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lamp The magazine of the NSW Nurses’ Association

volume 69 no.1 February 2012

VICTORIAN FIGHT FOR Print Post Approved: PP241437/00033

RATIOS

CONTENTS

The

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

SYDNEY OFFICE 50 O’Dea Avenue, Waterloo NSW 2017 (all correspondence) T 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnurses.asn.au W www.nswnurses.asn.au HUNTER OFFICE 8-14 Telford Street, Newcastle East NSW 2300 ILLAWARRA OFFICE L1, 63 Market Street Wollongong NSW 2500

lamp Volume 69 No.1 February 2012

COVER STORY

12 | Victorian nurses fight for ratios

2011 winners, left to right: Zena Coffey, Paul Esplin and Amanda Klahr

A battle royale is evolving in Victoria as nurses defend their hard-fought for ratios from a well-organised attack by the Liberal government of Ted Baillieu.

Do you know a remarkable nurse?

Recognise the outstanding efforts of a remarkable nurse by nominating them in one of three categories:

Graduate Nurse of the Year

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NOMIN ATE N O Nomin W! atio ns c 29 Feb ruary 2 lose 012

Nurse of the Year Innovation in Nursing

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S TICKEATLE ON S

REGULARS

5 5 6 6 8 8 35 39 37 41 37 42 42 45 45 47 47 49 48 50

Editorial Your letters News in brief Ask Judith Obituary Nurse uncut Nursing research online Books At the movies Crossword Diary dates

NURSE UNCUT

NOW

ACTU

20 | Voices from working Australia With more than 40,000 participants, the ACTU’s Working Australia Census was one of the biggest surveys of workers in Australia’s history.

PRIVATE

41 | How to grow your super savings

28 | To come

COMPETITIONS

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Winners announced at a gala awards ceremony on Thursday 10 May 2012 at Melbourne’s Crown Entertainment Complex.

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25 | To come

NSWNA Communications Manager Janaki Chellam-Rajendra T 8595 1258 For all Lamp editorial enquiries, letters and diary dates: EDITORIAL ENQUIRIES T 8595 1234 E lamp@nswnurses.asn.au M 50 O’Dea Avenue, Waterloo NSW 2017 PRODUCED BY Hester Communications T 9568 3148 PRESS RELEASES Send your press releases to: T 9662 1414 E gensec@nswnurses.asn.au EDITORIAL COMMITTEE • Brett Holmes, NSWNA General Secretary • Judith Kiejda, NSWNA Assistant General Secretary • Coral Levett, NSWNA President • John Lyons, Baradine MPS • Roz Norman, Tamworth Base Hospital • Elsie May Henson, Barraba Multi Purpose Service • Peg Hibbert, Hornsby & Ku-Ring-Gai Hospital • Michelle Cashman, Long Jetty Continuing Care • Richard Noort, Justice Health ADVERTISING Patricia Purcell T 8595 2139 or 0416 259 845 or 9662 1414 E ppurcell@nswnurses.asn.au RECORDS AND INFORMATION CENTRE – LIBRARY To find old articles in The Lamp, or to borrow from the NSWNA library’s nursing and health collection, contact: Jeannette Bromfield, RIC Coordinator T 8595 2175 E gensec@nswnurses.asn.au

The Lamp ISSN: 0047-3936 General disclaimer The Lamp is the official magazine of the NSWNA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

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

Subscriptions for 2012 Free to all Association members. Professional members can subscribe to the magazine at a reduced rate of $50.

Individuals $78, Institutions $130, Overseas $140.

THE LAMP FEBRUARY 2012 | 3

EDITORIAL

BY BRETT HOLMES GENERAL SECRETARY

History repeats in Victoria Victorian nurses are embroiled in a tough dispute, pitted against a well-organised and determined Liberal government, over ratios and pay. This may be an important cautionary tale for nurses in New South Wales.

Are your workmates or friends members of the NSWNA? Why not ask them. And, if not, invite them to sign up. Like you, they need the security of belonging to a strong and dynamic union.

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Coral Princess Cruises’ informative crew is always on hand to provide assistance and information about the fascinating reef life and habitats, and an experienced dive instructor can take you for an exhilarating introductory scuba dive, revealing even

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Three, four and seven-night cruises depart Cairns and Townsville each week, all year round. A special 10% discount is available to NSW Nurses’ Association members on the company’s range of small ship cruises on the Great Barrier Reef, Western Australia’s Kimberley, Across the Top of Australia, Papua New Guinea, Melanesia and New Zealand.

HURRY! Call the Association now for a recruitment kit and recruitment incentive scheme details.

Phone 8595 1234 (metropolitan area) or 1300 367 962 (rural) or go to www.nswnurses.asn.au RECRUITERS NOTE: nurses and midwives can now join online!

If you refer a new member to join online, make sure you ask them to put your name and workplace on the online application form. You will then be entitled to your vouchers and draw/s in the NSWNA Recruitment Incentive Scheme.

Victorian nurses had to fight each time – now with a Labor government – to retain and extend what they had won.

AS THE LAMP WENT TO PRINT TALKS between Victorian nurses and the Baillieu Government were about to recommence, following a brief lull over Christmas and after several bruising months at the end of 2011.

Some interesting observations can be made about the process so far, with possible lessons to be learnt from the experience of our Victorian colleagues in dealing with their new state government.

Ratios were implemented in Victoria 12 years ago after a catastrophic period for the Victorian health system under the previous Liberal government, led by Jeff Kennett.

Kennett slashed 2000 nursing positions from the public health system. On his watch, 16% of the health workforce lost their jobs. He cut permanent employment in the public sector and the health system became dependent on agency nurses.

It was out of this mess that the impetus for ratios came.

VICTORIAN NURSES HAVE ALWAYS HAD TO DEFEND RATIOS

Ratios became a reality when the newly elected Bracks Government agreed to fund the new positions that were required to fill them.

It was never a certainty that ratios would remain in subsequent enterprise bargaining campaigns run in 2004 and 2007, however.

Victorian nurses had to fight each time – now with a Labor government – to retain and extend what they had won.

Ted Baillieu promised to maintain ratios before the last Victorian state election. In hindsight, that looks like the first duplicitous act towards his state’s nurses. More were to come.

A Cabinet-in-Confidence paper, leaked to The Age in November, revealed a very sophisticated and well-planned strategy to roll back ratios and limit wage increases. This strategy, which involved provoking nurses into industrial action, was being implemented as the department of health was theatrically and dishonestly denying that it was stonewalling negotiations.

Despite the 12-year hiatus, there seems to be continuity between the actions of the Baillieu Government and the government of his Liberal predecessor Jeff Kennett.

FAIR WORK ACT NEEDS FIXING

A lesson that is obvious from the Victorian dispute is that the Fair Work Act has weaknesses that need to be addressed by the Gillard Government.

The Fair Work Act has many admirable features. It rolled back the nasty excesses of Work Choices and introduced important protections for individual workers.

But during large scale, intractable disputes such as at Cochlear, more recently at Qantas and now with the Victorian nurses, a loophole has become apparent, large enough for unscrupulous employers to drive a bus through.

While there is a requirement for employers to begin and conduct enterprise bargaining, there is no legal imperative for them to conclude an agreement.

For workers involved in health there is also a section of the act that allows for protected industrial action to be suspended or terminated if it ‘endangers the life, personal safety or health or the welfare of the population or a part of it’.

The Victorian nurses’ dispute shows how this part of the Fair Work Act can be manipulated and abused by employers.

LET’S BE ON GUARD

We will not jump to the conclusion that the NSW government will follow the Victorian strategy, yet prudence suggests that we need to be vigilant.

After the last NSW state election, the O’Farrell Government agreed to abide by the Memorandum of Understanding negotiated between the NSWNA and the previous Labor government.

We welcomed that announcement and acknowledge that, so far, they have stood by their word.

It is now less than 18 months till the current agreement expires. Our hope is that the O’Farrell Government recognises the enormous benefits ratios bring to our health system and to the people who count – the citizens of NSW. If anything, ratios should be extended into other areas where they are needed and a good government will plan to do so.

THE LAMP FEBRUARY 2012 | 5

LETTERS LETTERS

LETTERS

LETTER OF THE MONTH

Nursing is a battle Not many careers are simultaneously soul destroying and life affirming.

As a nurse working with children with cancer, my first two weeks were spent crying my way home from work and being dumbfounded as to how something so cruel could happen to ones so pure. My tears, however, dried up after those first two weeks and I haven’t cried since. Not once, not even when two patients died in one day.

I’m coping better than I thought I would, though who knows how much damage the daily terrors of paediatric oncology are inflicting on my subconscious. My partner tells me that almost every night I awake with a startle, or a flinch, when he caresses my sleeping hand.

At work, the fear and terror of families is palpable, if you pause a moment to feel its presence. It can be observed in faces, gestures, sleepless

EENs upgrading to RNs I would love to see an article exploring the role of the Endorsed Enrolled Nurse and why it is so difficult for them to upgrade their registration to Registered Nurse.

I am an Endorsed Enrolled Nurse (EEN) who completed my certificate in Enrolled Nursing (EN) in 2001. I went on to update my registration with the medication endorsement in 2010 and have been working since 2001 as an EN and EEN respectively in specialist practices and in hospital clinical settings since embarking on my career 10 years ago.

However, since applying to universities throughout NSW, I have repeatedly had the door slammed in my face for any ‘accelerated’ program, as my credentials are considered past their used by date. I have been advised that I would need to complete the entire three-year degree that would allow me to become a Registered Nurse.

While I understand that some of the course requirements have changed, I believe that we need to take a very good look at the course requirements for EENs looking to upgrade their registration. To spend an entire year, or in some cases two years, on units that have next to no relevance for a practicing nurse, not to mention clinical placements where I am being taught how to take a blood

pressure, is a little insulting to someone who manages the care of up to 10 patients alone in a busy medical ward in a Sydney hospital.

There has to be a more practical way for universities to ensure that EENs are learning to become Registered Nurses with units of study that are relevant to enhancing their theoretical knowledge, and practicals that enhance their performance on the ward.

To be told that my 10 years of experience as a nurse counts for nothing when I apply to become a Registered Nurse has been one of the most deflating experiences in my career.

When hospitals and other health care facilities are screaming for nurses, and when I am constantly reading about health care facilities that are shutting beds because of a shortage of nurses, I find it incredulous that educational facilities are making it so difficult and impractical for EENs to upgrade their registration.

I would love to see this addressed but am not sure where to begin.

Yours faithfully A 1st year nursing student with 10 years’ clinical practice experience as a nurse

6 | THE LAMP FEBRUARY 2012

nights and unknown medical terminology. Every element of my workplace is laced with a parent’s greatest fear being realised.

Rationalisation and logical analysis play no part in this nonsensical world. I cannot understand why these children have been given this fate, no matter how much time I have spent pondering it. Indeed, one could go quite mad trying to figure it out.

Therefore, I have found distraction and professional distance great enablers in allowing me to carry out my work. Great comfort can be

taken when staff members choose to busy themselves with tasks-at-hand, turning their minds to the banal and blessedly boring.

And it seems I’m not alone.

Yesterday, as I was pinning a child to his bed and forcing a tube down his nose, I happened to glance across at the cleaner. Among the chaos of the child’s protests, and the tears dripping down his little face, I saw that she was furiously scrubbing a spot on the floor. Averting her eyes to the plight of this child, she seemed very preoccupied with this stubborn spot on

More “Needless Hurdles” I am a Registered Nurse who has been out of the workforce for the past six years after having four children. I naively thought I would go back to work once my youngest child started kindergarten and was totally unprepared for what AHPRA had in-store for nurses (and other health professionals) like myself when I tried to renew my registration last year.

I have now been advised by AHPRA that I need to complete an Assessment of Competency Course through the College of Nursing within the next 12 months.

The fact that there is only one course available – full-time for eight weeks and with up-front payment of $10 000 – makes the whole process of reregistration bordering on discrimination against nurses who have left the workforce to have families.

There must be many other nurses who, like myself, wish to return to work either part-time or casually after several years of full-time parenting, and may not be able to commit to a full-

time course; with the demands of family and study after hours this course seems very daunting and unachievable.

