioning and sustainable public hospitals in NSW. A well-remunerated and well-resourced nursing and midwifery workforce is critical to achieving this.” n

Minister says Taskforce will review initial rollout

Health Minister Ryan Park said the joint government–union Safe Staffing Levels Taskforce will review the initial ratios rollout at Liverpool and Royal North Shore EDs “and use these experiences to help inform the rollout at future sites.”

Both hospitals are under critical pressure to serve their growing communities, Mr Park told parliament.

“Phase one (of the rollout) starts in Level 5 and Level 6 EDs, which treat

the most critically ill patients, and will then be progressively implemented across other hospitals and departments,” he said.

“Over the course of the next three years, the single biggest reform to the way in which we staff our hospitals will see around 2480 additional nurses pumped into a system that so desperately needs them.” n

15% pay claim an investment in nurses and midwives

The NSWNMA is campaigning for a 15 per cent pay rise, more funding for nurse-to-patient ratios and better working conditions in 2024.

The NSWNMA is calling on the state government to invest in nurses and midwives, to rebuild the public health workforce after years of wage suppression under previous governments.

A one-year 15 per cent increase from 1 July 2024 is a key part of the union’s 2024 log of claims for the Public Health System Nurses’ and Midwives’ (state) Award, which expires on 30 June.

The NSWNMA’s 15 per cent claim is “ambitious but reasonable” said NSWNMA Assistant General Secretary Michael Whaites.

It is a claim that members are prepared to “really fight for”, he said.

Michael said unity, commitment and a disciplined campaign “will put us in the best possible position to achieve our claims”.

“This is a claim that calls for the government to invest in nurses and midwives and invest in ratios.

“This is a claim that is aimed at assisting the government to recruit and retain the workforce we need to implement ratios.”

Nurses and most other public sector workers received a one-year 4 per cent pay increase in 2023, after the government lifted the previous Coalition government’s 2.5 per cent annual wage cap introduced in 2011.

The 2024 log of claims was strongly endorsed by a vote of NSWNMA branches following months of consultation, more than 30 branch resolutions, and intense discussion and decision making by the Log of Claims Committee.

OFFER ON TABLE IS NOT ENOUGH

Michael said the committee decided on 15 per cent after hearing from industrial relations expert Professor John Buchanan, and after looking at inflation compared to public sector pay rises since the wages cap was introduced in 2011.

“We also looked at productivity across the general economy for the same period. The committee felt, given the data, that 15 per cent is a claim that can be justified in the Industrial Relations Commission.

“Fifteen per cent would also make public sector pay competitive with Queensland, and return NSW nurses to being among the top paid in Australia.

“We must ensure nurses and midwives are compensated at a level that is competitive with other states.”

Michael said the pay claim takes into account a decade of wage suppression by previous governments, “and we’ll be sure to remind them of this every step of the way”.

“Nurses and midwives’ wages in NSW have been eroded over time.

“This is a necessary pay rise that addresses inflation and considers the productivity gains we’ve missed out on. It will lead to less overtime, reduced staff turnover, and ensure rosters are filled.

“This will attract more people into the professions, as well as retain our experienced and skilled nurses and midwives, so we don’t continue to lose them across the border or see them leave the industry early.”

During a media interview, Michael said nurses and midwives “need a much higher pay rise than is currently on the table”.

‘We must ensure nurses and midwives are compensated at a level that is competitive with other states.’

— Assistant General Secretary Michael Whaites

He was referring to the NSW Government’s offer of a 10.5 per cent pay rise over three years – and a $1,000 top-up if inflation exceeds 4.5 per cent – to all public sector workers. That would include nurses and other healthcare employees, cleaners, firefighters, police and prison officers.

The NSWNMA log of claims also seeks further funding for nurse-to-patient ratios to be rolled out in every ward and unit in every public hospital, across the five agreed clinical areas of emergency departments, intensive care units, medical/surgical and mental health wards, maternity, and multi-purpose services. n

Claims snapshot

The NSWNMA’s 2024 pay and conditions claim at a glance:

• A 15 per cent pay increase, plus superannuation, from 1 July 2024

• 30 per cent night-duty shift penalty

• 100 per cent salary packaging

• 20 days per year sick leave

• Improvements to Continuing Education Allowance for CNE/CMEs

• Meal allowance for Patient Transport Service

• Increase to car allowance and loading for Midwifery Group Practice

• All rostered days off to be consecutive, unless otherwise agreed

• No night duty before starting a day of annual leave, unless otherwise agreed

• Published rosters not to be changed without prior consultation with the affected staff member

• Access to paid union meetings and other improvements to existing provisions regarding union activities.n

15% needed to help close gender pay gap

A 15 per cent pay increase is justified and necessary in the current economic climate.

The NSWNMA combed through strong economic evidence from industrial relations and economics experts to reach a pay claim that is reasonable and achievable, said NSWNMA General Secretary Shaye Candish.

“The rate of pay for this female-dominated workforce is failing to keep pace with male-dominated professions,” she said.

“If we’re serious about closing the gender pay gap, if we’re serious about providing women with economic security, then raising the pay of nurses and midwives will go a long way to achieving those aims.

“Nurses and midwives are feeling the cost-of-living pinch.

“They’re struggling to find affordable and secure housing in reasonable proximity to their workplaces, and they’re being slugged parking fees at many public hospitals.

“Our community recognises the professionalism and incredible worth of nurses and midwives.

“It is time their pay reflects and respects their contribution to people’s lives and the economy.”

At a press conference alongside Health Minister Ryan Park to announce recruitment had commenced for the introduction of ratios, NSWNMA General Secretary Shaye Candish said the union would work constructively with the government, but was serious about boosting pay to match that of nurses in other states.

“We certainly will not rule out any action – our members are incredibly serious,” she said. n

‘Our community recognises the professionalism and incredible worth of nurses and midwives. It is time their pay reflects and respects their contribution to people’s lives and the economy.’

— General Secretary Shaye Candish

Push to end placement poverty

Despite a high student dropout rate, aspiring nurses and midwives are being punished by unpaid clinical placements.

The NSWNMA is campaigning for nursing and midwifery students to be paid when they do compulsory clinical placements.

A NSWNMA petition asking the federal government to commit to paid placements had gained almost 8000 signatures by late April (https://actionnetwork.org/petitions/ its-time-to-end-placement-poverty).

The petition notes that nursing and midwifery students must complete more than 800 hours of unpaid placement in hospitals, aged care facilities and community health facilities.

During placement, “students are not only working unpaid, but are also required to fund their own travel and accommodation, as well as loss of wages from their regular job,” the petition said.

“These unpaid placements make it really challenging to juggle jobs, cover their everyday expenses like rent, food, or transport, and keep up to date with their studies, all whilst fitting in large blocks of unpaid placement (sometimes up to 8 weeks long). This is known as ‘placement poverty’.”

It adds that unpaid placements are especially tough for students

in regional and rural areas, who are often given placements a long way from home; international students; and students from “marginalised communities”.

“Mature-aged students and those with family or caring responsibilities are disproportionately affected, as they often have to go without work during the period of their placements.”

‘I’m not allowed to work in my AiN role during

placements due to worries about work fatigue.’

– Nursing student Issy Baccarini

ANNUAL CONFERENCE CALLS FOR PAID PLACEMENTS

The union’s 2023 Annual Conference called for financial support to students undertaking clinical placements.

“Remuneration must include compensation commensurate to paid employment and provide additional funding for accommodation and parking,” said a position statement adopted by Conference.

NSWNMA General Secretary, Shaye Candish, said ending placement poverty is essential to encourage more students to enter nursing and midwifery.

ANGELIQUE DUMAS, VICTORIA ROBINSON, SHAYE CANDISH AND FEDERAL EDUCATION MINISTER JASON CLARE

Paid placements

“strikes me as a good idea”

–

Federal Education Minister Jason Clare

She said a report by the Australian Universities Accord recommended the federal government work with higher education providers and employers to introduce payment for unpaid placements, including government financial support for placements in nursing, care and teaching.

Shaye said federal education minister, Jason Clare, had spoken approvingly about paid placements and it was time for his government to act.

In an ABC Radio interview in February, Mr Clare said paid placements “strikes me as a good idea”.

He added: “I’ve spoken to lots of teaching students, lots of nursing students about what is effectively placement poverty, a big part of your degree for a teaching student; it’s 600 hours and for a nursing student it’s 800 hours. For a social work student it’s even more – it’s about a thousand hours.

“It can mean you have to move to do the prac. It can mean you have to quit the paid part-time job to do the unpaid prac, and it can lead to people sometimes not finishing the degree.” n

Work ban adds to placement stress

Like most nursing students, Issy Baccarini must also work to pay the bills.

Issy is a babysitter, dog minder and casual AiN at Newcastle’s John Hunter Hospital, where she is doing her third-year clinical placements.

As a full-time student, she finds it hard to earn enough to make ends meet – to cover rent, utilities, groceries, petrol and other basics.