Not-to-mention the cost, which is indeed half-clinical – are the students paying the clinical providers to enable them to complete their clinical practice while they are working in their hospital/facility? I would love to know whose pockets that money is lining.

The time then taken to reimburse such course fees, if only returning to work on a casual basis, will also be lengthy.

The whole purpose of me returning to work (apart from loving it) is to help us get out of debt, not deeper into it!

One must also take into account the added cost of childcare/before and after school hours. And don’t forget the added pressure on families of maintaining the usual routines of meals, housework, homework, extracurricular activities etc. Where would one fit in the extra hours of study required for the course?

I have four children under the age of 10. My eldest daughter has special needs, meaning drastic changes to family routines are likely to negatively affect her, which will be evidenced in difficult behaviour, making the ability to complete a full-time course even more challenging.

I am a firm believer that a

the floor. As she turned to face the opposite wall, I noticed her wiping a few tears from her eyes.

You quickly learn the art of professional distance. When discussing my favourite little child a more experienced nurse flatly told me, ‘don’t have a favourite, they might die’. Her bluntness struck me. Though, as time went on, I learned she wasn’t saying this out of cruelty. She was saying it out of the need to self-preserve. A smart tactical move in the ward-asbattlefield, it is necessary for the survival of the nurse.

I have always wanted to be a mother, though after working with families of children with cancer I have some serious doubts. How few could muster the motherly strength to soldier on through treatment? To be presented with a large black vortex and force themselves to step inside? Yet almost all of them do. Who knows what I would be like in this situation; the thought scares me off having children almost entirely.

What astounds me are the nurses who are themselves

Amanda Jones, RN

career in nursing is a calling. I felt compelled by the age of 15 to become a nurse. I completed Enrolled Nursing after my HSC, and went on to work my way through university as a part-time and agency EN, financially independent from my family. After marrying, I became a CNS in anaesthetics at St George Hospital and worked until having my third child.

I am passionate about nursing.

I love working in a dynamic team environment, and I have many more working years ahead of me. I feel frustrated by the thought that I may not be able to re-join the nursing workforce if I have to study full-time, as this will cause great sufferance

to my family, and ultimately, myself. At the moment I feel that the new system that is being enforced by AHPRA is unfair and is letting nurses, and the future of nursing for people with young families, down, at a time when the demand for nurses is so great.

Are any efforts being made to cater for nurses, like myself, who may only be able to study parttime? And are there any subsidies/grants/scholarships available to help with the cost of the Assessment of Competence course? What is the Nurses’ Association doing to support nurses in my position?

Nerida Chedra, RN

SAY SOMETHING

mothers of young kids, and yet can care for a dying patient the same age as their child. My experience has been to spoil my young niece with clothes and toys, surely as an indirect reaction to what I see everyday, or perhaps in the rejoicing of a life untainted.

Like all things in life there is balance; the horrid aspects of the job are somewhat balanced by the best parts of humanity. Everyday astounding moments happen – tender moments that make all the emotional baggage of the job worthwhile. Seeing a sickly little patient’s eyes come to life when someone blows bubbles above their bed; the delivery of ‘I love you’ in a small voice; a parent’s quick ‘thank you’ as you leave the room.

The trump card however, is that inevitable moment when a patient replaces her silent and fearful stare with a flicker of recognition and a smile when you walk into her room.

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

Please include a photograph along with your name, address, phone and membership number.

Letters may be edited for clarity and space.

Thank-you I would like to thank the union for supporting me in this cause (see article “Needless Hurdles, The Lamp, November 2011).

I am a professional member and since the issue of recency of practice standards has gone public, I have received correspondence from many nurses who have gone to a lot of trouble to track me down. They are in the same position as me and are thanking me for going public, wishing me well or just wanting to talk to someone else going through this devastating loss of identity. I do not intend to take this lying down and I am fighting for more than just myself.

I have also just been successful in gaining a NSW Health scholarship to attend the assessment of competence course at the College of Nursing.

Thank-you again!

Janelle Atkinson, RN Nurses and politics I wrote in support of nurses in The Lamp magazine at the last federal election. I maintain my support and stance, that nurses are significantly underpaid as opposed to other employees in the medical community.

Let’s be honest, it’s the nurses that do the work in our medical facilities. I speak from significant experience as a patient and as the carer of elderly parents.

If you want to know what is going on in a hospital, ‘ask a nurse’.

If your baby is going to be delivered, ‘the nurse will be there’, and the doctor may or may not turn up by the time the birth occurs to stake their claim to fame in the birthing process.

With a coalition government now reducing working conditions and employee numbers across the New South Wales workforce, we can expect more safety related deaths, across several industries, to occur.

To those who complain about our state government, just remember, someone voted for them – and it wasn’t me.

Those who are most at risk, or the poorest of poor, have and will continue to suffer while Backflip Barry O’ Farrell and his lackeys are in control. It’s Howard and Reith on a state level all over again!

Those who are the hardest working will continue to have their positions reduced and conditions eroded. These are the legacies of a conservative government. We should remember all of this when we go to the next state or federal elections.

Yours respectfully Lee Mitchell, patient and taxpayer

LETTER OF THE MONTH The letter judged the best each month will be awarded a $50 Coles Myer voucher courtesy of Moore Equipment. ‘Clever carts to help clever nurses.’ For details on the range of clax carts please call (02) 9519 5540 or visit www.moore equipmentcom.au Every letter published receives the Sydney Morning Herald and Sun Herald delivered 7 days a week for 26 weeks.

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THE LAMP FEBRUARY 2012 | 7

COMPETITION@NSWNA

NEWS IN BRIEF

60

%

of patients WAITED FOUR WEEKS TO SEE A SPECIALIST IN

DOWN TO IN

OECD slams attack on NHS

Aged care in ‘absolute crisis’

Britain has one of the world’s best health systems and proposed reforms by the conservative Cameron Government will undermine its quality, according to a landmark report into international health.

The British Parliament is considering a radical new health bill that would see a far greater role for the private sector in the National Health System. The wisdom of such reform is questioned in a report by the Organisation for Economic Co-operation and Development (OECD), which gave a glowing endorsement of the NHS. Deaths by heart attack have been cut by two-thirds since 1980; the public rarely has to pay to meet health needs; and citizens have comparable life expectancies to their neighbours in Europe. The UK also scores well on global diseases: less than 5% of adults had diabetes in 2010, contrasting with 10% in the United States.

The report warns, however, that each major reform sets back the health system.

‘The UK is one of the best performers in the world. But outcomes are not what you expect because there is a big reform every five years. We calculate that each reform costs two years of improvements in quality. No country reforms its health service as frequently as the UK,’ Mark Pearson, an economist and head of health at the OECD told the Guardian.

The OECD acknowledged improvements in the NHS under the previous Labour government, which dramatically cut waiting times. In 2005, 60% of patients waited four weeks to see a specialist; by 2010 that figure was 28%.

The report flagged future problems due to the cutbacks in care services and noted the large proportion of over-50s looking after family. In the UK, 15% of over-50s reported themselves ‘carers’ almost double the figure in some Nordic countries.

Pearson warned that having no ‘institutional set-up’ to deal with social care would extract a high economic price. ‘Caring for family reduces a worker’s pay, their hours of work, affects their health. It’s a cost.’

The British government’s relentless attack on public services has created an ‘absolute crisis’ in care for older people, according to the charity Age UK.

United States

US health: expensive and inferior A recent OECD (Organisation for Economic Co-operation and Development) report into international health has found that Americans pay far more for healthcare each year than any other OECD country, yet still die earlier than their peers in the industrialised world.

The cost of healthcare in the United States is 62% higher than in Switzerland, which has a similar per capita income and also relies substantially on private health insurance. The OECD said American life expectancy of 78.2 years ranked the country 28th among member nations. The US ranked fourth from the bottom for premature mortality, a statistic focusing on deaths among younger people. It reflects dangers posed by violence, accidents and environmental hazards. Only Hungary, Mexico and Russia had a worse record.

Other negative characteristics of the US health system highlighted by the OECD included: • an ‘underdeveloped’ primary care system with a marked shortage of family doctors and high rates of avoidable hospital admissions for people with asthma, lung disease, diabetes, hypertension and other common illnesses.

• pharmaceutical costs about 60% higher than in a range of European countries.

Americans have fewer doctors and hospital beds, make fewer doctor visits, go to the hospital less often and stay for shorter lengths of time than about three-quarters of people in other OECD countries.

The OECD said one reason prices are higher in the United States is that the healthcare system lacks an effective government mechanism to keep prices down. In 2010, the Obama administration tried to change the trajectory of US health with its bitterly contested healthcare reform law, which sought to control costs by altering incentives for doctors and other providers. The legislation now faces a constitutional challenge in the American Supreme Court and Republican presidential candidates have called for its repeal.

8 | THE LAMP FEBRUARY 2012

PENSIONERS LIVE BENEATH THE POVERTY LINE

‘We calculate that each reform costs two years of improvements in quality.’

Britain

1,800000

2005 20% 2010

Britain

The charity’s director Michelle Mitchell told The Guardian newspaper that increasing numbers of older people with high care needs were ‘getting absolutely no support at all, or poor quality and limited support’ as a result of budget cuts.

Her comments were backed up by research showing that the number of older people who need significant care support, but receive no assistance, will reach almost 900,000 in 2012, rising to one million by 2015.

‘Care is in crisis and it is getting worse. We have evidence to show that local authorities have cut care for older people by 4.5% this year, and this at a time when social care is chronically underfunded anyway.’

The squeeze on care services comes as older people are being forced to ‘eke out’ an existence on the edge of poverty due to rising fuel and food prices, Mitchell said. Age UK says 1.8 million pensioners live beneath the poverty line, one million of them in ‘severe poverty’.

‘One of the biggest worries, whether you are in poverty or whether you are managing on a very, very low income, is that the cost of living is increasing rapidly. This is a story about breadline Britain and the eking out of an existence for millions of pensioners.’

South Pacific

Solomon nurses to aid Vanuatu The medical head of Vanuatu’s main hospital says a plan to send 25 Solomon Island nurses to Vanuatu will help address a desperate shortage of nursing staff.

The Solomon Islands and Vanuatu governments have signed a historic health deal allowing the Vanuatu government to recruit Solomon Island nurses. 25 nurses will be initially employed on a three-year contract.

Dr Wilie Tonkon, medical superintendent of Vila Central Hospital, says the extra nurses will be a boon: ‘We’re working at about 30% of what we should be so our nurses are over worked in terms of long hours and workload. This is going to be a big help for us in the hospital.’

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NEWS IN BRIEF

NEWS IN BRIEF

United States

Bung hips to cost billions

1 billion PAID BY SULZER ORTHOPEDICS TO

6800

PATIENTS

The failure of thousands of all-metal artificial hips is expected to cost American taxpayers and insurers billions of dollars in coming years, according to the New York Times (NYT).

The metal-on-metal hips, in which a device’s ball and joint are made of metal, are failing at high rates within a few years, instead of lasting 15 years or more as artificial joints normally do, says the NYT. The wear of metal parts against each other is generating debris that is damaging tissue and, in some cases, crippling patients.

In the litigious US system the failing hips have led to more than 5000 lawsuits and complaints against makers of all-metal replacement hips. All-metal implants account for nearly one-third of hip replacements performed each year in the United States.

Some 500,000 patients have received an allmetal replacement hip, according to one estimate.

Last year the DePuy division of Johnson & Johnson recalled one all-metal model that had been implanted in 40,000 patients in the United States. Some 3500 patients filed a lawsuit involving that device.

Ten years ago Sulzer Orthopedics paid a staggering $1 billion to settle claims by 6800 patients who received artificial hips and knees that were contaminated with industrial oil during the manufacturing process. The failure of all-metal hips is expected to make this payout look like small beer, with the financial burden contributing to the soaring cost of American healthcare.

Australia

NBN boost to veterans’ health The Federal Government has launched an $8 million trial of technology to support chronic care management of critically ill veterans living at home, using the National Broadband Network.

Veterans Affairs Minister Warren Snowdon

said the initiative would take advantage of reliable, high-speed, high-capacity broadband to improve the way health services are delivered to veterans.

‘Vital statistics will be monitored from home and veterans will also have access to high definition video consultations with their GP or nurse coordinator when required,’ he said.

‘This will ensure the veterans’ health can be observed, irregularities can be identified and appropriate GP intervention provided in a timely manner.’

The trial will take place in Toowoomba in Queensland, Coffs Harbour and Armidale in New South Wales, Mandurah and Geraldton in Western Australia, and Kingston Beach in Tasmania, and is expected to benefit around 300 veterans.

Australia

Aboriginal health bodies advise e-health caution The National Aboriginal Community Controlled Health Organisation (NACCHO) says data obtained from e-health records could provide an incomplete picture of Aboriginal health, with adverse implications for funding.

The organisation says de-identified data will provide useful statistics around populations and diseases, but warns that the opt-in for e-health records will provide ‘an incomplete picture’ of the health of indigenous people.

‘There are concerns that new funding models for government initiatives may be created from these figures, and that will cause the sector to be underfunded for its work,’ a NACCHO spokesperson said.

The Aboriginal Medical Services Alliance Northern Territory agrees. ‘The PCEHR (Personally Controlled Electronic Health Record) must be recognised as a tool for better health outcomes for all Australians, and not a method to determine resource allocation.’

The two organisations fear that de-identified data poses a risk to people living in small communities where it ‘is not unforeseeable that a person and their medical information can be identified by just their location and age range’.

10 | THE LAMP FEBRUARY 2012

Australia

Speak up for OHS The ACTU has launched a new national awareness campaign called Speak Up, to inform workers of their rights, and employers of their obligations, under harmonised health and safety laws.

ACTU Assistant Secretary Michael Borowick said it was important workers understood they would have enhanced rights to elect their own health and safety representatives under the harmonised occupational health and safety (OHS) system that began on 1 January, 2012.

‘Workers need to know that when they are confronted by a health or safety issue in their workplace, they don’t have to deal with it alone,’ he said. ‘They have an ironclad right, under law, to elect their own health and safety representatives. These reps act as watchdogs within the workplace, making employers comply with the law well before regulators have to become involved.

‘They have the right to stop work and demand improvements when there are health or safety concerns.

‘Employers who interfere with the work of health and safety reps, or refuse to allow them to properly represent their workmates, are breaking the law.’

The ACTU has launched a new website www.safeatwork.org.au as part of the campaign. The website will be a hub of information for workers and OHS reps about common health and safety issues, rights and obligations, tips for safer workplaces, legislation, and news. Workers will also be able to post questions about health and safety and get advice from union experts.

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THE LAMP FEBRUARY 2012 | 11

COVER STORY

Victorian nurses in fight to protect ratios A battle royale is evolving in Victoria as nurses defend their hard-fought for ratios from a well-organised attack by the Liberal government of Ted Baillieu.

A MAJOR CONFRONTATION LOOMS in the Victorian health system as the state’s nurses mobilise against the Baillieu Government’s push to abolish nurse/midwife ratios, replace nurses with health assistants and replace eight-hour shifts with split shifts and fourhour shifts.

After nearly 400 hours of fruitless negotiations in enterprise bargaining, as 2011 drew to a close the ANF (Vic) moved to industrial action and community rallies.

The government’s strategy has followed the script outlined in a secret plot signed off by health minister David Davis, in a Cabinetin-Confidence document dated May last year, that was leaked to The Age newspaper in November.

According to The Age:‘The Baillieu Government has developed a secret plan to goad the state’s nurses into industrial action so it can force them into arbitration, cut nurse numbers and replace them at hospital bedsides with low-skilled “health assistants”.’

What you can do to support Victorian nurses Register your support and participate in online actions through their Respect Our Work campaign website: respectourwork.com.au Engage in the campaign and spread the word through the campaign’s Facebook page: www.facebook.com/Re spectOurWork?sk=wall Donate to the Victorian nurses’ hardship fund.

Many nurses and midwives have had their pay docked for participating in industrial action. The hardship fund has been set up to help nurses and midwives, who are found to be in need, to put food on their dinner tables and to meet urgent bills. anfvic.wufoo.com/form s/2011-vic-nursesmidwives-hardship-funddonations/ A petition of 40,000 signatures was presented to Minister David Davis, following a march on his office on 16 December.

12 | THE LAMP FEBRUARY 2012

More than 10,000 ANF members, their families, friends and community supporters marched on Parliament House.

Community rallies were held outside Victorian metropolitan and regional hospitals during the last two weeks of December.

The Victorian cabinet paper detailed a plan to: • cut the annual nursing budget by $104 million; • make nurse-to-patient ratios more ‘flexible’; • replace RNs with low-paid, low-skilled ‘health assistants’; • introduce shorter shifts and split shifts.

The government estimated these cuts would deliver 4% in savings. In return it would agree to a 3.5% pay rise. By comparison,Victorian police late last year received a 4.7% per annum pay rise.

NURSES WON’T TRADE PATIENTS FOR PAY ANF (Vic) secretary Lisa Fitzpatrick says her members will never trade off patient safety for a pay rise.

‘Working with unlimited health assistants, as part of the existing nurse/patient ratios in acute care with seriously ill patients, is unacceptable. Nurses and midwives have serious concerns that the Baillieu Government fails to recognise that its push to replace nurses with health assistants, and cut their hours, ignores the strong evidence that shows lower qualified nursing numbers are linked to poorer patient outcomes,’ she said.

‘If patient care is compromised – or something goes seriously wrong – it will be the nurse or midwife, who has no control over staffing-level decisions, who must accept the legal responsibility and the legal consequences.

It will be the nurse or midwife called before the Australian Health Practitioner Regulation Agency and the courts.’

PROVOCATION IS GOVERNMENT STRATEGY A key government tactic in the secret plot revealed by The Age was to force the ANF into ‘forced arbitration’ rather than ‘consent arbitration’ in Fair Work Australia.

Due to limitations on Fair Work Australia’s

power under the Australian Constitution, forced arbitration can not include ratios. The dispute over ratios can only be resolved by genuine negotiation, or by reaching agreement on a process allowing a Fair Work Australia member to decide through less formal ‘consent’ arbitration.

Lisa Fitzpatrick says both the Baillieu Government and the Victorian Hospitals Industrial Association have lacked good faith during talks and have dragged out the negotiations.

‘Government negotiators staged a “breakdown” in negotiations to bait nurses and midwives into taking further industrial action that would pull the “forced arbitration” trigger.

Industrial action would also trigger Federal Court proceedings against nurses and midwives and the ANF.’ NURSES WALK A FINE LINE Despite the legal dangers presented by industrial action, Victorian nurses have been successful in maintaining pressure on the government.

Results of a secret ballot of 30,000 members (the largest protected action ballot in Australian history) conducted by the Australian Electoral Committee, were released on 4 November and showed 98% support for industrial action, including closing beds.

Protected industrial action began on 12 November. A mass meeting at Melbourne’s Festival Hall on 21 November moved to continue closing beds, implement bans on paperwork and for nurses to wear their campaign t-shirts at work.

Three days later, more than 10,000 ANF members, their families, friends and community supporters marched on Parliament House.

The ANF (Vic) had to change tack after Fair Work Australia suspended protected industrial action for 90 days, after the government argued that industrial action endangered or threatened to endanger the health, welfare or safety of the community. The ANF complied with the order and moved from industrial action to a series of community rallies across Victoria.

More than 30 community rallies were held outside Victorian metropolitan and regional hospitals during the last two weeks of December. A petition of 40,000 signatures was presented to Minister David Davis, following a march on his office on 16 December.

The same day, a statewide ANF members’ meeting moved to give individual consideration to resigning en masse from the Victorian public health system, in light of the risks to registration, duty of care and deterioration of employment conditions.

As The Lamp went to press, conciliation talks between ANF, the Victorian Hospitals Industrial Association and Baillieu Government were to resume in Fair Work Australia, (FWA) with the assistance of a FWA commissioner.

THE LAMP FEBRUARY 2012 | 13

COVER STORY

Ratios make the difference Tracey Meacham was driven out of the Victorian public health system by Jeff Kennett’s scorched earth policy, came back when ratios were introduced and is now perplexed by the Baillieu Government’s attempt to roll them back.

TRACEY MEACHAM HAS SOME BAD memories of working as a nurse in Victoria under Jeff Kennett.

‘It was very stressful, full of pressure and hard work and conditions were unsafe.We just didn’t have enough nurses,’ she says.

At the time, Tracey was working at the Peter MacCullum Cancer Institute as an oncology nurse.

The pressures and the risks finally drove her out of the profession.

‘It wasn’t a decision I made easily. It was difficult.

I thought I’d chosen the wrong career. I had colleagues leaving and making other career choices.They too found it too hard and too stressful,’ she says.‘There weren’t enough of us to give good patient care. I had fears for patient safety. I also had fears for my national registration. It was on the line if safety wasn’t right.’

Tracey says she was aware that if something went wrong she would be held personally responsible.

‘You’d be drawn over the coals. You’d end up taking the blame. So, you found yourself powerless, that you were pushed into a corner and the only choice you had was to resign.’ …continued page 16

14 | THE LAMP FEBRUARY 2012

THE GESTATION & BIRTH OF VICTORIAN RATIOS: A TIMELINE

1992 ‘I noticed that ratios made a difference.

I found it safer and I felt supported.’

Life in Victoria’s hospitals became very tough after the election of the Kennett Liberal Government. Within two years of being elected, Kennett had slashed permanent employment in the public sector. About 16% of those in the health workforce lost jobs. Incredibly, the government argued that there was an over-supply of nurses and eliminated 2000 nursing positions.

This slash and burn of nurses’ positions occurred during a period of steeply increasing demand in public hospitals.

1992–99 By the end of the 1990s, when Kennett had allowed hospitals to staff as they wished, with flexibility, there were more than 1300 vacant permanent nursing and midwifery positions and 400 hospital beds closed every day. During the Kennett years, ANF Victoria honed its tactic of bed closure as a weapon of industrial action.

1999 The election of the Bracks Labor Government created the political opening for the introduction and implementation of nurse-to-patient ratios.

2000 Victorian nurses include nurse-to-patient ratios as a centerpiece of their enterprise bargaining campaign.

The ANF argues that the use of agency nurses is driving committed permanent nursing staff to leave the health sector and that this will undermine the professional integrity of nursing and the supply of nurses overall. When the ANF puts it case to the Australian Industrial Relations Commission, testimony from nurses about their workloads is so compelling that even employers begin to acknowledge the need to address the issue of workload and its influence on nurse professionalism and patient safety. The ANF convincingly argued that a system-wide problem of work intensification called for a system-wide solution. On 31 August 2000, the AIRC ruled that nurse-to-patient ratios represented the most effective response to both the workload and staffing crises facing the Victorian health sector. The Bracks Government agreed to fund nursing positions to comply with the outcome of the arbitration proceedings, allocating $198 million to fund ratio positions. In 2001 another $300 million was set aside.

2004–07 With the Victorian Labor government still in power, ratios were renewed in Enterprise Bargaining Agreements (EBAs) negotiated in 2004 and 2007, but only following sustained pressure from nurses.

THE LAMP FEBRUARY 2012 | 15

‘It’s crazy. I can’t believe here we are today fighting for ratios.’