“Once the bills are paid there’s not much left over. The financial strain is quite stressful,” she said.

The weeks leading up to unpaid placements are particularly worrying because Issy must find extra work to earn income that she is not permitted to earn during placement time.

“I’m not allowed to work in my AiN role during placements due to worries about work fatigue. Therefore, I have to rely on savings and Centrelink to get by,” she said.

Issy will do this year’s placements in two blocks of four weeks and six weeks.

“Third year is the longest placement load and also the heaviest because I’m following the shift patterns of another nurse, which includes night shifts.

“I am currently in an acute surgical ward, where they are very understanding and flexible. They originally had me down for four night-shifts in a row this week, but they recognised that was too much considering I wasn’t being paid. So, they switched me to just one night shift this week and I have to make up an extra four hours.

‘Getting paid during placements would make a big difference to my financial situation and sense of security.’

– Nursing student Issy Baccarini

Issy believes paid placements would go a long way towards reducing the high dropout rate among nursing students and help some part-time students to switch to full-time study.

“One of my best friends, who is also doing placements, is in her forties. She has to work to support herself and her two young kids, whom she looks after most of the time.

“I am a ‘standard pathway student’; a single 24-year-old with no kids and I don’t have family or carer responsibilities.

NSWNMA Position Statement on Financial and Time Burden Faced by Nursing and Midwifery Students https://www.nswnma. asn.au/publications/ policies-and-procedures/

“Following a full-time roster and trying to recover from night shift plus full-time study is stressful enough, without worrying about not being able to cover the bills.

“Getting paid during placements would make a big difference to my financial situation and sense of security.”

“I’m very lucky to be eligible for Centrelink as many others find it difficult to jump through the hoops to get that.

“When I’m talking with other students in the same position as me, we often say, at least we don’t have children on top of all this study load and workload.”n

Money worries tarnish placement experience

Unpaid placements bring financial stress and anxiety.

Getting financial support during clinical placements

“would make the world of difference” to third-year student nurse Victoria Robinson.

“It takes a lot of mental energy to prepare for placements, partly because I have to build up enough savings to cover the periods we are not permitted to earn any income,” said Victoria, 21, who is studying at University of Technology, Sydney.

“It would help a lot if I knew I was going to be financially viable during placements.”

She has no carer responsibilities “but I don’t live with my family, so I’ve got to meet rent every week plus utilities and groceries – and the cost of everything keeps going up.”

She works as an AiN but is required to take a minimum 10-hour break between the end of any work shift and the start of a placement shift.

That rules out paid work during placements, which for Victoria this year will add up to around 500 hours (including placement time carried over from 2023).

“Placement is not only a financial stressor, it is also a very big mental stress,” she said.

“Nurses have to take on a lot of responsibility and a big emotional load. If you’re employed as an RN or AiN and have a really bad day at work, you can somehow justify it by

‘If you let anxiety about your financial circumstances weigh you down too much, it starts impacting on your placement experience.’

– Nursing student Victoria Robinson

telling yourself you can at least pay for this week’s groceries.

“You can’t do that with unpaid placements.

“If you let anxiety about your financial circumstances weigh you down too much, it starts impacting on your placement experience.

“I’ve heard of people doing night shift to fund themselves, and then passing out from exhaustion during placement the next day.

“If that happened you could fail your placement, or it might be cancelled. The hours that you completed would not count and you would have to do another placement to make up for it.

“You could potentially fail a subject as a result.”

Victoria did not realise the full extent of costs involved in getting a nursing degree before starting her studies.

“In first year, I had to pay for textbooks, student services and amenities fees, nursing shoes, and equipment such as a stethoscope and fob watch – and then I had to fund myself during placements and pay for petrol to get to them.

“I knew placement would be tough, but I didn’t realise how tough until I got into it. The dropout rate during and soon after the very first placement of three weeks was enormous.”

Victoria said nursing students in regional and rural areas are particularly hard hit by costs associated with placements.

She did her first year at Charles Sturt University in Port Macquarie, where most placements were more than 90 minutes drive from home.

“I knew a student in Port Macquarie who was given a placement in Dubbo, about 600 kilometres from home.” n

Poverty by numbers

• Seventy per cent of all full-time tertiary students were employed as of February this year (an increase from 55 per cent at the same time in 2016).

• About one third of students said they lost their entire weekly income because of a placement, according to a 2022 survey.

• Eighty per cent of students reported their mental health had been negatively affected because of the financial hardship associated with their placement.

• Only 66 per cent of nursing and midwifery students finish their degrees, with a 10.4 per cent dropout rate in the first year.

• Sixty-five per cent of nursing students were unable to work during clinical placements and one third incurred a financial liability from their placements.

• Seventy-nine per cent of nursing students reported financial hardship, and financial hardship affected 62 per cent of students’ health and wellbeing.

• Median weekly rent for apartments across the capital cities has climbed to $620, and as high as $700 in Sydney.

• The median savings of Australians aged 18–24 is less than $3000.

Sources:

“Unpaid internships are one thing, but paying to work? That’s absurd,” Sydney Morning Herald, 16 April 2024.

“Position Statement on Financial and Time Burden Faced by Nursing and Midwifery Students,” NSWNMA Annual Conference 2023. n

STOP PRESS

Paid placements from next year

Lobbying by the NSWNMA and others has persuaded the federal Labor government to give financial support to nursing, midwifery and other tertiary students during mandatory workplace placements.

After meeting an NSWNMA delegation, including student nurses, education minister Jason Clare announced the government would establish a “Commonwealth Prac Payment” for Australians studying to be a nurse, midwife, teacher or social worker.

Mr Clare said the new payment of $319.50 per week during clinical and professional placement periods would be paid from 1 July 2025, in addition to any income support a student may also receive.

The Prac Payment would be “benchmarked” to the single Austudy per-week rate and be paid to about 73,000 university and TAFE students each year.

“Placement poverty is a real thing,” Mr Clare told ABC Radio, citing a conversation he had with a nursing student in Sydney the previous week.

The Prac Payment will be means tested and Mr Clare said he would work with unions and universities to define the means-testing model “to make sure that we’re giving this to the people who need it the most”.n

VICTORIA ROBINSON, ANGELIQUE DUMAS AND SHAYE CANDISH

Voluntary assisted dying –what it means for nurses

Voluntary assisted dying (VAD) became available in NSW in November 2023, following an 18-month implementation period. The Lamp looks at the introduction of VAD at Nepean Hospital in Western Sydney.

Elizabeth McKervey is the VAD clinical nurse consultant for Nepean Blue Mountains LHD based at Nepean Hospital. She coordinates the LHD’s VAD team, provides clinical education, and supports patients, their families and ward staff.

The Nepean Blue Mountains LHD VAD team includes an admin assistant and several doctors in parttime roles.

Patients in the Nepean Blue Mountains LHD who request VAD support are referred to the VAD service.

Elizabeth has 35 years of nursing experience, including many years in cancer care. As the clinical nurse consultant, she assists with coordinating the patient’s pathway to accessing VAD.

She talks with the patient to make an initial assessment of whether they are eligible for VAD, and assigns a coordinating practitioner to do a clinical assessment.

This is followed by a series of mandatory steps before the coordinating practitioner can apply to the independent Voluntary Assisted Dying Board for a medication authorisation.

NURSE EDUCATION

Elizabeth educates nurses on the legal and clinical aspects of VAD – complementing the online

‘A nurse can have as little or as much involvement in the voluntary assisted dying process as they feel comfortable with.’

— Elizabeth McKervey, VAD team coordinator

education available via NSW Health’s My Health Learning page (course code: 501951057).

“My role is to provide continuous support for nurses and staff on the ward, whether it be education or prebriefing and debriefing,” she said.

“That applies to all nurses, whether they have a specified role in VAD, or they are a ward nurse caring for a patient who has made a request.”

She pointed out that nurses are allowed to have a conscientious objection to VAD.

“This means a nurse can have as little or as much involvement in the VAD process as they feel comfortable with.

“Any nurse can legally provide information to a patient who asks about VAD.

“It could be the phone number for the VAD service in their LHD, or 1300 802 133 for NSW Health’s VAD Care Navigator Service.

“Nurses can talk to the patient about the process and support them and their family as they go through the process.

“If the nurse has been caring for a patient for a period of time, the nurse might feel comfortable supporting a family right through to post-death care, as they might after the death of any patient.”

Elizabeth said the presence of a dedicated VAD team has been a source of comfort for patients and families.

“In my role, I aim to spend as much time with patients and their families as they need,” she said.

“There is a lot of gratitude from both patients and families. They say the presence of the team in Nepean Blue Mountains LHD has made them feel supported to pursue the option of VAD.” n

Kindness, compassion and respect

Careful preparation has been vital to the success of voluntary assisted dying (VAD).

Helen McCarthy, Director of Nursing and Midwifery at Nepean Blue Mountains LHD, said VAD had been received “very positively” by patients and families.

“We’ve had really good feedback so far. Families have been very appreciative; they have found the process to be dignified and respectful,” she said.

“VAD can be quite an emotive topic and careful preparation has been key.”

Nepean Hospital undertakes preparation a week before a VAD patient is admitted to a ward to begin the process.

“During the week, managers have the opportunity to look at the roster, speak to nurses and identify those who will care for the patient during the VAD process,” Helen said.

“Any nurse who elects to be a conscientious objector is fully supported in that decision.

“Some nurses may not feel comfortable from an education perspective, so having the time for preparation gives us an opportunity to provide support. We may buddy them with another nurse who has provided this care before.

“The preparation period allows time for staff to be given information about the patient and to ask questions. This ensures that when the patient comes through, they and their family or loved ones know they are welcome and are in good hands.

“We aim to make the process as peaceful and dignified as possible within a clinical hospital setting.

“Some family members and patients might want to be together, and other families might want to leave messages in the room.

“Many patients want to wear their own clothes, and we’ve had family members bring in balloons.

“Some of our wards have beautiful views of the mountains, so we turn their beds to give patients that view.

“We care for these patients with kindness, compassion and respect.

We can help make their life pass in a dignified and beautiful way, with their family and loved ones present and with acknowledgement from their family. I think that’s a very positive process for nursing to be part of.”

Helen said having a dedicated VAD team was vital to the successful introduction of VAD.

“Our staff really benefit from having a nursing coordinator who is able to provide support and advice from a nursing perspective,” she said.

“It gives our NUMs an extra layer of information and support that they are then able to pass on to the nursing teams who will be present during VAD.

“The combination of care between medical and nursing staff has been very positive and it helps to ensure a positive outcome for families as well.” n

‘We can help make their life pass in a dignified and beautiful way, with their family and loved ones present and with acknowledgement from their family. I think that’s a very positive process for nursing to be part of.’

— DONM Helen McCarthy

Public campaign aided law reform

The NSWNMA was part of a grassroots campaign that finally achieved the introduction of voluntary assisted dying (VAD) in New South Wales.

NSW was the last Australian state to legislate for VAD, in May 2022.

Parliament had been considering VAD laws for 20 years before finally adopting it.

This time the legislation had a record 28 co-sponsors from across the political divide, and MPs from all parties worked together to get it passed with a two-thirds majority. Crucially, the legislation was backed by a strong grassroots campaign headed by Dying with Dignity NSW and Go Gentle Australia.

The independent MP who drove the legislation, Alex Greenwich, told The Lamp that the legislation had “really great support” from healthcare workers and their unions, including the NSWNMA.

Mr Greenwich said it was important for MPs proposing difficult legislation such as the VAD bill to “focus on building coalitions of support that really bring people together”.

Politicians needed to be patient with opposing views and any undecided colleagues, he added.

‘Many people shared their personal stories of either their own terminal illness or the terminal illness of friends or loved ones, and the horrible deaths that people had experienced.’

— Alex Greenwich, independent MP

“I think the NSW Parliament was ready to embrace VAD, because my colleagues had seen the impact and difference it had made in other jurisdictions in Australia.

“We were able to closely watch the legislative debates in all the other states and make sure ours had the right balance of safeguards and pathways to access VAD.

“My colleagues were able to talk to medical practitioners who had dealt with VAD in Victoria, which meant they were able to really understand how it was already operating.

He said, “Also, so many people shared their personal stories of either their own terminal illness or the

NSWNMA Conference backed VAD – with conscientious objection

The NSWNMA’s 2023 Annual Conference re-endorsed its support for voluntary assisted dying for people with a terminal or incurable illness. Conference added that “No individual, group or organisation shall be compelled against their will to either participate or not participate in an assisted or supported death of a person.”

The NSW Health website says healthcare workers who have a conscientious objection to VAD have the right to refuse to:

• participate in the request and assessment process

• prescribe, supply, or administer a VAD substance, and/ or

• be present at the time of the administration of a VAD substance n

terminal illness of friends or loved ones, and the horrible deaths that people had experienced.”

REFORM PASSED BY CONSCIENCE VOTE

While then premier Dominic Perrottet and Opposition leader Chris Minns both opposed the reform, they supported a conscience vote “which really opened the door to allow the reform to happen.”

Mr Greenwich said that since the passage of the legislation, NSW Health and its VAD Care Navigator Service had done “a really excellent job in making sure that the community, healthcare professionals and those with a terminal illness are educated on all the processes and steps relating to VAD.”

“VAD is something that is understandably and importantly heavily regulated.”

He said he had received “really touching correspondence from people who have sought to access the scheme and from the loved ones of people who have gone through all steps of VAD from application through to death.”

“I have been told that the scheme is accessible – obviously with the appropriate safeguards.” n

Voluntary assisted dying in NSW

There are 11 steps in the voluntary assisted dying process in NSW. You can pause or stop the process at any time.

STEP 1.

You make a first request for voluntary assisted dying to a doctor

A coordinating doctor completes a first assessment

Another doctor does a consulting assessment

You complete a written declaration

You make a final request for voluntary assisted dying

Your coordinating doctor completes a final review

You decide how to take the medication, with support from your doctor

Your doctor applies for a medication authorisation. The Voluntary Assisted Dying Board grants approval

Your doctor prescribes the medication

You take or are given the medication if and when you choose

A death certificate is issued

The NSW Voluntary Assisted

Care

Service is a phone line to answer questions about voluntary assisted dying. The Service will support everyone including patients and families. Call 1300 802 133 Monday to Friday 8:30am to 4:30pm.

Nurses win joint environmental award

NSWNMA members were recognised at the NSW Environment Awards for their campaign contribution to stop a major gas project that threatens to contaminate the Great Artesian Basin.

The Santos Narrabri Gas Project would see 850 gas wells constructed on 95,000 hectares of farmland and state forest in the Pilliga Forest in northern NSW.

“The Gomeroi [the traditional owners] have been fighting gas projects and Santos for over a decade now, and their voice wasn’t being respected by Santos or by state and federal governments,” says Damien Davis Frank, an RN at St Vincent’s Hospital in Sydney.

“Australia hasn’t learned from its past of colonisation and destruction of Aboriginal land and Aboriginal voices.”

Damien is part of a group of nurses who have travelled to the Pilliga to form an alliance with Gomeroi leaders, environmental groups, other unions such as the Maritime Union of Australia, and the Country Women’s Association, to stop the project going ahead.

The ‘Standing With Gomeroi’ campaign, co-ordinated by Unions NSW, won the Jack Mundey Award at this year’s Environment Awards, hosted by the Nature Conservation Council of NSW.

‘Climate issues are health issues.’

— Damien Davis Frank, RN

Members of the campaign include another nurse and NSWNMA member Matthew Shields, a Gomeroi man and a registered nurse and midwife.

Damien says his motivation to join the campaign was because of the “stark environmental damage” that will result if the project goes ahead. “Not just on Gomeroi land, but all over Australia”, by tainting the Great Artesian Basin, an aquifer that services communities all over the country.

“And all of us will suffer from the incredible emissions that this project is going to create. Climate issues are health issues, and I think it is one of the biggest health challenges we are going to be facing in the coming 20–30 years,” said Damien, who also works as an Aboriginal chronic care coordinator.

The Jack Mundey Award

AN IMPORTANT SITE OF BIODIVERSITY

Covering half a million hectares of temperate eucalypt woodland, the Pilliga Forest is the largest native forest west of the Great Dividing Range. One of the most important sites of biodiversity in eastern Australia, it is home to threatened birds, including the glossy black cockatoo, grey-crowned babbler, and mammals such as koalas, the squirrel glider and black-striped wallaby. Earlier this year the campaign against Santos’s gas project won a small victory when the Federal Court ruled the National Native Title Tribunal erred in 2022 by not taking into the public interest the question of climate change when it gave the $3 billion project the go ahead. But the battle continues, Damien says, and the NSWNMA and other unions have resolved “to stand on the ground with the Gomeroi if a time comes where roads need to be blockaded to prevent this devastating mining project going ahead, if all other avenues fail.” n

The Jack Mundey Award is given to a person or group who has contributed the most to cooperation between the conservation movement and the trade union movement.

It is named in honour of the legendary Builders Labourers Federation (BLF) leader and environmentalist Jack Mundey, who spearheaded campaigns that saved countless heritage buildings, bushland and parks in Sydney from destruction in the 1970s.

Professional Perspectives

As an EN, what do I need to do to meet my requirements for recency of practice?

Recency of practice means that a nurse or midwife has maintained an adequate connection with, and recent practice in nursing and/or midwifery since, qualifying for or obtaining registration.

Should an individual be asked to demonstrate recency of practice as an enrolled nurse (EN), they will need to be able to demonstrate they meet the requirements of the Enrolled Nurse Standards for Practice, for the practice on which they are relying on for their recency.

The Enrolled Nurse Standards for Practice are the core practice standards that provide the framework for assessing EN practice. They communicate to the public the standards that can be expected from ENs and can be used in a number of ways, including:

• development of nursing curricula by education providers

• assessment of students and new graduates

• assessment of nurses educated overseas seeking to work in Australia and

• assessment of ENs returning to work after breaks in service.