HIP members beneďŹ t from great insurance

It became too much for Tracey and after 10 years as a nurse, she left. ‘I went off and had a family, worked in a sandwich bar and in family day care looking after kids. But I missed nursing.You don’t go into nursing. It chooses you. I really missed it.’ Six years and a change of government later, an advertising campaign that extolled the virtues of improved working conditions, with ratios, rekindled Tracey’s desire for the profession. ‘It was splashed all over the papers “Come back to nursing. Ratios have been introduced.� They offered refresher courses for six weeks. It was fantastic. The government was using ratios to get people back. And we did come back. ‘When I walked back in the door I thought “this is the place for me.� I noticed that ratios made a difference. I found it safer and I felt supported.’ Tracey says she is stunned that the government now wants to take it all away. ‘It’s crazy. I can’t believe here we are today fighting for ratios. 10 years ago it got us all back. Now we are defending them again. It makes me very sad. ‘There’s no other workforce that has to fight so hard for community safety. It doesn’t seem fair.’ Tracey says she and many others are prepared to resign en masse if that is the only way to bring the government to its senses. ‘It’s a huge decision. It’s very out of character for me to do this but I feel very passionate. I look at nurses before me and wonder what is the legacy I will leave behind? I have to fight. Resigning is about taking a stand. If we lose ratios we’ll never get them back.’ Tracey says NSW nurses should be appreciative and protective of what they have won. ‘You can’t take ratios for granted. Celebrate and talk about them.They keep management honest. It means they have to keep staff levels up and safe. Ratios need to be talked about and be part of the language.’

HIP works hard to offer members better income protection and death cover.

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SO FAR IN THE CURRENT CAMPAIGN: A TIMELINE may 2011 The cabinet of the Victorian Liberal government signs off on a secret plot to provoke the state’s nurses into industrial action so it can force them into arbitration, cut nurse numbers and replace them at hospital bedsides with low-skilled ‘health assistants’.

july 2011

16 november 2011 Fair Work Australia hands down a decision ‘suspending’ protected industrial action for 90 days from 17 November, rather than terminating as sought by the government.

9 november 2011

24 november 2011 More than 10,000 ANF members, family, friends and the community rally in Bourke Street Mall and march to Parliament House.

The Age newspaper publishes a story regarding lock out plans of the Baillieu Government.

12 november 2011 Protected industrial action commences, including bed closures and bans on paperwork.

16 december 2011 Statewide ANF members’ meeting decides to give individual consideration to resigning en masse from Victorian public health system, in light of risks to registration, duty of care and deterioration of employment conditions.

16 december 2011 december 2011 More than 30 rallies held outside Victorian metropolitan and regional hospitals.

ANF members deliver petition containing more than 40,000 signatures to Minister David Davis following a march to his office from Dallas Brooks Centre.

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ANF serves a ‘log of claims’ on each of the public health services that make up the Victorian public health sector.

This log took the form of the current EBA, with amendments to reflect improved ratios, new ratios and various improvements in wages and conditions

october 2011 The Australian Electoral Commission (AEC) undertakes the largest protected action ballot in Australian history.

More than 30,000 ANF members received a ballot paper and more than 98% of nurses and midwives approve the proposed industrial action, allowing protected action including bed closures.

16 | THE LAMP FEBRUARY 2012

This information from Health Industry Plan contains general advice only. It is not speciďŹ c to your personal ďŹ nancial situation, objectives or needs. Get the facts (including a Product Disclosure Statement) from www.hipsuper.com.au or talk to a ďŹ nancial advisor before making any super decisions. The Trustee of HIP ABN 50 030 598 247 is Private Hospitals Superannuation Pty Ltd ABN 59 006 792 749, AFSL 247063.* This calculation is based on members aged between 16-36 at four units of cover, and only if members apply for an additional three units of cover within 60 days of joining the Fund. Insurance beneďŹ t is reduced each subsequent year. Please refer to the HIP Insurance Booklet or PDS for full details. ** Subject to a maximum monthly beneďŹ t of 75% of the member’s monthly income. Please refer to the HIP Insurance Booklet or PDS for full details.

COVER STORY

Fair Work Act needs more work Although it has delivered many benefits for workers, employers have found a major weakness in the Fair Work Act and, as Victorian ANF Industrial Officer Leigh Hubbard explains, are setting out to exploit it.

CERTAINLY, THE FAIR WORK ACT introduced in 2009 is much better for protecting vulnerable individuals and for initiating and conducting the enterprise bargaining process.

Among other things the new Act: • reintroduced unfair dismissal in workplaces of less than 100 employees; • abolished individual contracts (Australian Workplace Agreements); • introduced a more stringent test for new agreements against existing Award and Agreement standards; • established new bargaining rules that require both sides to bargain in good faith and ensure that an employer can’t put dodgy agreements to a vote without time for proper consideration by employees.

But when it comes to intractable and large-scale disputes, the Fair Work Act is found wanting.The good faith bargaining provisions of the Act are welcome, but the intractable dispute they were designed to overcome – at the Cochlear bionic ear plant – remains unresolved. Unlike New Zealand, where once bargaining commences an agreement has to be reached, the legislation places no pressure on Australian employers to do more than sit politely at the table (surface bargaining).

EMPLOYERS CRY WOLF In situations where unions organise their members and hold a ballot to take protected industrial action, a key problem is within section 424 of the Act. In economically significant or health/community related industries, it is incredibly hard to avoid having protected industrial action either suspended or terminated

by Fair Work Australia. This can occur when Fair Work Australia determines either that the action “has threatened, is threatening or would threaten” to “cause significant damage” to the 18 | THE LAMP FEBRUARY 2012

Australian economy or part of it (as in the Qantas dispute) or it will “endanger the life, personal safety or health, or the welfare of the population or of a part of it” (as withVictorian nurses).

Where protected industrial action is terminated there is a 21-day period of conciliation (that can be extended to 42 days if there is progress), after which time there must be arbitration (an industrial action related workplace determination under s266 of the FWA) as soon as practicable.

ANF Industrial Officer Leigh Hubbard

When it comes to intractable and large-scale disputes, the Fair Work Act is found wanting.

THE QANTAS HYPOCRISY In the example of Qantas, the employer engineered the termination of protected action, and the move to arbitration, by grounding its fleet and locking out its workforce. Think of the irony.A company makes an application to take away workers rights to protected industrial action, by initiating its own industrial action, which it then claims is significantly harming the Australian economy! In the Qantas example, the legislation left the Fair Work Australia full bench with little choice but to terminate the industrial action. Remember, the only action Qantas pilots had taken was to wear red ties and make in-flight announcements. It is no wonder there are now calls for the legislation to be amended to stop such an abuse by employers.

In the case of the Victorian nurses, the second limb of section 424 came into play; that of endangering health and welfare.A cabinet document leaked in early November revealed that the Baillieu Government strategy was to have the ANF protected action terminated and then seek arbitration of the dispute.

Just as in the case of Qantas, the government knew that on matters of workplace flexibility and ‘managerial prerogative’, members of Fair Work Australia (FWA) have been historically

reluctant to impose conditions or restraints.

So, whether it is limits on contracting work overseas, in the case of Qantas, or skill mix clauses or nurse-patient ratios as in the case of nurses, management knows it is highly unlikely that FWA will act decisively to limit management discretion in these areas.

An added barrier for Victorian nurses is that, due to constitutional law and the limits on the referral of Victoria’s state industrial relations powers to the federal system in relation to public sector employees, it is possible that Fair Work Australia has no jurisdiction to arbitrate matters related to staffing or skill mix.

At the very least, there could be six months arguing these jurisdictional issues in the High Court. The Victorian Government, with an agenda of removing nurse-patient ratios and introducing short and split shifts, has counted all along that Fair Work Australia would be either unwilling or unable to include such matters in arbitration.

FAIR WORK TAKES CONSERVATIVE POSITION Fair Work Australia takes a very conservative view when deciding whether to suspend or terminate protected industrial action under section 424. In the Victorian nurses case, the FWA full bench, when presented with very thin evidence of delays to elective surgery, or of a few people staying longer than normal in ED, opted for a safety first approach. This was despite the ANF Victorian branch taking great care when closing beds and cancelling elective surgery (their advice to members was ‘if in doubt, open your reserved emergency beds’). FWA decided to suspend the protected industrial action for 90 days rather than ter-

minating it. One suspects that the full bench, being acutely aware of the Cabinet strategy of engineering an arbitrated outcome, did not want to be seen as a pawn of the state government. This was a shock to management and has lead to the current stalemate.

So, the right to take protected industrial action is hollow for many groups of workers.

But what happens next?

The ANF Victorian Branch took unprotected action for several days but quickly faced employer applications for an injunction to stop the industrial action in the Federal Court.

Once an injunction is granted, any breach will lead to contempt of court proceedings and the risk of heavy fines. In addition, the Fair Work Ombudsman indicated that it was ready to prosecute the union for multiple breaches of the Fair Work Act.There was also a risk of common law damages actions; last year Qantas won damages of several million dollars against the Transport Workers’ Union for unprotected industrial action that only lasted a few weeks.

The stakes are high and the options available to unions and their members are few.

Victorian nurses are determined that they will not be forced into an arbitration that might deliver wage increases, but cannot protect staffing and professional standards. In more recent times the ANF Victorian Branch has turned to community campaigning and a discussion with members about the prospect of mass resignations – on the basis that such resignations are not ‘industrial action’. As The Lamp went to press, more than 90 workplace meetings are being held to determine the attitude of members to that proposal.

Victorian nurses are determined that they will not be forced into an arbitration that might deliver wage increases, but cannot protect staffing and professional standards.

THE LAMP FEBRUARY 2012 | 19

RATIOS IN NSW

Ratios lower stress and deliver better care The orphopaedics and rheumatology ward at Royal North Shore Hospital was among the first to implement ratios in NSW and despite teething issues they are delivering positive benefits for patients and staff.

FOR STAFF IN WARD 9A AT ROYAL North Shore Hospital, Sydney, the introduction of the new nurse-to-patient ratios, won last year, has brought increased capacity for better care and for staff training.

It also came with perfect timing, with the ward due to expand later this year with a move into a new building.

The nursing unit manager of the orthopaedics and rheumatology ward, Rose Hills, said ratios required her to find the equivalent of five full-time nurses and ‘that is quite daunting, but has been worth it’.

It was also a challenge of change management of existing staff, with the initial elation followed by an adjustment period then another rise in mood.

‘The recruitment process is slow in hospitals. A big bonus for the ward is we have got a lot of permanent staff and didn’t have to use a lot of casuals,’’ she said. The ward has more than 20 staff for its 25 patients covering the 24/7 of shifts.

The ward has also hired assistants in nursing.

‘I advertised for endorsed enrolled nurses but didn’t get a response. But I also advertised for nursing assistants - secondyear undergraduates (check) - and got a massive response,’’ Rose said.

The ward now has 85 per cent registered nurses to 15 per cent non-registered, 20 | THE LAMP FEBRUARY 2012

‘I’ve noticed a lot less beds ringing. Staff appear less stressed and are getting breaks in time, and the ward is tidier.’ compared with 89 per cent to 11 per cent before the change.

Maybe get another comment about this from Rose.

‘When the funding for the new ratios started in July, my ward was one of the first to shift to the ratios. We thought it best to recruit before the ratios, so we had our own staff rather than depending on casuals.

We had quite a lot of meetings, on how to make Ward 9A a much better working environment and how to utilise staff best.

‘The problem before ratios was that on the evening and night shifts, the nurse in charge also had to take on patient load, as

well as on the morning shift on Sundays,’ Rose said.

‘I’d come in on Monday morning and the staff would be stressed and feeling unable to complete their work in a satisfactory fashion.

‘The weekends were the tipping point.

Some senior staff were on but they would be very stressed, with the patient load very challenging. Staff would be unloading concerns on Mondays about the weekend, about not being able to adequately look after patients.They were just barely getting by.

‘Because it’s a surgery ward, a lot of patients don’t come back until the afternoon shift, so the evening shift is very busy and that flows on to the night shift,’’ she said.

Before the new ratios, the ward had six nurses on the morning and afternoon shifts and three on the night shift, while at weekends there were seven on Saturday morning, five on the afternoon shift and three at night. On Sundays there were six, five and three respectively.The shifts in the morning start at 7am, the afternoons at 1.30pm and, at night, with 10 hours instead of eight, three shifts start at 9.30pm and one at 11pm.

‘After recruitment, by early October, we had enough to start the new ratios,’’ Rose said.

THE LAMP FEBRUARY 2012 | 21

RATIOS IN NSW

‘The ratios are calculated on the basis of six patient hours per nurse, over a week.