To assist with understanding Nursing and Midwifery Board of Australia (NMBA) recency of practice for Enrolled Nurses, refer to the NMBA’s Recency of Practice and other regulatory documents that set the regulatory requirements for ENs:

• https://www. nursingmidwiferyboard.gov.au/ Codes-Guidelines-Statements/ Professional-standards/enrollednursestandards-for-practice.aspx

• https://www. nursingmidwiferyboard.gov.au/ Registration-Standards/Recencyof-practice.aspx

Each individual application is considered on its merits and circumstances by the NMBA.

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

Nurses and midwives are reminded that as professionals they have a responsibility to ensure they are safe and competent to practice. This is particularly important when nurses and midwives transition from nonclinical to clinical practice and/or change their scope of practice.

I am planning to retire but want to keep my registration open, in case my circumstances change or I wish to return to practice. What is the best option for me at registration renewal?

You can opt to renew a full registration, keeping in mind you can take a break from practice as long as you maintain your 20 hours of CPD and have achieved 450 hours of practice over the past five years. For example, if you achieved the 450 hours over the preceding two years prior to retirement, you could take a couple of years break and still be able to meet registration requirements regarding recency. Alternatively, you could opt to renew with a non-practising registration, but this will involve further steps if you choose to return to practice later.

More details can be found here: https://www. nursingmidwiferyboard.gov.au/ Codes-Guidelines-Statements/FAQ/ Nonpractising-registration-fornurses-and-midwives.aspx

I have a mental health condition; however, it is stable and well managed by my clinicians and doctor. I have never practised while unwell and haven’t made a declaration to AHPRA that I have an impairment. My doctor recently gave me a letter to say I am safe to practise and has told me to submit this to AHPRA. Do I need to do this?

The National Law defines impairment as “a physical or mental impairment, disability, condition or disorder (including substance abuse or dependences) that detrimentally affects or is likely to detrimentally affect your capacity to practice the profession”.

An illness or health condition that is safely managed is not the same as an impairment, as the latter do not have detrimental impacts on your capacity to practice. There is no obligation for you to report your stable health condition to AHPRA. As your condition is safely managed by you, clinicians, and your doctor, it does not count as an impairment.

For further information on mandatory reporting, you can visit the AHPRA website: https://www.ahpra. gov.au/Notifications/ mandatorynotifications/Mandatorynotifications.aspx

A helpful article by the Black Dog Institute can be located on this link: https://www.blackdoginstitute. org.au/theessentialnetwork/faqs-for-ten/ faqs-for-mandatory-reporting/

I have been off work for a year – am I still able to renew my registration even if I haven’t been working?

Provided you have met recency-ofpractice requirements, which are 450 hours of practice within the past five years, you should still be able to register as normal.

Remember, even if you are not working you are still required to undertake 20 hours of CPD each year.

I have been on the non-practising register as a nurse for 11 years but I still work clinically as a midwife. Is there a time limit on the amount of time I can remain non-practising?

No, there is no time limit to being on the non-practising register provided you continue to pay the registration fee. Once on the non-practising register you are not required under the National Law to meet registration standards of recency of practice, CPD, or professional indemnity insurance. However, due to the amount of time spent non-practising, you will be unable to re-enter the workforce without further study.

Aged care members take campaign to Canberra

A delegation of 60 aged care nurses from across Australia visited Parliament House in Canberra recently to speak to politicians about the staffing crisis in the sector.

Members of the NSWNMA joined with nurses from Queensland, the ACT and Tasmania to meet with parliamentarians from across the political spectrum, to send a message that many aged care centres are not meeting mandatory staffing levels, and that nurses, carers and residents deserve better.

Australian Nursing and Midwifery Federation (ANMF) secretary, Annie Butler, said many providers were “cutting corners” and failing to comply with the mandatory care minutes and staffing requirements that came into effect last year (see box opposite).

‘It may be a workplace for us, but for (residents) it’s their home.’

— Stella Moktan Lama, RN

“Our members are reporting that many providers are failing to meet the mandatory staffing requirements and are instead rearranging rosters to appear compliant,” Annie said.

NSWNMA General Secretary, Shaye Candish, said nurses and carers needed to feel empowered to speak up about their workplace conditions. She added that nurses and carers should have the right “to monitor compliance and identify risks in real time, to ensure aged care facilities are meeting quality standards”.

EVERYTHING COMES DOWN TO STAFFING

One of the NSWNMA delegates to Canberra, Stella Moktan Lama, said she wanted politicians to understand that staffing levels are impacting the quality of care residents receive.

“Everything comes down to staffing. When we don’t have enough staff, we can’t give the residents the care they deserve,” said Stella, a registered nurse RN who works at a small regional facility of 40 beds.

“We are running between residents, rushing to do the shower. If patients all press their buzzers at the same time and we are taking care of someone else at that moment, we either have to leave the patient or pull staff from another wing, or not attend. It’s a mess.”

“If we had a proper ratio of staff and the residents, we could provide proper care.”

Stella said constantly running between residents makes it harder for staff to manage residents with challenging behaviours.

“Some residents will hit staff or abuse them verbally or emotionally. But I think if we had the time to build up a proper relationship with them, we could better predict and control those behaviours before they happened.

“At the moment, staff are physically exhausted, emotionally drained and mentally stressed. We are burnt out. Everyone is frustrated and feeling guilty that they can’t give their 100 per cent at work,” said Stella, who was part of a group that spoke with crossbencher Dai Le, the independent member for the Parramatta-based seat of Fowler.

Nurses who were part of the delegation to Canberra broke into small groups to meet with politicians

NSWNMA MEMBERS AND GENERAL SECRETARY SHAYE CANDISH MEET WITH MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER.

from across the political spectrum, including the Minister for Health and Aged Care, Mark Butler, and his colleague Anika Wells, the Minister for Aged Care.

They spoke about a staffing crisis that meant people are working on tasks beyond their level of training, and about what appears to be a reluctance among facility managers to hire more staff.

Stella said at her facility there are staff who would be happy to increase their hours, adding that management isn’t properly consulting with staff before setting rosters, to ask if they are available.

“When I get old, if I end up in an aged care home, I don’t want people to rush me to do the care and rush me to eat. I would like to have a real relationship with the people caring for me. It may be a workplace for us, but for them it’s their home.”

ADVOCATING FOR BETTER STANDARDS

Attending the delegation to Canberra was “empowering”, Stella said. “When I saw there were so many people like me, from all over Australia, I felt stronger and I was not scared to speak up.”

“I was a member of the union before, but I did not realise the unity and the power to meet the leaders of the country.”

Stella was particularly pleased to see other nurses from Nepal at the delegation, her home country. And with so many nurses from Nepal now

working in Australia, she is keen to build a network of Nepalese nurses within the union.

Shaye Candish said members in the Aged Care sector are the best advocates for improving standards in their own facilities.

“They see the flaws in the system and know what needs to change to enable them to provide the care that every resident should receive. We also need to see greater financial transparency from providers. The federal government should not be topping up their funds with taxpayer dollars, while they are failing to improve the quality of care for older Australians.”

On the day, several parliamentarians agreed to sign the union pledge asking them to support aged care nurses in their campaign for compliance in care hours and quality standards, and in their fight for fair pay and conditions. n

‘The federal government should not be topping up (providers) with taxpayer dollars, while they are failing to improve the quality of care for older Australians. ’

— NSWNMA General Secretary, Shaye Candish

Mandatory staffing in aged care

• Since 1 July 2023, aged care providers have been required to have an RN on duty 24/7.

• From 1 October 2023, providers were required to deliver 200 mandated minutes of care per resident every day, with at least 40 of those care minutes delivered by an RN.

• From 1 October 2024, the care minutes will increase to 215 care minutes per resident per day, including 44 minutes of direct RN care. Also from this date providers will be able to use up to 10 per cent of RN targets with care time provided by ENs. For example, for a service with an RN target of 44 minutes, 4.4 EN minutes may be counted.n

AGED CARE DELEGATION IN CANBERRA

Scan to Register

pd2024

closes Sunday 28 July

NSW Nurses & Midwives Professional Day

Wednesday 7 August 2024 ICC Sydney, Pyrmont Theatre

MC Sophie Scott OAM

Sophie is an award-winning broadcast journalist, international speaker and educator specialising in maximising human potential, mental health and mindset. She is an ambassador for Bowel Cancer Australia and Pain Australia

Dr Julia Baird*

The Human Quality of Grace

Julia is an award winning journalist, broadcaster and author. She hosted The Drum on ABCTV and has been a columnist for The Sydney Morning Herald, The Age and the New York Times. Julia is an acclaimed author, from the best-selling “Victoria: The Queen” to multiple award winning “Phosphorescence”. Her latest book “Bright Shining” is a beautiful and timely exploration of that most mysterious but necessary of human qualities: grace.

PANEL Understanding nursing and midwifery migration

SPEAKERS

Filomena B Talawadua

General Secretary of the Fiji Nursing Association (FNA)

Ethical impacts of sourcing labour from developing countries

Liz Ellis AO

How do you stay motivated when all you see in front of you are obstacles!

A much-respected voice in Australian sports media, Liz has forged a career as an advocate for women’s sport and a thought-provoking sport commentator. She was one of Australia’s most successful netballers and led the Australian Netball Team to a World Cup victory in 2007. Liz has served on various boards including the Australian Sports Commission, NSW Institute of Sport, Sydney Olympic Park Authority and Players Voice.

Prof Hannah Dahlen AM

Professor of Midwifery, Discipline Leader of Midwifery and Associate Dean, School of Nursing and Midwifery, Western Sydney University

The value of midwives and women centred care

Prof Rae Cooper AO

Professor of Gender, Work and Employment

Relations, University of Sydney Business School

Gender equity and the value of care work

Zenei Triunfo-Cortez

President of the California Nurses Association/National Nurse Organizing Committee

The role of unions in providing agency and leadership for Culturally and Linguistically Diverse workers

*Dr Julia Baird’ appears by arrangement with Claxton Speakers International

Dr Ali Drummond

RN/CEO of CATSINaM. His people are the Meriam and Erubam people of Zenadh Kes (Torres Straits), and the Wuthathi people of Cape York Peninsula

CATSINaM – Supporting Aboriginal and Torres Strait Islander nursing and midwifery advocacy and activism

Dr Catherine Gilbert

School of Architecture, Design and Planning, University of Sydney

Key worker housing: issues and challenges

Melissa Neighbour

Environmental town planner, community builder and sustainability specialist, Sky Planning Building better communities

Branch Beat

Collectivism in action

Branch Beat with NSWNMA Assistant General Secretary Michael Whaites

Over time, words like solidarity and collectivism have somewhat dropped out of mainstream public discourse, but in the union movement we are privileged to know these values are still alive and well.

Sticking together, working together, respecting each other, fighting for each other – these are the core ingredients of the teamwork needed to aspire for, and to achieve a better life for ourselves and our families.

In this month’s Branch Beat we see these values in action in a small, rural, private facility in Bathurst where registered nurses (RNs), recognising the worth and contribution of enrolled nurses (ENs) to the hospital, threw their weight behind them to get the fair pay increase they deserved.

Our members at Bathurst Private Hospital also recognised that their agreement gave them rights, which they exercised after questioning a decision of management that was going to cost them.

This led to a strong branch evolving, where members support each other personally and professionally, and which provides the sound base for achieving good industrial outcomes.

RNs go into bat for EN pay rise at Bathurst Private Hospital

In a show of solidarity with their colleagues, RNs nurses at Bathurst Private Hospital argued for endorsed ENs to be given an extra pay increase during their recent enterprise agreement negotiations.

Robyn Wormald, an RN at the hospital, told The Lamp that they wanted to see the ENs they work alongside receive more recognition for the work they do.

“As a small facility, there are only two nurses in our hospital, an RN and an EN, on weekends and on weeknights after theatre hours. The ENs are very experienced – they really run the place.”

Bathurst Private Hospital, with just two theatres and 16 overnight beds, relies on a small team of dedicated staff. Over time, endorsed ENs at the hospital have developed a deep base of skills.

“ENs can often end up doing the work of an RN, but for half the money,” said Robyn.

Jenny Hossle, an EN who has been with Bathurst Private for 11 years, told The Lamp she was happy with the way branch members worked together to negotiate the agreement.

“We have good relationships at the hospital. We are a tight-knit branch, and we all wanted the same thing: we wanted recognition for the work we do.

“I love being part of the union, and it is only in our favour to be involved. Our organiser, Heidi [McNamara], and industrial officer, Cameron

[Smith], have been fantastic. We couldn’t have done it without their support.”

The new enterprise agreement will see an initial pay rise of 4 per cent, backdated to November 2023, with an additional 4 per cent increase from July 2024.

ENs will get an extra pay rise on top of this increase, via an improved classification structure for advanced ENs. A new classification level will recognise an advanced EN above the highest EN classification level.

This new level is effectively a “loyalty recognition” for experienced ENs who have at least five years of continuous service at Bathurst Private.

ROBYN WORMALD, RN AND JENNY HOSSLE, EN

‘We are a tightknit branch, and we all wanted the same thing: we wanted recognition for the work we do.’

— Jenny Hossle, EN

IMPROVEMENTS TO CONDITIONS

Since the last agreement (EA) at Bathurst Private expired in 2020, staff have received only nominal administrative wage rises. And without a new agreement, there have been no opportunities for staff to update and negotiate improved conditions.

The new agreement will see staffing ratios improved, with ACORN staffing standards implemented in theatres and recovery.

The new EA also includes an increase in staff parental leave, with up to 15 weeks leave for a primary care giver, and up to five weeks leave for a supporting partner.

“Our wages are still a fair way behind the public system, as a lot of private hospitals are,” Robyn said. “But after our last agreement ended, we were just getting further and further behind.”

ACTIVE BRANCH DROVE BARGAINING

Branch members at the hospital first started to become more active in 2021, after management suddenly announced an extended Christmas closedown. If the closedown had gone ahead, staff would have had to take leave without pay, or they would have had to use up annual leave they might have been saving for another time of year.

When branch delegates raised the issue with the union, they were advised that the EA required the hospital to give staff sufficient notice of shutdowns. Management backed down when members questioned the decision – an important win that has given the Bathurst branch a renewed sense of purpose.

Since that time, the Bathurst Private branch has held regular meetings and with good attendance. Members

have worked hard to negotiate this new agreement, with delegates successfully securing support from a majority of members after circulating petitions for a log of claims and enterprise bargaining to commence.

“It can be hard for private hospitals to keep up with the public system wages, but we care about our patients,” Robyn said. “And if they are going to be looked after, we have to look after our staff as well.” n

ROBYN WORMALD, RN AND JENNY HOSSLE, EN

Ask Shaye

Changing

status and

employment

ADOs

in the PHS

I am changing from full time to part time in the public health system. Must I use my ADOs prior to changing my employment status?

Yes. The NSW Health Leave Matters Policy Directive PD2023_045 in paragraph 16.4 states that “employees must utilise ADOs prior to implementing changed employment arrangements e.g. changing from full time to part time or changing legal employers within the Health System”. If you change employment status to part time without using your ADOs, there is no Award or policy entitlement to then access these ADOs hours until they are paid out when you retire or resign (or return to fulltime status) at some point in the future, as these ADO hours cannot be used whilst you have an active part-time assignment.

Maximum timeframe for a recruitment decision

Is there a timeframe in the public health system for how long recruitment processes should take from start to finish?

Yes. The NSW Health Recruitment and Selection of Staff to the NSW Health Service Policy Directive (PD2023_024), in clause 5.2 states the maximum timeframe for recruitment is 40 business days. Unfortunately, there have been various cases where this timeframe has been exceeded due to extenuating circumstances. If you are waiting more than 40 days on an outcome for a recruitment decision, we recommend contacting the convenor in writing.

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

New laws on changes to permanent employment

Do the recent Fair Work Legislation Amendment (Closing Loopholes No. 2) Act 2024 make it easier for casual employees to request conversion to permanent employment?

Yes. The Australian Government has made further workplace laws as part of its “Closing Loopholes” changes. From 26 August 2024, the existing definition of “casual employee” in the Fair Work Act is being improved and strengthened. This will make it easier for eligible employees to request casual conversion to permanent employment. These new changes complement the existing National Employment Standards (NES), which currently provides eligible casual employees with a pathway to become a permanent employee.

Working for an agency after redundancy

If I take a redundancy package from NSW Health, can I work as an agency nurse in a public hospital during the exclusion period?

You may be able to work for a public hospital if you are employed and paid by the agency. If you are employed by the agency but paid by the hospital directly, this could be considered a breach of your redundancy terms, meaning you would be required to pay back some or all of the redundancy. It would be best to check with both your agency and the hospital prior to signing any contract.

Implications of consuming legally prescribed cannabinoids

I have a condition and have been prescribed medication. What are the implications of consuming legally prescribed cannabinoids for workrelated stress?

While it’s legal to consume legally prescribed cannabinoids, we would urge a lot of caution as these products are intoxicating and may remain in the system for many days and show up in drug testing. We would suggest you discuss with the prescriber the potentially serious risks associated with working, driving, and the potential for impairment if you do decide to seek a prescription. We would also urge you to consider other alternatives for managing work-related stress, such as the Employee Assistance Program, counselling, or calling the Association about any workspecific questions or problems.

Enhanced parental leave

I am a permanent full-time nurse in an NSW Health public hospital and my wife and I are having a baby. My wife is due on 7 September 2024. My wife does not work with NSW Health, but her employer will give her some time off with government paid parental leave. I want to know whether I get parental leave as well, as her partner.