There was me and seven staff on the morning shift, seven on the afternoon and four on the night. At weekends it was seven, six and four.’

Rose says the experience of change will benefit the hospital when it moves to new quarters now under construction.Ward 9A moves at the end of November and will increase to 30 beds from 25.

‘We’ve gone through a big change with highs and a bit of a low,’’ Rose said. ‘We’ve had to look at how to work in a new environment. This experience has equipped us to do change and it looks achievable with the new ratios. The increase in staff to accommodate patients means we won’t have to worry.’

Generally, Rose said staff were much more satisfied with their work. ‘It is a much safer working environment and we are more likely to retain staff. We have only a 0.6 vacancy in our ward. We’ve got a lot of very good staff.We have had minimal clinical errors and complaints are few. Before, it ran reasonably well but the frustration level was high.’

‘After implementation almost everyone was happy and positive and noticed changes, such as things they could start to do. For example, on the night shift, the nurse in charge has no patient load now.’

‘For the two permanent night shift staff, it has made an enormous difference. Previously they felt unable to complete their tasks satisfactorily. They were not able to get all charts checked until 2am or 3am or pick up issues earlier or speak to the patients and hear their concerns. The ward is more organized now.’

Rose said other benefits aside from those relating directly to patient care were more time for in-service staff education,

‘One patient said he felt very handsome.The nurse had time to shave him and comb his hair.’

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‘I was able to spend more time with the student nurses under my supervision and go through policies and procedures more thoroughly.’

breaks on time and more time for equipment checks.

‘It’s a big change. Before, people were flat out. Now everyone gets a fair go, including having the time to do in-service hours, which is important, as it is now a requirement for registration of nurses.’

‘There was a short period of people not fully understanding the nuances of the system. A few were under the impression 1:4 meant only four patients each. I think we had to go through that, and have people read the award. With six hours NHPPD, we couldn’t have four patients each but there would be enough staff around to help.

‘We slowly introduced team nursing in the process, and it is working really well, and team nursing has become embedded in our ward. 95 per cent are nursing in this way and finding it very beneficial.

‘I think with change, there is a high, then a bit of a low and then back up again.’

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22 | THE LAMP FEBRUARY 2012

ACTU CENSUS

Voices from working Australia

With more than 40,000 participants, the ACTU’s Working Australia Census was one of the biggest surveys of workers in Australia’s history. Its findings are a fascinating snapshot of contemporary working life.

ACTU PRESIDENT GED KEARNEY says the results of the Working Australia Census highlight the real issues, concerns and aspirations of the majority of Australian people.

‘For them, what matters are not esoteric economic arguments or political gamesmanship, but tangible things like good wages and conditions, dignity and respect at work, time with their family and friends, and the daily struggle of making ends meet,’ says Ged, a former nurse and ANF Secretary.

She said census respondents were overwhelmingly union members who were committed to their jobs and their communities.

‘Union members are good people. They are community people. Half of them are volunteers outside of work, compared with a third of the general population.They are dedicated to their jobs and are hard working.’

Nearly half (48.3%) of respondents had done voluntary work in the previous 12 months, compared to the Australian Bureau of Statistics figure of 34% for the overall population.A third of Working Australian Census respondents said they remained in their current job because they felt it allowed them to positively contribute to the community.

SQUEEZED BY WORK The findings show that many people are working additional hours to cope with high workloads and a lack of resources: 24 | THE LAMP FEBRUARY 2012

• 61% work more hours than they are paid for; • 73% are regularly contacted outside of work hours, about their job; • 58% have paid for work-related expenses and not been compensated.

Ged sees this as a ‘productivity squeeze’, meaning that workers achieve productivity through unpaid work and greater pressure.

‘For workers, productivity isn’t an abstract expression. All too often it means unpaid hours, phone calls out of work hours and doing more for less. Flexibility is actually a code for giving employers the ability to cut hours, or even sack you, when it suits them.’

The survey reveals that the demands of work are translating into less-than-flattering attitudes towards senior management: • More than a third (33.8%) of respondents said that senior managers in their organisation did not take a genuine interest in improving conditions at work.

• A third (32.7%) also disagreed with the statement ‘senior management is competent and has a plan for the future’.

THE FEMINISATION OF UNIONS Ged said the Working Australia Census picked up a substantial shift in the profile of the typical union member.

‘The blue-collar base of the union movement remains strong, but there is a shift in over-

all membership towards female workers in jobs like teaching, nursing, the community sector and the public service,’ she says. ‘Twenty years ago about one in three union members was a woman. Now, our gender split is close to 5050, and in 2010, for the first time, union density among women was higher than for men.’

THREE STRUGGLING GROUPS The Working Australia Census identified three groups that are struggling to balance the pressure of work, family and finances: • The sandwich generation – a group of women who have carer responsibilities for children and parents, while also working full time. The single biggest thing they said would improve their work life was to have the flexibility to balance work and family • The forgotten blokes – men aged 45 to 64 who said they were currently not working, but were looking for work and having difficulty finding it. More than half (52.2%) said they couldn’t find work because employers thought they were too old.

• The insecure youth – workers under the age of 25, employed and living out of home and facing labour market and financial stress. 27.7% said they were finding it difficult, or very difficult, to get by on their current household income.

Nurses conflicted between home and work in duty of care Sandwiched between the needs of the generations in an ageing society, nurses are caught between multiplying pressures that can cost them their jobs.

For some workers, having both children and ageing parents is a mixed blessing that comes at the cost of permanent employment.

The burden of care tends to fall more heavily on women, especially professionals such as nurses, whose working lives are already stressful due to their obligations to patients, and who have rules to meet.

One finding of the ACTU’s Working Australia Census, a survey of 41,600 people, provided confirmation of the existence of a group the ACTU terms ‘the sandwich generation’, usually women working full-time or permanent part-time. They can also be called the ‘three-jobs generation’ in the sense they have unpaid care responsibilities for their parents or parents-in-law, their children and a paid job.

Until nearly a year ago, Lee McKinney worked full-time as a nurse in the intensive care unit at St George Hospital, Sydney. Now she works as a relief casual, averaging about two afternoon shifts a week, in clinical emergency response.

Lee is a mother of three children, aged 11, 10 and 5, and a part-time carer for her father, who is in his early 70s. Until recently, Lee’s parents were healthy with no chronic problems. However, her father, who lives in his own home with his wife, now travels regularly to hospital for cancer treatment. Although Lee’s father is relatively young, the conflict Lee faces is of a kind likely to grow in our ageing society.

For Lee, her sense of professionalism ruled out taking high levels of absences to care for her children and her father. She felt she would let down colleagues in her nursing unit if she tried to maintain full-time employment without keeping up the usual shifts. She decided, reluctantly, to step aside from permanent employment at the hospital. It was her call, and a tough one.

‘It’s too difficult on a permanent roster, with three children of your own,’ says Lee. ‘My husband and I had to make a decision.

Until the kids had settled down, that [casual] would have to be the basis of work.’

She found support from the hospital and her unit.‘I had a fantastic boss in the intensive care unit where I worked. If ever there was an issue, I could go to her or give her a call and explain what was going on.

‘It wasn’t like I was pushed out.The hospital tried to accommodate my situation. It was my philosophy, [about] how dedicated I should be.’

With teamwork central to the intensive care unit’s operation, Lee thought it was unfair to leave the unit with an agency replacement, if one could be found, when she was unable to work.Where teamwork is involved, because of the inter-reliance of staff, it is problematic for the members of a nursing unit to work with someone not experienced in the unit’s

work, or familiar with hospital policies and procedures.

Lee believes more staffing and flexibility would ease pressures on employers and nurses.

‘Patients are much sicker than before. The acuity is rising,’ she says.‘More staff would help.

A better patient ratio wouldn’t wear people down so much. If a hospital is well staffed, it has a very safe and very supportive environment.’

Lee is one of a generation of nurses that has been coping with both older and younger care.

‘Our parents are going into their 70s and having health problems,’ she says. ‘My father has been sick for about 10 months. He developed cancer and it rapidly spread. I and my two sisters have done everything we can to make him comfortable at home.’ That care includes taking him to and from hospital.

‘I run the in-laws around to a point, too,’ Lee says.

‘A better patient ratio wouldn’t wear people down so much.’

THE LAMP FEBRUARY 2012 | 25

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Friday 29 June 2012, Armidale

Friday 6 July 2012, Albur y

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Friday 17 August 2012, Griffith

Friday 21 September 2012, Albur y

Member Memberss $40 Non Member Memberss $85

PRIVATE HOSITALS

New deal for 1100 SAHL nurses

Pay rise at St Vincent’s Private

Workloads were top of the agenda when the NSWNA negotiated a new agreement with one of Sydney’s biggest private hospitals.

The NSWNA has won pay increases and new and improved allowances for nurses at St Vincent’s Private Hospital

ABOUT 1100 NURSES EMPLOYED

by Sydney Adventist Hospital Limited are benefiting from a new agreement negotiated by the NSW Nurses’ Association.

The agreement covers Sydney Adventist Hospital in Wahroonga (352 beds), Dalcross Adventist Hospital in Killara (more than 50 beds) and the San Day Surgery in Hornsby.

It delivers a 3.9% increase in wages and allowances paid from 27 September 2011 and a further 3.75% increase from 1 July 2012.

It introduces a localised process to resolve workload issues – something Sydney Adventist Hospital nurses have wanted for several years.

Other benefits include an increase in paid parental leave to 14 weeks for those with a minimum four years service, a redefined Assistant Director of Nursing Classification with increased pay rate and introduction of Nurse Practitioners.

Nurses voted overwhelmingly in support of the agreement negotiated by a team of nurse representatives from most work areas and classifications plus NSWNA officers.

‘The nurse representatives on the negotiating team all worked tremendously hard plus we had terrific bargainers from the union,’ said NSWNA Branch Secretary Julia Taylor.

‘We had a really broad representation of nurses on the negotiating committee,’ said Julia, a clinical nurse specialist.

‘That gave us a clearer outlook on what was happening and what people were thinking in different parts of the hospital, and we were able to keep everyone informed.’

Union membership at Sydney Adventist 28 | THE LAMP FEBRUARY 2012

‘Now we have to make the workload clause work for us.’

Hospital Limited jumped by 30% during the two-month campaign for the new agreement.

Julia said the negotiating team made a special effort to go into areas with low union membership to encourage people to join.

‘We had lots of meetings and discussions with nurses and they showed a lot more interest in the negotiations this time.’

She said members were happy they finally achieved a clause in the agreement setting out a procedure to deal with workload issues at a local level.

The workload clause provides a clear escalation process with a time frame to resolve problems. It specifies factors to be taken into account including occupancy levels, nurse hours per patient day, patient acuity and the skill mix among nurses.

A staff survey on workloads conducted by the NSWNA got 200 written responses.

82% of the 200 reported having to work through a meal break in the previous three months with 40% saying it happened ‘too many times to count’, ‘all the time’ or more than half the time.

The survey helped mobilise support for the campaign and put workloads at the top of the union’s agenda.

‘The union reported the findings to management, which helped convince them to deal with the issue,’ Julia said. “Now we have to make the workload clause work for us.’

The NSWNA and the Sydney Adventist Hospital will train nurses to help raise understanding of workload issues and negotiate improvements.

‘We have to make sure that nurses have someone to talk to in their work area who can help them solve their problems.’

A UNION-NEGOTIATED ENTERPRISE agreement at St Vincent’s Private Hospital recognises the value of post-graduate qualifications for nurses with the introduction of a new allowance.

The allowance adds $30 per week to the base rate of pay of nurses who are required to have relevant post-graduate qualifications. Those required to have a master’s degree get an additional $30.

Management had resisted this allowance in negotiations for earlier enterprise agreements.

Incorporating the post-graduate allowance into the base pay rate delivers an increase in all payments such as annual leave loading, shift penalties and superannuation.

St Vincent’s Private in the Sydney suburb of Darlinghurst employs about 620 nurses. Under the agreement all receive a 3.9% pay increase fully backdated to the first full pay period in January 2011, followed by a 3.5% increase from the first full pay period in January 2012 and 3% from the first full pay period in January 2013.