Yes, you do.

Historically, under the Public Health System Nurses’ and Midwives (State) Award 2023 (the Award), maternity leave and parental leave was available for the parent who took primary responsibility of their child. This is now changing (thanks

to years of lobbying the state government) with the recent “enhanced parental leave” provisions by the NSW Government. The enhanced leave provisions provide greater flexibility to both parents in managing leave and care arrangements. The new provisions became effective from 1 October 2022 and apply to children born on or after 1 October 2022. These provisions entitle you (as the partner) to 14 weeks paid parental leave “if the leave is associated with the birth of a child of the employee, the employee’s partner or the employee’s legal surrogate, provided you are a permanent employee and you have completed 40 weeks of continuous service at the date of the child's birth.”

PROFESSIONAL EDUCATION CALENDAR

JUNE–NOV 2024

Go online to register for these education sessions and our free range of live webinars. Use the dropdown search fields to search by topic (Professional Courses, WHS Courses and Webinars), suburb or month.

Waterloo

Medications: How we do it better

Thu 6 Jun, 9am-4pm, 6 CPD Hrs

Members $95/non-members $190

Wound Care: Negative Pressure Wound Therapy

Fri 26 July, 9am to 4pm, 6 CPD Hrs

Members $95/non-members $190

Clinical Communication and Documentation

Wed 31 July, 9am-4pm, 6 CPD Hrs

Members $95/non-members $190

Law, Ethics and Professional Standards in nursing and midwifery

Thu 26 Sept, & Thu 21 Nov, 9am-4pm, 6 CPD Hrs

Members $95/non-members $190

Mental Health Nurses Seminar

TBC Oct, 9am-4pm, 6 CPD Hrs

Members $75/non-members $150

Blacktown

The Strengthened Aged Care Quality Standards

Thu 25 July, 9am-3pm, 5 CPD Hrs

Members $95/non-members $190

Aged Care Seminar

Fri 20 Sept, 9am-4pm, 6 CPD Hrs

Members $75/non-members $150

Broken Hill

Nursing and Midwifery Seminar

Tue 15 Oct, 9am-4pm, 6 CPD Hrs

Members $75/non-members $150

Coffs Harbour

Medications: How we do it better Tue 19 Nov, 9am-4pm, 6 CPD Hrs

Members $95/non-members $190

Gymea

Wound Care: Understanding Wound Care Products

Wed 20 Nov, 9am-4pm, 6 CPD Hrs

Members $95/non-members $190

Newcastle

Clinical Communication and Documentation

Wed 18 Sept, 9am-4pm, 6 CPD Hrs

Members $95/non-members $190

Port Macquarie

The Deteriorating Patient

Tue 10 Sept, 9am-4pm, 6 CPD Hrs

Members $95/non-members $190

Understanding Your Annual CPD Obligations

Wed 11 Sept, 9am-1pm, 3.5 CPD Hrs

Members $50/non-members $100

Shellharbour

Effective and Timely Management of the Deteriorating Older Person

Thu 17 Oct, 9am-3pm, 5CPD hrs

Members $95/non-members $190

Wagga Wagga

The Deteriorating Patient

Thu 7 Nov, 9am-4pm, 6 CPD Hrs

Members $95/non-members $190

Understanding Your Annual CPD Obligations

Fri 8 Nov, 9am-1pm, 3.5 CPD Hrs

Members $50/non-members $100

UPCOMING SEMINARS

Aged Care Seminar

Friday 20 September, 9am-4pm

6 CPD Hrs

Club Blacktown

40 Second Avenue, Blacktown NSW 2145

Hear from a range of speakers, network with colleagues and share experiences across the aged care sector. For RNs, ENs and AINs in residential, community and hospital aged care settings, across private and public sectors, or anyone with an interest in the aged care sector in NSW.

PROGRAM:

• Keeping on the weight – Preventing weight loss in older people and enhancing quality of life

• Engaging older people in service delivery and navigating complaints

• Sexuality and Ageing with Dementia

• Why Work Health and Safety Laws Work for Members: Four fundamentals on what WHS laws mean for members

Program subject to change

Cost: Members $75 / Non-members $150

Lunch and refreshments are provided and there will be time throughout the day to network with colleagues.

Health and Safety Representative Training

5-DAY TRAINING:

9-13 September / 4-8 November

9am to 4pm • NSWNMA, 50 O’Dea Ave Waterloo

A SafeWork NSW Approved Course

This course aims to provide you with the knowledge and skills necessary to fulfil your role as a Health and Safety Representative (HSR).

IT PROVIDES

an understanding of the Work Health and Safety (WHS) legislation

an understanding of how it applies to your role as an elected Health and Safety Representative (HSR) or deputy HSR the knowledge and skills necessary to assist you to improve safety outcomes in your workplace.

WHO SHOULD DO THE COURSE?

Persons eligible for the SafeWork NSW HSR Training are HSRs or deputy HSRs elected under the WHS Act.

All trainers meet the qualification and experience requirements set out by SafeWork NSW for delivering this training.

COURSE FEE*

*The WHS Act stipulates that HSR course fees are covered by the employer.

REGISTER NOW

REGISTRATION

Public course:

$792, incl. GST

On-site course:

$5,060, incl. GST (for up to 20 attendees)

Roz Norman was an outstanding activist, branch official and Councillor of the NSWNMA and ANMF. In honour of her outstanding contributions, the Roz Norman Scholarship was created to further humanitarian, social or community causes. The scholarship covers fees for an approved course promoting activism and the development of campaigning skills or public advocacy, including ongoing financial support for reasonable costs associated with campaigning for a period of one year, up to a maximum of $5,000.

NSWNMA Branch Officials or highly active members who can demonstrate leadership qualities are encouraged to apply. Successful recipients are required to report back to Committee of Delegates (COD) at the end of the scholarship period.

THE NSWNMA MEMBERS’ REWARD SYSTEM

HOW THE SCHEME WORKS

AUSTRALIA

Half of Australians in aged care have depression

Rates of depression in aged care appear to be increasing, but only a minority of residents with depression receive services specific to the condition.

Symptoms such as low mood, lack of interest or pleasure in life, and difficulty sleeping are common.

Yet, less than 3 per cent of Australian aged care residents access Medicare-subsidised mental health services, such as consultations with a psychologist or psychiatrist, each year, according to academics from Swinbourne University of Technology.

“Instead, residents are typically prescribed a medication by their GP to manage their mental health, which they often take for several months or years. A recent study found six in ten Australian aged care residents take antidepressants,” they wrote in The Conversation. They cited other research that described “serious limitations of the current standard of care” in reference to the widespread use of antidepressants to treat frail older people with depression.

The Swinbourne researchers suggest that psychological therapies may be an effective approach for people living in aged care, reducing symptoms of depression and improving quality of life and psychological wellbeing.

However, they found that “psychological therapy may not be more effective than extra social contact in reducing symptoms of depression”.

“Older people commonly feel bored, lonely and socially isolated in aged care. So, identifying ways to increase meaningful engagement day-to-day could improve the mental health and wellbeing of older people in aged care,” they said.

A recent study found six in ten Australian aged care residents take antidepressants.

GAZA

Gaza’s hospitals are now “empty shells” says WHO

Gaza’s healthcare system has been systematically dismantled, says the UN’s health organisation.

A WHO-led multi-agency mission in April found that, like most hospitals in the north of Gaza, “Al-Shifa Hospital – once the largest and most important referral hospital in Gaza – is now an empty shell” after the latest siege by the Israeli army.

“No patients remain at the facility. Most of the buildings are extensively damaged or destroyed and the majority of equipment is unusable or reduced to ashes,” it said.

The WHO team said the scale of devastation has left the facility completely non-functional, further reducing access to life-saving health care in Gaza.

“Restoring even minimal functionality in the short term seems implausible,” it said.

The hospital’s emergency department, surgical, and maternity ward buildings were extensively damaged due to explosives and fire. At least 115 beds in what once was the emergency department were burned and 14 incubators in the neonatal intensive care unit (NICU) destroyed, among other assets.

The WHO mission found that “numerous shallow graves have been dug just outside the emergency department, and the administrative and surgical buildings”.

“In the same area, many dead bodies were partially buried with their limbs visible,” it said.

WHO said that prior to its mission, their efforts to reach the hospital to medically evacuate patients and staff, and conduct an assessment, were repeatedly denied, delayed or impeded.

‘The scale of devastation has left Al-Shifa Hospital – once the largest and most important referral hospital in Gaza – completely nonfunctional.’ – WHO

US to implement minimum nurse staffing levels in aged care

US government has created new rules for minimum staffing in aged care homes, but many experts say they are inadequate.

The country’s 15,000 nursing homes will be required to have 3.48 hours of staffing per resident per day, of which 0.55 must comprise registered nurses and 2.45 must be nurse aides, reported Nursing Times.

A White House briefing explained this would mean a setting with 100 residents would need a minimum of two to three registered nurses, 10 to 11 nurse aides and two additional nursing staff, who could be registered or non-registered.

In addition, the new law would require a setting to always have a registered nurse on site, including at night and over the weekend.

Providers will be given up to three years to implement the new rules.

The increased staffing was first promised by Joe Biden in 2022, after more than 200,000 aged care residents died of COVID-19 in just two years, and after staffing levels had plummeted in the wake of the pandemic.

Richard Mollot, head of the Long Term Care Community Coalition, said the minimum staffing levels were “completely inadequate”, and a missed “once-in-ageneration opportunity”.

“It is a tremendous dereliction of duty. We are continuing to allow nursing homes to warehouse people and to rip off the public,” he said.

‘We are continuing to allow nursing homes to warehouse people and to rip off the public.’

— Richard Mollot, Long Term Care Community Coalition

AUSTRALIA

NSW considers end to COVID mandate for health workers

NSW Health is consulting with staff, health unions, and local health districts about proposed changes to mandatory COVID-19 vaccination requirements for healthcare workers.

NSW Chief Health Officer, Dr Kerry Chant, said if consultation leads to any change to the current COVID-19 vaccination mandate, NSW Health will continue to strongly recommend all its workers stay up to date with their vaccinations, in line with its advice for the broader community.

“COVID-19 vaccination continues to provide strong protection against severe illness, particularly for people at higher risk of serious illness and death from COVID-19, including older adults and those with underlying health conditions,” Dr Chant said.

“While the latest evidence shows most people have now developed protection from serious disease due to vaccination and/or previous infection, COVID-19 remains a serious public health issue.”

In August 2021, during the pandemic, NSW Health introduced mandatory COVID-19 vaccination for all healthcare workers, to protect staff and their families, patients, visitors, and the broader community.

Under the current work health and safety framework for infectious disease screening and vaccination,

NSW Health workers are required to have had at least two doses of a COVID-19 vaccine unless they have a medical contraindication.

NSW Health has said, as with all public health policy, it conducts regular reviews to ensure policy reflects the latest expert advice.

NSW Health will continue to strongly recommend all its workers stay up to date with their vaccinations, in line with its advice for the broader community.

Workplace AI, robots and trackers are bad for quality of life: study

But technology such as laptops, tablets and instant messaging has a more positive impact on wellbeing.

The study of over 6000 people by the Institute for the Future of Work examined the impact of various technologies on wellbeing.

According to the study, increased exposure to technologies like AI-based software, wearable trackers, and robotics, correlates with poorer health and wellbeing among workers, The Guardian reported.

“We found that quality of life improved as the frequency of interaction with ICTs [information, communication and technology] increased, whereas quality of life deteriorated as frequency of interaction with newer workplace technologies rose,” the report said.

The authors pointed out their findings were consistent with previous research, which showed “such technologies may exacerbate job insecurity, workload intensification, routinisation and loss of work meaningfulness, as well as disempowerment and loss of autonomy”.

Economists at Goldman Sachs speculated last year that 300 million jobs worldwide could be automated out of existence by 2030 as a result of the development of generative AI.

Mary Towers, the British Trade Union Congress’s lead on AI, said: “These findings should worry us all. They show that without robust new regulation, AI could make the world of work an oppressive and unhealthy place for many.

“If we put the proper guardrails in place, AI can be harnessed to genuinely enhance productivity and improve working lives.”

‘Without robust new regulation, AI could make the world of work an oppressive and unhealthy place for many.’

— Mary Towers, British Trade Union Congress

WORLD

Pay rises for workers covered by collective agreements reaches 15-year high

Data for the December quarter showed average pay rises of 4.3 per cent for workers on collective agreements.

The ACTU welcomed the increase and said it reflected the impact of the Albanese government’s Secure Jobs Better Pay reforms.

The boost to workers’ incomes was fuelled by an increase in 227,000 more workers covered by collective agreements than a year earlier, with coverage reaching 2 million workers in total, or 16.7 per cent of the workforce, up from 15.2 per cent in December 2022, the ACTU said.

The 4.3 per cent increase represents the highest quarterly average pay rise for workers on newly approved collective agreements since 2009, exceeding the 3.0 per cent average increase in December 2022.

ABS data showed inflation slowing, from 7.8 per cent in the year to December 2022 to 4.1 per cent in December 2023.

“Collective bargaining is how working people can win pay increases beyond the bare minimum,” said ACTU President, Michele O’Neil.

“Under the decade of Coalition government, the number of workers covered by collective agreements collapsed and wages stagnated. We have seen this trend start to reverse – more workers are on collective agreements and, as a result, they’re winning higher pay.

“If you’re a working person, the best way to get a pay rise is to join your union and be covered by a collective agreement.”

‘ If you’re a working person, the best way to get a pay rise is to join your union and be covered by a collective agreement.’ – ACTU President, Michele O’Neil

WORLD

A “staggering” number of workers vulnerable to climate-related health hazards

Climate change creates a ‘cocktail’ of serious health hazards for 70 per cent of the world’s workers, says the ILO.

A “staggering” number of workers, amounting to more than 70 per cent of the global workforce, are likely to be exposed to climate-change-related health hazards, and existing occupational safety and health (OSH) protections are struggling to keep up with the resulting risks, according to a new report by the International Labour Organization (ILO).

The ILO estimates that more than 2.4 billion workers (out of a global workforce of 3.4 billion) are likely to be exposed to excessive heat at some point during their work. When calculated as a share of the global workforce, the proportion has increased from 65.5 per cent to 70.9 per cent since 2000.

However, the impact of climate change on workers goes well beyond exposure to excessive heat, the report said, creating a “cocktail of hazards”, which result in a range of dangerous health conditions.

The report noted that numerous workers’ health conditions have been linked to climate change, including cancer, cardiovascular disease, respiratory disease, kidney dysfunction and mental health conditions.

ACTU Assistant Secretary Liam O’Brien said workers are on the frontline of the climate crisis.

“Be it working outdoors in extreme heat, or those battling floods and extreme weather conditions, the climate crisis is having a detrimental effect on workers’ health,” he said.

Read the report:

OSH and climate change: https://www.ilo.org/resource/ news/climate-change-creates-cocktail-serious-healthhazards-70-cent-worlds

AUSTRALIA

ACTU calls for 9 per cent pay increase in key feminised industries

Workers in key feminised industries should get at least a 9 per cent pay rise in the Annual Wage Review, according to the ACTU.

The ACTU said this rise would be a critical step in achieving equal pay for workers in occupations that historically have been undervalued based on gender. This includes care and degree-qualified occupations in early childhood education, education and health support services, veterinary care and disability home care, among others.

The 9 per cent pay rise call is based on the 5 per cent increase the ACTU is advocating across all awards, supplemented by at least an additional 4 per cent in key lowpaid feminised industries.

If accepted, a full-time care worker could see their pay boosted by $90 a week – a step towards equal pay – pending a full assessment. A similar assessment in aged care recently found that workers required up to 23 per cent pay increases to achieve pay equity.

The ACTU is also calling for a process to provide interim increases quickly, while a proper valuation of underpayment is done in retail, pharmacy, administrative services, cabin crew, and legal services, among others.

This year’s Annual Wage Review is working to address equal pay, in line with the Albanese government’s 2022 changes to the Fair Work Act to achieve gender equality.

ACTU Secretary, Sally McManus, said a 9 per cent increase would be a vital first step to properly valuing the work of working women doing critical work for our community.

“Achieving equal pay for women requires systemic change and targeted pay rises in industries traditionally dominated by women and historically very low-paid,” she said.

‘Achieving equal pay for women requires systemic change.’

ACTU Secretary, Sally McManus

CROSSWORD SOLUTION

health+wellbeing

Helping a colleague

As nurses, midwives, and nursing and midwifery students, you may find yourself in a position where you feel concerned about the health and behaviour of a colleague. What should you do if you find yourself in this situation?

Should I be concerned?

Balancing family and work can be challenging, especially in a demanding profession like nursing and midwifery.

As well as workplace pressures, nurses, midwives and students face the same life pressures and challenges as everyone else. At times it can be difficult to find a work–life balance.

So, how can you tell if your co-worker is just “having a bad day” or if there might be something more going on – or if they could potentially have a health issue that could affect their work?

And if there is something going on, what options are available to you to help support your colleague?

Signs to look for

This is a guide to help you identify warning signs your colleague might be struggling and need support with potential health issues, which may require intervention or increased support.

Often, changes in behaviour and physical appearance occur over time and can be indicative of worsening health.

Uncharacteristic behaviours

• unpredictable mood swings

• increased irritability or defensiveness towards co-workers

• less engaged emotionally with co-workers and/or patients and clients

• isolating or distancing behaviour at work, such as taking breaks alone and not joining in with social activities

• poor professional boundaries, such as disclosing personal information to patients or breaching confidentiality

• regularly late for work or increased absenteeism

• overreaction to criticism or tending to blame others

• complaints of poor client or patient care

• increasing clinical errors or incident reports

Concerning behaviours may be early warning signs that a colleague might be developing a physical or mental health issue that could affect their ability to work.