Union members unanimously endorsed the agreement negotiated by a combined team of ward representatives and NSWNA officers.

NSWNA Branch President at the 250-bed hospital, Paul Pager, said members were generally pleased with the agreement, especially the size of the pay increase, the fact that it is fully backdated and the recognition of post-graduate qualifications.

‘We had good turnouts at most membership meetings to discuss the negotiations and a very good turnout at the final meeting,’ said Paul, an acting nurse educator.

‘Management tried to get us to relinquish some allowances in return for the pay rises but through negotiations and the combined effort of all the nurses involved, management eventually agreed to the increases without any trade offs.’

Under the agreement all receive a 3.9% pay increase fully backdated to the first full pay period in January 2011, followed by a 3.5% increase from the first full pay period in January 2012 and 3% from the first full pay period in January 2013.

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aged care

30 | THE LAMP FEBRUARY 2012

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aged care

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aged care

34 | THE LAMP FEBRUARY 2012

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OBITUARY

Sandra Elizabeth Weeks ‘THE SINGING NIGHT NURSE’ 27 February 1952 — 8 June 2010 [e\

Sandi was gifted in countless ways and could create anything from almost nothing: weaving any odd bit of grass, potting with local mud, spinning wool, knitting, crochet, sewing, cross stitch, tatting, gardening, cooking, preserving fruit, vegies and jam, and of course making her amazing chilli relish. We all remember saving bottles for her famous bottle wall.

Sandi was born in Exeter, England and came to Australia as a young girl with her family in the early 60s. She commenced training at Parramatta District Hospital in 1972, graduating as a Registered Nurse in 1975 and being awarded the Parramatta Ladies’ Auxiliary Memorial Prize for ‘proficiency in the operating theatre’, reflecting her extremely proficient personality.

Proud Proud to o be the the lawyers lawyers for for NSWNA NSWN NA me members mbers

Sandi worked at Baulkham Hills Private Hospital theatre from 19761977.After this she and her young family moved to the North Coast where she worked at Crowley Retirement Village, Ballina Hospital and St Vincents Lismore.

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Agitated, Disruptive – Even Aggressive Patients?

Finally, in 1987, she found the ‘Royal’, Campbell Hospital, Coraki, where she worked full time until 2006.

She then packed her bags and headed north in an old bus decked out for living accommodation with her partner, Morrie.The bus had a mind of its own and returned to Coraki where Sandi took up a position as Practice Nurse at the Coraki Medical Practice in late 2006. During her time there she was diagnosed with breast cancer but continued to work when able. She endured several lots of surgery, extensive chemotherapy and radiotherapy. Sandi was a dedicated nurse whose brilliance shone in the field of emergency nursing, hence becoming our educator for many years.A staunch unionist, she represented our site as NSW Nurses’ Association delegate for 15 years.

Since 1980, CPI has been teaching health care professionals proven methods for managing difficult or assaultive behaviour. To date, over six million individuals—including thousands of nurses and other health care professionals—have participated in CPI’s highly successful Nonviolent Crisis InterventionSM training course.

Visit crisisprevention.com/LAMP for more information and to download our FREE eBook, Creating a Safe and Caring Work Environment, containing insightful tips you can share immediately with your staff.

Australia and New Zealand Office PO Box 509, Dulwich Hill • Sydney, 2203, NSW Free Phone: 1300 244 674 Tel (Local Australia): +61 (0) 2 9516 5177 Email: information@crisisprevention.com • crisisprevention.com

36 | THE LAMP FEBRUARY 2012

We will always remember Sandi as a person of integrity who prided herself in her punctuality and had the ability to articulate her exact thoughts in a professional manner. Her strength of character enabled her to deal with her illness in stoic fashion. It was both a pleasure and a privilege to have worked with her, been a part of her life and to have had her as a part of ours.

— Margaret Harris and the staff at Campbell Hospital, Coraki

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We can help!

This course teaches staff not only how to respond effectively to the warning signs that someone is about to lose control, but also addresses how staff can deal with their own stress and anxiety when confronted with these difficult situations.

Poetry recitals became an expected part of Sandi’s company, or singing meaningful songs at any time of the day or night. Composing lengthy, apt poems at every opportunity came naturally to her, as did her impersonations of doctors, co-nurses and patients – all in good fun. On one occasion she arrived at a party with all the attributes of an elderly lady – it took us a while to work out who it was. Sandi gave generously of her time and talents at Brownies and Girl Guides in her local community.A true intellect, her very neat scribe quickly became a memorable part of life at The Campbell.

ARCHI Join us at an upcoming 2012 training course: 21–24 Feb. Perth, WA 28 Feb.–2 March Sydney, NSW 6–9 March Kent Town (Adelaide), SA 13–16 March Brisbane, QLD 20–23 March Melbourne, VIC Priority Code: LA120

Australian Resource Centre for Healthcare Innovations

ARCHI is a free, national knowledge sharing and networking service for health professionals, supporting clinical practice improvement and innovation. ARCHI promotes discussion, sharing tools and resources as well as connecting health professionals across the country.

What’s new on ARCHI? Father Links Baby Shed Project - A health promotion project offering early intervention to increase fathers’ engagement with their babies and enhance their confidence in parenting.

Ambulance to Emergency Department Handover Project - This handover protocol ensures the smooth transfer of pre-hospital care in the acute setting, standardising the information and processes that surround handover.

Visit the ARCHI website today at

www.archi.net.au

THE LAMP FEBRUARY 2012 | 37

Q&A ‘N

ASK JUDITH

$8

NEW!

On call on day off

NEW!

I work in a public hospital and everyone in the unit is required to do their share of on call. However, when I am placed on call after my last shift, before proceeding rostered days off, I only get paid the regular on-call allowance, not the on-call-onrostered-day-off allowance. I think I should be entitled to a higher allowance.

Yes, you should be paid the higher rate. The Public Health System Nurses’ & Midwives’ (State) Award sets out the two on-call allowances at clause 12 (ii) (a) for the lower allowance of $3.17 per hour with a minimum of $25.34 and at (b) for the higher allowance of $6.34 per hour with a minimum of $50.68.

Two questions immediately arise: what happens when on call from end-of-shift to start-of-day-off, and what happens on the day rostered back-to-work, but before start-of-first-shift?

In the first instance, the on call on day-off allowance is paid and this is why, in the example you describe, you should be paid the higher rate. In the second instance, the lower rate is paid from midnight to the commencement of first shift back. This is set out in Department of Health Information Bulletin 2004/17, “Public Hospital Nurses’ (State) Award — On Call and Call Back” issued 18 May 2004.

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I have worked full time in a permanent position in a private practice for 20 years.

I have never taken long service leave. Do I have an entitlement and if so how much?

You need to check your local Enterprise Agreement or Union Collective Agreement for the Long Service Leave (LSL) entitlement. If the agreement draws the entitlement directly from the NSW Long Service Leave Act 1955, the provisions of the Act apply.

The Long Service Leave Act provides at section 4 (2) (a) (i) an entitlement of two months for 10 years’ service and one month for each five years thereafter. So, for 20 years’ service the entitlement is four months LSL. Service means “service of a worker with an employer”. This is defined at 4 (11) (a) as “continuous service, whether on a permanent, casual, part-time or any other basis, under one or more contracts of employment”.

That is, the service must be continuous with the one employer.

I am an EN working in a nursing home. I recently returned to work following maternity leave and like to go home in my meal break to nurse my baby. My DoN is saying that I must stay within the facility, even on my meal breaks, which are unpaid. Is this correct?

You should be able to go wherever you like in your meal break if it is unpaid. If there is any requirement for you to stay in the facility during unpaid meal breaks, you are entitled to be compensated by way of an oncall-during-meal-break allowance.

This does not remove your entitlement to a meal break, it just means that you cannot leave the facility while taking your break. If your DoN insists on you staying in the facility, you should receive this allowance.

/

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I am an RN working in a public hospital. I have accrued some annual leave. I would like to take some single annual leave days for family reasons, but my NUM refused to approve it, saying that annual leave has to be taken by weeks and not days.

Is this correct?

While the award does provide for the taking of single days, this is by agreement between the employer and the employee and can be dependant on service provision and the requirements of the employer. The Public Health System Nurses’ and Midwives’ (State) Award 2011 states in clause 30 “Annual Leave”: (vi) Annual leave shall be given and taken either in one consecutive period or two periods, or if the employer and employee so agree, in either two, three, or four separate periods but not otherwise. Provided that up to five single days per year may be taken at times convenient to both the employer and the employee.

What this means is, you are entitled to take your annual leave in two lots. However, if you do want to break it up into more than two lots, then this can only occur where the employer agrees.

Rather than using your annual leave you should consider applying for Family and Community Service (FACS) leave

days. FACS leave is an award provision under clause 32 and covers a variety of family and carer responsibilities that employees may have from time to time.

NSW Nurses’’ Association As

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When it comes to your rights and entitlements at work, NSWNA Assistant General Secretary JUDITH KIEJDA has the answers.

Signature

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The latest NSWNA mer merchandise chandise is not only stylish and comfortable, comfor table, it is affordable af fordable and sold at cost to members.

To order, order form for m to Glen Ginty, 1414 or post to: NSWNA, rs. To order, fax the order Ginty y, (02) 9662 9 50 O’Dea A Ave 2017. .nswnurses.asn.au ve v NSW N 2017. Merchandise Merchandise order order forms for ms available on our website www.nswnurses.asn.au www w..nswnur

* All membersh membership rship ship fees include GSTT + Trainee Trrainee eee AiN’ AAiN’ss have have their heir fees es waiv waived wa ed for or the period of their t traineeship.

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THE LAMP FEBRUARY 2012 | 39

NURSE UNCUT

INTERNATIONAL INTERNA ATTIONAL NUR NURSES’ SES’ DAY DA AY 2012 2012 | 12 MAY MA AY 2012

Nurses & Midwives Photographic Competition

‘Nurses & Midwives at Work’

Photographs can speak a thousand words, and what better way than this medium to show and express the interesting and varied work you do as a nurse, midwife or student of nursing or midwifer y? We’ll be celebrating International Nurses’ Day, 2012 with an exhibition of the best entries, celebrating the wonder ful work nurses and midwives do.

Our sponsor is First State Super which has provided the prizes – $2000 first prize and two $500 r chosen for exhibition on Intern again at the Association’s ociation’s Ann Annual Confer ted as the mo photograph is voted most popular will r We are looking for ward to rece n to the Asso get your entries in Association by 16 Mar

ion For more infor mat NA g rding the NSW rega ives Nurses and Midw hiic o ograph at Work Phot Competition see .asn.au www.nswnurses

Proudly Pr oudly sponsor sponsored ed by

Authorised by B. Holmes Holmes, s, General Secretary, Secretar y, NSWNA

Make sure you get your photograph to us by 16 Marchh!

What’s HOT on Nurse Uncut?

AiNs the big winners in new aged care agreements, NSWNA launches campaign to fight for public services, Men in Nursing forum hailed a success, and tips on how to grow your super savings. Read all the latest happenings at www.nurseuncut.com.au

Hot topics AiNs big winners in aged care agreements www.nurseuncut.com.au/ains-the-big-winners-from-aged-careagreements/ More than 90 employers, covering 176 facilities in the not-for-profit aged care sector, have signed up to a new template agreement that delivers an average 9.2% pay increase to nurses over three years. The three-year agreement includes a 3% pay increase in the first year (from 1 July 2011), 2.8% in the second year and 3% in its final year. Wage increases are even higher for AiNs, with their wages to be at least 3.5% above the Nurses’ Award minimum rate.

NSWNA will fight for public services www.nurseuncut.com.au/nswna-launches-campaign-to-fight-for-public-services/ The NSW Nurses’ Association has embarked on a campaign for a Financial Transactions Tax (FTT) to be introduced in Australia, with the money raised used on much-needed spending increases in programs such as health and aged care. Read the full story at Nurse Uncut.

More men in nursing www.nurseuncut.com.au/men-in-nursing-forum-hailed-a-success/ Around 29 men attended the Men in Nursing forum held late last year, hailing it a huge success. Among key points raised at the forum, which was attended by both students and registered nurses, was a desire to communicate more broadly to young men about the rewarding career that nursing can provide. There was also a call for the NSWNA to promote men in nursing through advertising, and to include an all day, Men in Nursing forum on their education calendar.

How to grow your super savings www.nurseuncut.com.au/how-to-grow-your-super-savings/ Your super is an investment in the future – your future. But the basic amount your employer contributes to your super on your behalf (known as Super Guarantee or SG contributions) may not be enough to support you in your retirement. Fortunately, you don’t have to rely solely on employer contributions. Read about your two other options at Nurse Uncut.

What nurses are talking about?

Help please – wanting to register in Canada www.nurseuncut.com.au/forum/component/option,com_ccboard/Itemid,24/forum,11/topic,6 98/view,postlist/#ccbp4162 “I am wondering if anyone has registered in Canada to work? If so, how complex is the registration?”

Night shift penalties ... what’s the status? www.nurseuncut.com.au/forum/component/option,com_ccboard/Itemid,24/forum,13/limitsta rt,20/topic,463/view,postlist/#ccbp4184 “Re: the night shift penalty case. The Commission directed the parties (Dept & NSWNA) to gather more specific information. This is now in process with a survey being recently being conducted with many nurses taking the time to answer questions regarding their night duty experiences while nursing. This research survey has resulted in follow-up forums now being held across the state. All information gathered will be collated for presenting to the Commission at a later date. It’s a slow process but we are lucky that this case will not fall into the current government dictate re: wage increases being no more than 2.5%.”

On the ‘I Support Nurses’ Facebook page: Will you leave the age care sector if the wages gap is not fixed? www.facebook.com/NurseUncutAustralia “I’m a carer in aged care, studying to be an RN. I love the work I do now, and the people I care for, but as soon as I graduate I won’t go into aged care because of the pay.”

The Quakers Hill Nursing Home Fire www.facebook.com/NurseUncutAustralia “There are many fantastic, caring and dedicated nurses working 24/7 to help our communities. One messed up person does not define us. We grieve for those lost and their families and those nurses who knew them and loved them. RIP.” “We cannot allow one registered nurse’s behaviour to represent/reflect the reputation and image of nursing.

Let us not focus too deeply on this. There is foul play evident among all healthcare professions.”

THE LAMP DECEMBER 2011 — JANUARY 2012 | 41

NURSING RESEARCH ONLINE

COMPETITIONS

Lucky NSWNA prize winners! $2000 cash Join on Line.

Older workers: research readings Francesca Beddie & Tabatha Griffin

The triumph of hope over experience Nigel Edwards

Reorganising and restructuring have been common activities in the British National Health Service (NHS) during the past 20 years and are on the agenda again with the coalition government.This 16-page electronic report by the NHS Confederation looks at the available evidence about the pattern of reorganisation, why there’s so much of it and why it often fails, and outlines important points to consider when reorganising services.The NHS Confederation is an independent membership body that represents all types of organisations providing and commissioning NHS services in England.

www.nhsconfed.org/Publications/reports/Pages/triumph-of-hope.aspx

One of the significant challenges facing Australia is the ageing of its population.This has led policy makers to consider how older workers can be kept in the workforce.To generate discussion on older workers, NCVER (the National Centre for Vocational Education Research) commissioned six researchers to draft essays on various issues around keeping older Australians engaged in the workforce. These essays, and responses by six additional discussants, were presented at a roundtable held in Canberra in May 2011. Themes to arise from the roundtable included the need to consider the diversity of older workers, the challenges of low literacy and numeracy skills for some older workers, discrimination and stereotypes, and the recognition that not all older workers want to keep working. NCVER an independent body responsible for collecting, managing, analysing, evaluating and communicating research and statistics about vocational education and training (VET).

www.ncver.edu.au/publications/2422.html

Direct Debit Union Shopper $2000 gift certificate.

"IG 3AVINGS FOR 5NION -EMBERS

Sponsored by First State Super Sophia Re’Bon from Wollongong Hospital had no idea she was in the running for a $2000 cash prize when she chose to join the Association using our Join on Line option. So she was surprised and delighted when we called her with the news!

We are running this promotion throughout 2012, so if you know of friends or colleagues who want to join the Association, but haven’t got around to it, let them know they can Join on Line and possibly win $2000. Have them put your name on the form as the recruiter and you could win prizes too. See details of the NSWNA Recruitment Incentive Scheme on our website www.nswnurses.asn.au

Sponsored by Union Shopper Grace Trapolini form Westmead Hospital was thrilled to find out she had won a $2000 Union Shopper gift certificate, just by switching her Association membership fees from pay roll deduction to direct debit.

We are urging all members on pay roll deductions to make the switch to direct debit, as members who stay on payroll deductions leave themselves vulnerable to becoming un-financial, should the state government suddenly remove the option of payroll deductions. Many members are making the switch, as they know how important it is to stay financial. Be prepared by making the switch today.

Grace is thinking about buying a new car so the $2000 Union Shopper gift certificate will certainly help her make a saving. She could also use it to buy a wide range of electrical goods such as a new coffee machine, fridge, dishwasher or air conditioning – the choices are endless!

Find out about our direct debit promotion by visiting our website www.nswnurses.asn.au

Women, health and ageing – findings from the Australian Longitudinal Study on Women’s Health Julie Byles, Annette Dobson, Nancy Pachana, Leigh Tooth, Deborah Loxton, Janneke Berecki, Richard Hockey, Deirdre McLaughlin and Jenny Powers.

The Australian Longitudinal Study on Women‘s Health (ALSWH), is a large longitudinal cohort study funded by the Department of Health and Ageing and conducted by a team of researchers and staff based at the Universities of Newcastle and Queensland.The ALSWH first collected data in 1996 from three cohorts of women then aged 18-23 45-50 and 70-75.

National disability insurance scheme: podcast Rhonda Galbally & Graeme Innes

The Federal Government recently announced that it would create a National Disability Insurance Scheme. But what will this scheme really mean for people with disability and their carers? To answer those and other questions, Dr Rhonda Galbally AO joined Disability and Race Discrimination Commissioner Graeme Innes in this installment of Pod Rights. Dr Galbally is chair of the National People with Disability and Carers Council, which prepared the Shut Out report that led to the reference to the Productivity Commission. She has personally lobbied hard for the scheme.

www.humanrights.gov.au/podcasts/2011/podcast_2011_16.mp3

42 | THE LAMP DECEMBER 2011 — JANUARY 2012

This report focuses on the findings into the health of older women.

Women live longer than men and as the population ages will comprise an increasingly larger proportion of the Australian population.

Older women who are married may become carers of increasing frail or ill husbands, and this may limit their capacity to look after their own health.When the women are widowed they suffer financial disadvantage and may face difficulty maintaining their homes and with transport. Nevertheless, provided they are in good health, they lead more active social lives than older men. Due to their longer life expectancy, older women make up a majority of the people with dementia, sensory impairment, falls and fractured femurs. They are more likely to need aged care services. Also, caring for older women impacts on the lives of middle-aged women, who often become their informal carers. Helping older women to remain healthy and live independently for as long as possible is an important long-term goal.

www.alswh.org.au/Reports/OtherReportsPDF/ALSWH_Major%20Report%20E_Final%5B1%5D.pdf THE LAMP FEBRUARY 2012 | 43

BOOKS

DON’T PUT YOUR NSWNA MEMBERSHIP AT RISK! The State Government could at any time stop payroll deductions.

As a matter of urgency please convert to the Direct Debit or Credit method of paying your fees.

BE PREPARED. CHANGE TODAY. Download, complete and return your Direct Debit form to the Association.

www.nswnurses.asn.au Alternatively call us on Metro 8595 1234 or Rural 1300 367 962 Authorised by B Holmes NSW Nurses’ Association.

44 | THE LAMP FEBRUARY 2012

BOOK ME SPECIAL INTEREST Understanding Pathophysiology Judy Craft, Christopher Gordon and Adriana Tiziani Elsevier/Mosby RRP $145.00 ISBN 9780729539517

Waltzing Matilda and the Sunshine Harvester Factory: the Early History of the Arbitration Court, the Australian Minimum Wage, Working Hours and Paid Leave.

Understanding Pathophysiology prioritises diseases relevant to nursing students and presents them according to prevalence and rate of incidence in Australia and New Zealand, with the aim of providing a balance between science, clinical case material and pharmacology. The book first explores each body system by structure and function, then by alteration. It incorporates a lifespan approach and explores contemporary health, with specific chapters on stress, genes and the environment, obesity and diabetes, cancer, mental illness and Indigenous health.

Hon. R. S. Hamilton Fair Work Australia RRP $20.00 ISBN 9780646548814

Mosby’s Guide to Physical Examination (7th ed.)

Henry M. Siedel, Jane W. Ball, Joyce E. Dains, John A. Flynn, Barry S. Solomon and Rosalyn W. Stewart Elsevier/Mosby RRP $128.00 ISBN 9780323055703

This is a textbook of physical examination, history-taking, and health assessment, with an emphasis on differential diagnosis and variations across the lifespan. The book conveys a patient-centered approach to physical examination with a strong evidencebased foundation.

Clinical Coach for Nurse Practitioners Rhonda Hensley and Angela Williams F. A. Davis (available through Elsevier Australia) RRP $48.00 ISBN 9780803621718

Written specifically for the nurse practitioner student, this text aims to assist the student in decision-making in the clinical setting. Experienced nurse practitioners coach the student as they analyse 30 of the most common patient complaints, ruling out each differential until they reach the correct diagnosis.

The book features charts, guidelines, screening tools, and tables, as well as practical advice on issues such as legal considerations, licensure, billing and coding.

Waltzing Matilda and the Sunshine Harvester Factory details why the Conciliation and Arbitration Court was established in 1904 and explains how it influenced social, economic and political life. The book “reminds us that our workplace conditions have been hard fought for, and we must never take them for granted.” Edited by Fair Work Australia Deputy President Reg Hamilton, many contributed to its production including professors Joe Isaac and Stuart Macintyre from the University of Melbourne; the Australian Council of Trade Unions; Australian Industry Group and Australian Chamber of Commerce and Industry.

Values-Based Health and Social Care: Beyond Evidence-Based Practice Edited by Jill McCarthy and Pat Rose Sage (available through Footprint Books) RRP $49.95 ISBN 9781848602021

Values-Based Health and Social Care: Beyond Evidence-Based Practice calls into question the dominance of evidence-based practice and sets out an alternative vision of care that places holism, professional judgment, intuition, and client choice at its centre. Bringing together writers from a range of health and social care backgrounds, the book describes the rise of evidence-based practice and explores major criticisms of the approach.

Student Workbook for Essentials of Anatomy and Physiology (6th ed.)

Valerie C. Scanlon and Tina Saunders F. A. Davis (available though Elsevier Australia) RRP $33.95 ISBN 9780803623248

The purpose of this book is to help students learn the material presented to them in a basic anatomy and physiology course. It can also act as a stand-alone study guide, guiding the student, chapter-by-chapter, in exercises and labelling activities that promote an understanding of the essentials of anatomy and physiology.

All books can be ordered through the publisher or your local bookshop. NSWNA members can borrow the books featured here, and many more, from our Records and Information Centre (RIC). Contact Jeannette Broomfield gensec@nswnurses.asn.au or Cathy Matias 8595 2121 cmatias@nswnurses.asn.au. Some book reviews are based on information received and have not been independently reviewed. Reviews by NSWNA RIC Coordinator Jeannette Broomfield.

Publisher websites Elsevier Australia ww.elsevierhealth.com.au/ Fair Work Australia www.fwa.gov.au F. A. Davis www.fadavis.com/ Footprint Books www.footprint.com.au/ Sage Publications www.uk.sagepub.com THE LAMP FEBRUARY 2012 | 45

MOVIES

MOVIE OF THE MONTH BUCK

NSWNA HR AD

This was a gem of a film. I rushed off to see it after a busy day of work and with absolutely no expectations. All I recalled, as I walked briskly down Market Street towards the cinema, were the words,‘horse whisperer’.Though I put these out of my mind as I navigated through the charging throng of people, in a busy peak-hour Sydney street, to find the screening room.