• difficulty in concentrating

• frequently attending work with hangovers

• less interested in work.

Physical signs

• deterioration in appearance

• poor hygiene

• diminished alertness or drowsiness

• excessive sweating

• excessive tremor

• unsteady gait

• changes in speech, such as increased volume, rate of speech or slurring of speech

• smell of alcohol on breath.

Barriers to discussing or reporting your concerns

Raising concerns about a colleague can be difficult for a range of reasons:

• not wanting to jeopardise an existing professional or personal relationship with the person

• thinking it is the responsibility of managers to respond to concerns

• your place in the workplace hierarchy e.g. this colleague is in a higher position

• peer protection — a strong desire to protect a colleague

• issues are not deemed sufficient to warrant a formal report

• you are experiencing similar health issues

• fear that reporting will result in the colleague involved losing their job and registration

• not wanting to be accused of being a “whistle blower”

• fear of retribution, such as scrutiny and criticism of your own work

• fear your colleague may deny any issues exist, if questioned

• fear that if you discuss an issue with a colleague, they may become angry and hostile

• justifying and dismissing concerns if no harm has occurred

• deciding that ignoring or covering up the behaviour is the best outcome for your colleague

• fear of ramifications from other colleagues in the team. These are all normal and valid concerns. However, it is important that if you are concerned about a co-worker, you do something.

Starting the conversation

Sometimes you may openly discuss and seek support within your team when facing personal or workplace challenges. This provides an informal pathway to check in and validate your feelings.

It also gives you an opportunity to actively encourage a colleague who is expressing concerns, to seek support.

Colleagues may not openly discuss their personal and/ or professional challenges and they may not be aware of the consequences their health issues are having on their work performance or collegial relationships. They may also be fearful or ashamed to acknowledge that a health issue may be affecting their job performance.

As nurses, midwives and students, you have a professional and legal obligation to report colleagues who may display concerning behaviour that could harm clients or patients.

It is important to acknowledge that concerning behaviours may be early warning signs that a colleague might be developing a physical or mental health issue (including substance-use dependence) that could affect their ability to work. If you have identified concerns relating to a colleague’s health or practice, you should act on these concerns.

Depending on your relationship with a colleague, a first step might be to have a confidential and private conversation with your colleague about your concerns. Use a simple, caring and compassionate approach: “Is everything okay? I am concerned as I have noticed ...”

If during this conversation your colleague confirms your concerns, you can encourage them to seek appropriate professional support and speak with their manager.

Many nurses, midwives and students report a sense of relief when their health issue is identified and support and treatment begins.

Sensitive discussions relating to health concerns can be difficult. Many nurses, midwives and students report a sense of relief when their health issue is identified, and support and treatment begin. If you are uncomfortable in raising your concerns with a colleague, or the situation requires immediate attention (for example, if you are aware your colleague is working while intoxicated on drugs or alcohol), then it is essential you speak with a manager or education provider.

As nurses, midwives and students, you have a professional and legal obligation to report colleagues who may display concerning behaviour that could harm clients or patients.

What can I do next?

Why not use Nurses and Midwife Support service finder, to find out about some of the services available?

Nurse and Midwife Support provides free and confidential support, 24/7, to nurses, midwives and students Australia wide. If you would like to speak to someone, call 1800 667 877, or you can request support via email.

New South Wales Nurses and Midwives’ Association

Summary of Financial Information for the Year Ended 31 December 2023

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

A copy of the Financial Statements, including the independent Audit Report, will be supplied free of charge to members upon request. Certificates required to be given under the Act by the Accounting Officer and the Committee of Management (“Council”) have been completed in accordance with the provisions of the Act and contain no qualifications.

SUMMARY STATEMENT

INFORMATION TO BE PROVIDED TO MEMBERS OR REGISTRAR

In accordance with the requirements of the Industrial Relations Act, 1991 [NSW] the attention of members is drawn to the provisions of Sub-Sections (1) and (2) of Section 512 which read as follows:

(1) A member of an organisation, or the Industrial Registrar, may apply to the organisation for specified information prescribed by the regulations in relation to the organisation.

(2) An organisation must, on the making of such an application, make the specified information available to the member or the Industrial Registrar in the manner, and within the time, prescribed by the regulations.

REPORT OF THE INDEPENDENT AUDITOR ON THE SUMMARY FINANCIAL STATEMENTS TO THE MEMBERS OF THE NEW SOUTH WALES NURSES AND MIDWIVES’ ASSOCIATION Opinion

The summary financial statements, which comprise the summary balance sheet as at 31 December 2023 and the summary statement of profit or loss and other comprehensive income for the year then ended are derived from the audited financial report of New South Wales Nurses and Midwives’ Association for the year ended 31 December 2023. In our opinion, the accompanying summary financial statements are a fair summary of the audited financial report.

Summary Financial Statements

The summary financial statements do not contain all the disclosures required by section 510 of the Industrial Relations Act 1991 [NSW] or Australian Accounting Standards. Reading the summary financial statements and the auditor’s report thereon, therefore, is not a substitute for reading the audited financial report and the auditor’s report thereon.

The Audited Financial Report and Our Report Thereon

We expressed an unmodified audit opinion on the audited financial report in our report dated 16 April 2024. Our Independent Auditor’s Report to the members on the Financial Report did not contain any particulars of any deficiency, failure or shortcoming as referred to in the Industrial Relations Act, 1991 [NSW], as applied by section 282(3) of the Industrial Relations Act, 1996

Council’s Responsibility for the Summary Financial Statements

The Council is responsible for the preparation of the summary financial statements.

Auditor’s Responsibility

Our responsibility is to express an opinion on whether the summary financial statements are a fair summary of the audited financial report based on our procedures, which were conducted in accordance with Auditing Standard ASA 810 Engagements to Report on Summary Financial Statements.

Michael Mundt

Partner 16 April 2024, Wollongong

Liability limited by a Scheme approved under Professional Standards Legislation

A copy of the Financial Report, including the Independent Audit Report, is available to members on the Member Central portal accessed via www.nswnma.asn.au.

Members can obtain a hard copy by emailing the General Secretary, NSWNMA at gensec@nswnma.asn.au or calling 1300 367 962 .

Daley Audit

test your Knowledge

ACROSS

1. Localisation related condition characterized by muscle jerks and seizures (9.8)

10. Annihilator (11)

11. A mouthlike opening (5)

12. Odontostomatognathic (1.1.1)

13. Evolutionary change of one species into another (13)

15. Critical care unit (1.1.1)

16. Immunocytochemistry (1.1.1)

17. The removal of limbs from a body (13)

21. Left eye (1.1)

22. Tubular covering or layer (17)

26. Symbol for sodium (2)

27. One time only (4)

28. Ornamental neck chain (7)

29. Moral flaw or bad habit (4)

30. Thin discharge from the eyes or nose (5)

31. In a feminine manner (13)

34. Government's principal revenue collection agency (1.1.1)

35. Point of connection between bones (5)

36. A contraceptive device (1.1.1)

37. Reproductive cells of fungi (6)

38. Sound (17)

DOWN

1. Thomsen disease (8.9)

2. Related to the study of eggs (9)

3. Running east to west on a map (11)

4. Water wheel (5)

5. Positions (5)

6. Vein associated with the navel (13.4)

7. Old term for rabies (5)

8. Thyrotropin-releasing hormone (10)

9. Strongly desire or long for (5)

14. Nonoperative management (1.1.1)

18. Examiner (11)

19. Cavities, pouches or recess (11)

20. One-color vision condition (11)

23. A type of printer (6)

24. Nitrocellulose (2)

25. Budding (9)

32. Lost color over time (5)

33. Shed feathers, skin, or fur (5)

Asked to attend a disciplinary or fact finding interview with your employer

Threatened with dismissal

Instructed to provide a statement for any reason

Contacted by the Health Care Complaints Commission or the Nursing and Midwifery Council of NSW

Contacted by police or solicitors in relation to a Coronial Inquest

Applications for the Edith Cavell Trust Scholarships are being accepted from 1 May 2024, closing 31 July 2024, for studies being undertaken in the academic year 2025.

Members or Associate Members of the NSW Nurses and Midwives’ Association or the Australian Nursing and Midwifery Federation (NSW Branch) are invited to apply.

All grants, awards or loans shall be made to financially assist nurses, midwives, assistants in nursing, assistants in midwifery (including students of those disciplines), and accredited nursing or midwifery organisations, schools and faculties in the furtherance of:

(i) accredited nursing or midwifery studies;

(ii) such academic research programs as are approved by the Trustees in the theory or practice of nursing or midwifery work; or

(iii) clinical nursing education programs at graduate, post-graduate and continuing education professional development level; in accordance with a number of categories.

Full details of the scholarship categories, how to apply and to obtain the official application form is available from the NSWNMA website. Prior to applying, please ensure you have read the Edith Cavell Trust Scholarship Rules.

Robynne, Nurses & Midwives Health member

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