CINÉ FILES Buck is a documentary about Buck First time director Brannaman, the man who Cindy Meehl was a fashion inspired the film and book The designer and artist before Horse Whisperer and who, as we discover in this film, rose like a she attended a horse clinic phoenix from the ashes of a with Buck Brannaman and suggested making a wretchedly violent and grief documentary strewn childhood to become an about his life. understanding, compassionate and humble man. His gift with horses has led him to dramatically transform the lives not only of horses but, more amazingly, the people connected with those horses. Buck himself says: ‘Often, instead of helping people with horse problems. I’m helping horses with people problems.’ The documentary shows old footage of a very young Buck and his brother performing with their vindictive and controlling father. Buck’s mother died while the boys were still young, after which beatings by their father became even more brutal.The boys were finally rescued from further beatings when a teacher discovered thick welts and scarring on their backs. Buck found safe haven in a loving, supportive foster family, where he healed and flourished to grow into a handsome, gentle and respectful man.

The documentary includes interviews with Robert Redford, and footage of a very young Scarlett Johansson, that leave you in no doubt of the admiration and respect felt for this man who became a mixture of mentor, legend and folk hero.

This documentary is about far more than horses; its power lies with the principles Buck teaches and how they can become life altering.

There were moments of drama, laughter and even the urge to sob, but the film overwhelmingly left this viewer with a renewed feeling of hope and encouragement about life in general. It might also leave you wanting to go out and buy a horse. I’m looking forward to seeing it again.

Anni Cameron, RN, BHA, MEd, is Teacher of Nursing at St George Tafe

Only at the movies FEBRUARY 16

Be warned – you may feel the desire to saddle up after you see this documentary, writes ANNI CAMERON.

‘Often, instead of helping people with horse problems. I’m helping horses with people problems.’

Sydney Hospital & Sydney Eye Hospital is proud to introduce a 16 week

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MEMBERSGIVEAWAY The Lamp has 20 in-season double passes to giveaway to Buck, thanks to Madman Entertainment. The first 20 members to email their name, membership number, address and contact number to lamp@nswnurses.asn.au will win!

THE LAMP FEBRUARY 2012 | 47

NSW Health Nursing and Midwifery Scholarship Fund

2012 Postgraduate Scholarships NSW Health is offering the following nursing & midwifery postgraduate scholarships in 2012:

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These scholarships are available to full time or part time registered nurses or registered midwives employed and currently working in the NSW public health system (Further criteria applies).

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For further information and application forms visit www.health.nsw.gov.au/nursing/scholarships.asp

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• Are you a Registered, Endorsed, Enrolled or Assistant Nurse?

• Are you looking for a Quality driven organisation to work for?

• Would you like the flexibility of choosing where and when you work?

• Would you like to receive above award wages?

The Professional Nursing Agency is committed to providing the Canberra community and now the Riverina with High Quality Care and Professionally Qualified staff to meet the client’s needs 24 hours a day.

We are looking for Nurses at all levels in the Riverina with a similar commitment to the Health Industry to us to meet our clients requirements.

Please contact Eric on 0418 867440 or through our website www.professionalnursing.com.au

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ROYAL Easter Show

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Down 1. An animal parasite 2. In front of the elbow 3. The characteristic way an individual behaves 4. Third stage in the memory process 5. A protein encoded by the PRNP gene (5.7) 6. Helium 7. To separate, set apart from others 8. Inflammation of the prostate 9. Deprive of food 15. Inflammation of a valve 18. Hormone that stimulates the uterus to contract during childbirth 21. To translate a message, signal, or stimulus into code 22. Someone who is physiologically dependent on a substance 23. Mentally responsive 25. Together or joined 27. Nasopharyngeal airway (1.1.1) 28. And so forth THE LAMP FEBRUARY 2012 | 49

CONFERENCES, SEMINARS, MEETINGS SYDNEY, HUNTER & ILLAWARRA National Disability Services NSW 2012 Annual State Conference 13 -14 February 2012 Hilton Hotel, Sydney NSW Register online www.ors.net.au/NDS_ASC12.html Registrations close 8 February Miriam Sosin 9256 3133 or miriam.sosin@nds.org.au www.nds.org.au/events/1317882370

Education Forum for A.C.A.T Nurses 21 February 2012 Bankstown Hospital, Aged Care Day Hospital Allied Health Building Meeting Room Wendy Oliver 9722 7236 or wendy.oliver@sswahs.nsw.gov.au

Nepean Midwifery 21st Annual Conference 2 March 2012 Sebel Resort, Windsor murrayt@aimhigherevents.com.au

NSW Operating Theatre Association 2012 Annual Conference Perioperative Nurses Out in Front 8-10 March 2012 Grand Pavilion, Rosehill Gardens Racecourse Registrations close 17 February 9799 9835 or info@nsw-ota.asn.au

2nd Whole Person Care National Symposium 21-22 March 2012, Sydney 9368 1200 or wholepersoncare@iceaustralia.com www.iceaustralia.com/wholeperson12

CNC/NP Professional Day 2012 e Nursing – The Machine goes Ping 29 March 2012 Royal Prince Alfred Hospital, Missenden Rd, Camperdown Free – please reserve your place Jane Mawson (CNC) 9515 7630 or jane.mawson@sswahs.nsw.gov.au Lynn Hyde-Jones (NP) 9515 7278 or lynn.jones-hyde@sswahs.nsw.gov.au

Australasian College for Infection Prevention and Control (ACPIC)* National Conference 2012 8-11 October 2012 Sydney Exhibition and Conference Centre 8204 0770 or conferenceinfo@ashm.org.au *formally Australian Infection Control Association (AICA)

10% discount if you book online: www.mkupdate.co.uk

Canterbury Hospital 50-year reunion

The ECG Workshop

Graduate nurses from 1960s 6 February 2012 Kathy 9644 8520 or mealing.kathleen@gmail.com Roslyn 0400 273 300

Manchester 9-10 February 2012 Nottingham 1-2 March 2012 bookings@mkupdate.co.uk or 017687 73030 10% discount if you book online: www.mkupdate.co.uk

The Australian Pain Society 32nd ASM Integrated Perspective of Pain 1-4 April 2012 Melbourne Convention and Exhibition Centre www.dcconferences.com.au/aps2012

14th National Nurse Education Conference 2012 11-13 April 2012 Pan Pacific Hotel, Perth WA nnec@iceaustralia.com www.iceaustralia.com/nnec2012

Australia and New Zealand Urological Nurses Society & USANZ Annual Scientific Meeting 21-24 April 2012 Darwin Convention Centre, Darwin urological_nurses@hotmail.com or 9990 4148 www.anzuns.org

International Conference on Integrative Medicine Jerusalem 13-15 May 2012 +41 22 5330 948 or Skype +41 22 5330 948 rlevy@paragon-conventions.com www.mediconvention.com

13th International Mental Health Conference Positive Change: Investing in Mental Health 6-8 August 2012 Call for Abstracts Outrigger Inn (formerly Holiday Inn) Gold Coast, Qld www.anzmh.asn.au/conference

10th International Conference for Emergency Nurses New Frontiers in Emergency Nursing 10-13 October 2012 Hotel Grand Chancellor, Hobart TAS info@cdesign.com.au www.cdesign.com.au/cena2012

REUNIONS

REGIONAL INTERSTATE & OVERSEAS

Manly Girls High School 1967-1972 reunion

Discharge Planning Masterclass

3 March 2012 Lyn 07 3869 1936 or 0409 691 936 Jill 9938 1220 or 0413 709 424 mghs67to72@gmail.com

London 3 February 2012 Manchester 23 March 2012 bookings@mkupdate.co.uk or 017687 73030 10% discount if you book online: www.mkupdate.co.uk

Wound Care for Registered Nurses Edinburgh 20 February 2012 bookings@mkupdate.co.uk or 017687 73030 50 | THE LAMP FEBRUARY 2012

St Vincents Hospital Darlinghurst Jan-Mar 1972 40-year reunion 4 February 2012, from 11am Paddington RSL, Oxford St, Paddington NSW Jennifer Purcell 0418 944 320 or jennacell86@gmail.com

24 March 2012, Sydney Jan O’Dea (nee Parsons) 0402 800 046 or janodea@hotmail.com Jenny Smith (nee Sinclair-Harris) 0427 016 822 or jennifer.smith@det.nsw.edu.au

Sutherland Hospital 1973 reunion

RPAH 50-year reunion 8 February 2012 Still seeking RN graduates from the Royal Prince Alfred Hospital January 1962 PTS group barbdryland@hotmail.com or Rosemary at rabrab75@gmail.com

March 2012 Marianne Beuzeville marianne@upsidedowninsideout.com.au

RGHC 1972 Groups 103/104/105

28 April 2012, 5.30 pm Helm Bar, Darling Harbour Jane Howland 6580 1119 page 0050 or jane.howland@ncahs.health.nsw.gov.au

40-year reunion 11 February 2012 Venue TBA Marjorie Willard (nee Bruce) majiwillard@hotmail.com Judy Rafferty sheep55@bigpond.com

EDUCATION DATES For more information on NSWNA Education Courses contact Carolyn Kulling (02) 8595 1234 Free call 1300 367 962 or www.nswnurses.asn.au/topics/2761.html

NOTICES

Third bi-annual Gladesville Hospital reunion 26 February 2012 Warren 0428 727 384 or warrenjmartin@hotmail.com Colin 0425 258 709 or colc@live.com.au, Rob 0416 764 200

PAM Hospital Tenterfield 150 year celebration 3 March 2012, 6pm Tenterfield Golf Club Karen Holley 02 6739 5223 or Bradholleycontracting@hotmail.com

Tenterfield Hospital Fete

APNA Online Learning (APNA CPD endorsed) STI and Blood Borne Viruses This course aims to assist PHCNs to gain a better understanding of the management of STIs, HIV and viral hepatitis within general practice. Limited FREE enrolments available to primary health care nurses working in a general practice setting in NSW. Register via education@apna.asn.au or www.apna.asn.au/scripts/cgiip.exe/WServ ice=APNA/ccms.r?PageId=11513

4 March 2012 Karen Holley 02 6739 5223 or Bradholleycontracting@hotmail.com

A N T E C U B I T A L N O P A I

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NSWNA EVENTS

Grafton Base Hospital 40-year reunion

9th Tri-National (German Language) Psychiatric Nursing Conference Health promotion and health competency Vienna 4-5 October 2012 Call for abstracts (German language only) until 30 March 2012 info@oudconsultancy.nl

RPAH Jan 1969 reunion lunch

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*Awarded to Kia Rio Si model. #Vehicles advertised are demos, unless stated otherwise and available at time of printing. Offers ends 31st January 2012 or while stocks last. ^$500 free accessories valid with every new Nissan sold between 1st & 29th Feb, 2012. Offer not redeemable for cash. Voucher must be presented at time of purchase. Vehicles are available at time of printing. Cannot be used in conjunction with any other offer or promotion. Offers end 29.2.12. MD20305 YPA2837

NISSAN & KIA 02 8014 4487 | 37 Blacktown Road | Blacktown www.landernissan.com.au

www.landerkia.com.au

Part of Australia’s Largest Motoring Group

www.ahg.com.au

ONLY 4 MINS FROM PROSPECT HWY TURN OFF ON THE M4

First State Super the fund for all nurses We have a range of well-priced investments which are simple to understand.

First State Super has made super a whole lot easier for nurses If you work in either a public or private hospital (or perhaps both) you can use First State Super for all your super requirements. This could include your employer’s superannuation guarantee (SG) contributions if they provide choice of fund. You may need to complete a Standard Choice form – visit Publications & forms on our website for a copy.

And stay with us when you retire with a choice of two First State Super income streams.

More More information information Web:

www.firststatesuper.com.au w ww.firststatesuper.com.au

Phone: 1300 650 873 Email: enquiries@firststatesuper.com.au

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First State Super – take us with you wherever you work!